215047 12/04/2012 CITY OF CARMEL, INDIANA VENDOR: 00350569 Page 1 of 1
ONE CIVIC SQUARE HOOSIER MICROBIOLOGICAL LAB
CARMEL, INDIANA 46032 912 W MCGALLIARD CHECK AMOUNT: $120.00
MUNCIE IN 47303-1702 CHECK NUMBER: 215047
CHECK DATE: 12/4/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 20783 120 . 00 OTHER EXPENSES
HML, Inc Invoice
912 W. McGalliard Rd
Muncie, IN 47303 Date Invoice#
765-288-1124 11/19/2012 20783
Bill To
Carmel WWTP
Teresa Lewis
9609 Hazel Dell Parkway
Indianapolis, IN 46280
P.O. No. Terms Due Date
Net 30 12/19/2012
Quantity Description Rate Amount
1 Fecal Coliform (SM9221 E) 120.00 120.00
SA#263212
Total $120.00
DETACH AND RETURN LOWER PORTION WITH PAYMENT t '� I t0 , OS
VOUCHER # 126205 WARRANT # ALLOWED
00350569 IN SUM OF $
Hoosier Microbiological Laboratory
912 W.MCGALLIARD RD.
MUNCIE, IN 47303
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO# INV# ACCT# AMOUNT Audit Trail Code
20783 01-744.0-05 $120.00
Voucher Total $120.00
Cost distribution ledger classification if
claim paid under vehicle highway fund
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
00350569
Hoosier Microbiological Laboratory Purchase Order No.
912 W.MCGALLIARD RD. Terms
MUNCIE, IN 47303 Due Date 11/27/2012
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
11/27/201: 20783 $120.00
I hereby certify that the attached invoice(s), or bill(s) is (are) true and
correct and I have audited same in accordance with IC 5-11-10-1.6
i/43,//-Y -
Date Officer