217089 02/13/2013 CITY OF CARMEL, INDIANA VENDOR: 358403 Page 1 of 1
ONE CIVIC SQUARE CHARDON LABORATORIES INC
CARMEL, INDIANA 46032 ACCTS RECEIVABLE CHECK AMOUNT: $1,750.00
y,. 7300 TUSSING ROAD
CHECK NUMBER: 217089
REYNOLDSBURG OH 43068
CHECK DATE: 2/13/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1208 4350900 10090258 1, 750 . 00 OTHER CONT SERVICES
CHARDON LABORATORIES
Corporate Service&Research Center Invoice No. 10090258
7300 Tussing Road
Reynoldsburg,Ohio 43068
1.800.848.9526
Fax: 614.759.2558
Web: www.chardonlabs.com
• . •
ACCOUNTS PAYABLE JOHN DUEEY
CARMEL REDEVELOPMENT COMM CARMEL ENERGY CENTE�
30 W MAIN STREET 777 THIRD AVENUE SW
SUITE 220 CARMEL, IN 46032
CARMEL, IN 46032
To include the applicable chemicals&service outlined in Schedule 12 for Cooling Towers,Schedule 13 for Steam Boilers and/or Schedule 14 for Closed Systems. For detailed
information on these schedules,please s-ee you Master Service Agreement.
NET 30 297709 1/16/2013
ZSERVICE PowerPure/Tower/Loop service 1,750.00 1.00 1,750.00
ZFUEL Fuel Surcharge 0.00 1.00 0.00
REMIT TO: CHARDON LABORATORIES, INC.
Sales Total 1,750.00
ACCOUNTS RECEIVABLE
7300 TUSSING ROAD Trade Discount 0.00
REYNOLDSBURG, OHIO 43068 Shipping&Handling 0.00
Misc.Charges 0.00
We hereby certify that goods used in conjunction with these services were produced in compliance with all applicable Tax Total 0.00
requirements of Sections 6,7 and 12 of the Fair Labor Standards Act,as amended and on regulation and orders of the 1,750.00
United States Department of Labor issued under Section 14,thereof. Less Paid Amount 0.00
Afinance charge of 1.5%per month,18%annum,will be added to overdue invoices.
•]f--111 1,750.00
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 service rendered, by
whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc.
Payee
Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s)or bill(s))
01/16/13 10090258 Energy Center $1,750.00
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
20
Clerk-Treasurer
VOUCHER NO. WARRANT NO.
ALLOWED 20
Chardon Laboratories, Inc
Accounts Receivable IN SUM OF $
7300 Tussing Road
Reynoldsburg, OH 43068
$1,750.00
ON ACCOUNT OF APPROPRIATION FOR
Administration Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
-up
�D 10090258 $1,750.00
I hereby certify that the attached invoice(s), or
bill(s) is (are)true and correct and that the
materials or services itemized thereon for
which charge is made were ordered and
received except
Monday, February 11, 2013
Director, Administration
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund