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219914 05/07/2013 CITY OF CARMEL, INDIANA VENDOR: 00353237 Page 1 of 1 ' � ONE CIVIC SQUARE TESTAMERICA INC CHECK AMOUNT: $119.70 CARMEL, INDIANA 46032 PO BOX 122314 DEPT 2314 DALLAS TX 75312-2314 CHECK NUMBER: 219914 CHECK DATE: 517/2013 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 651 5023990 24142078 119 . 70 OTHER EXPENSES TestAmerica THE LEADER IN ENVIROU'LlIFNTAI,TESTING Invoice/Credit No. 24142078 Invoice Date April 24,2013 Terms See Below Federal Tax ID 23-2919996 Remit to TestAmerica Laboratories,Inc.PO BOX 204290,Dallas,TX 75320-4290 Bill to: Ship to: Carmel WWTP Carmel WWTP Attn:Accounts Payable 9609 Hazel Dell Pkwy 9609 Hazel Dell Pkwy Indianapolis,IN 46280 Indianapolis,IN 46280 P.O.Number W.O.Number Contract Number Work Ordered by Purchase Order not required Teresa Lewis Job Description Site Name SDG Number Invoice Contact See below Lisa Kempa Job No. Job Description Receipt Date Quantity Unit Price Amount Method/Test Description J22982-1 Carmel 04/10/2013 335.4- Cyanide,Total 1.00 30.00 30.00 200.7 Rev 4.4-Total Recoverable Cadmium 1.00 12.00 12.00 200.7 Rev 4.4-Total Recoverable Chromium 1.00 12.00 12.00 200.7 Rev 4.4-Total Recoverable Copper 1.00 12.00 12.00 200.7 Rev 4.4-Total Recoverable Lead 1.00 12.00 12.00 200.7 Rev 4.4-Total Recoverable Nickel 1.00 12.00 12.00 200.7 Rev 4.4-Total Recoverable Silver 1.00 12.00 12.00 200.7 Rev 4.4-Total Recoverable Zinc 1.00 12.00 12.00 Environmental Management Fee 1.00 5.70 5.70 Project Number Client Number Project Manager Subtotal $119.70 24009460 1406871 Josh McKinney Latest Sample Receipt Date Latest Report Date Phone Number Total $119.70 0411012013 04/24/2013 (330)497-9396 For proper credit,please include invoice number on all remittance TestAmerica Canton-4101 Shuffel Street NW,North Canton,OH 44720 This invoice falls under TestAmerica Laboratories Inc Standard T&C's of Net 30 Days unless superseded by another valid contract vehicle in Page 1 of 1 place at the time these services were rendered. VOUCHER # 135413 WARRANT # ALLOWED 00353237 IN SUM OF $ TESTAMERICA INC PO BOX 99742 Chicago, IL 60690 Carmel Wastewater Utility ON ACCOUNT OF APPROPRIATION FOR Board members PO# INV# ACCT# AMOUNT Audit Trail Code 24142078 01-7352-05 $119.70 I Voucher Total $119.70 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 00353237 TESTAMERICA INC Purchase Order No. PO BOX 99742 Terms Chicago, IL 60690 Due Date 4/30/2013 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) Amount 4/30/2013 24142078 $119.70 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 t_ Date Officer