214817 11/20/2012 CITY OF CARMEL, INDIANA VENDOR: 00351367 Page 1 of 1
ONE CIVIC SQUARE SHERRY LABORATORIES INC
CARMEL, INDIANA 46032 PO BOX 7048,GROUP 3 CHECK AMOUNT: $228.85
INDIANAPOLIS IN 46207-7048 CHECK NUMBER: 214817
CHECK DATE: 11/20/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 86680 228 . 85 OTHER EXPENSES
Sheri-v Laboratories Indiana,1J.0
®SHERRY Indianapolis,Box 7048,Group 3 INVOICE
1N 46207-7048
LABORATORIES 77:1:260-471.7000 Invoice Date: October 31, 2012
1'I1G Mn-."POT MI-C iOMOIigO'.\' IYebsite:www.Shern,labs clnn Print Date: October 31, 2012
Invoice No: 86680
Client PO:
Account Code: 80142
INVOICE TO: Client ID: CARAVEL 611147/1 REMIT TO:
Carmel WWTII Sherry Laboratories Indiana, LLC
,I'eresa Lewis Zach A. Bowman
9609 Hazel Dell Pkwy PO Box 7048,Group 3
Indianapolis, IN 46280-2935 Indianapolis, IN 46207-7048
TEL: T`E L:260-471-7000
WorkOrder Test Total Misc.Charge Total Discount Surcharge WorkOrder Total
12103035 $0.00 $0.00 0.1 0 $0.00
12100189 $244.00 $9.25 0.1 0 $228.85
Prepaid: $0.00 Please Pay this amount: $228.85
Sample Details: Analysis Remarks Price
WorkOrder: 12100189
Lab Sample ID: 12100189-001
Date Received: 10/2/2012 AMMONIA as N in SLUDGE $12.72
Client Sample ID: Sludge Produced Sept'12 METALS IN SOLID BY ICP,3051A Prep $16.54
Matrix: Sludge Metals in Solids by ICP-MS,3051A Prep $172.04
SDG: Microwave Digestion for Metals $7.09
Project Name: Sludge NITRATE IN SLUDGE $10.60
PERCENT MOISTURE $5.09
Solids,Total $5.09
TOTAL KJELDAHL NITROGEN IN SOLIDS $14.84
Miscellaneous Charge Summary Test TOTAL: $244.00
Item Unit Qty 'total Discount: 10.0%
Return_Shipping_FW $925 1 $9.25 Surehar e: 0.0%
Miscellaneous Charges:1 $9.25
Total Workorder Amount: $228.85
Pre aid: $0.00
BalanceDue: $228.85
Comments:
TERMS:
All invoices are due and payable net 30 days from receipt.
C
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Prescribed by State Board of Accounts City Form No.201 (Rev 1995)
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice or bill to be properly itemized must show, kind of service, where
performed, dates of service rendered, by whom, rates per day, number of units,
price per unit, etc.
Payee
351367
SHERRY LABORATORIES INC. Purchase Order No.
P.O. BOX 1385 Terms
INDIANAPOLIS, IN 46206-1385 Due Date 11/9/2012
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
11/9/2012 86680 $228.85
hereby certify that the attached invoice(s), or bill(s) is (are) true and
:orrect and I have audited same in accordance with IC 5-11-10-1.6
>i//L//L
Date Officer
VOUCHER # 126088 WARRANT # ALLOWED
351367 IN SUM OF $
SHERRY LABORATORIES INC.
P.O. BOX 1385
INDIANAPOLIS, IN 46206-1385
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO# INV# ACCT# AMOUNT Audit Trail Code
86680 01-7352-05 $228.85
Voucher Total $228.85
Cost distribution ledger classification if
claim paid under vehicle highway fund