220684 06/04/2013 CITY OF CARMEL, INDIANA VENDOR: 358238 Page 1 of 1
ONE CIVIC SQUARE LABCHEM INC
CARMEL, INDIANA 46032 200 WILLIAM PITT WAY CHECK AMOUNT: $458.55
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PITTSBURGH PA 15238 CHECK NUMBER: 220684
CHECK DATE: 6/4/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 828723 458 . 55 OTHER EXPENSES
INVOICE
EahChem Invoice ID :828723
_— Sales Order ID :835696
performance through chemistry Invoice Date : 5/16/2013
Jackson's Pointe Commerce Park-Building 1000 Ship Date : 5/16/2013 8:20:00 AM
1010 Jackson's Pointe Court,Zelienople,PA 16063 Customer PO ID S13579
Ph:412-826-52301 Fax:724-473-0647 1 www.labcheni.coni
Page Number I of I
AR Terms: Due Date: Amount Due:
Net 30 Days 6/15/2013 $458.55
Bill To: 1265 Ship To:
CARMEL WWTP CARMEL WWTP
ATTN: ACCOUNTS PAYABL 9609 HAZEL DELL PKWY
760 3RD AVE SOUTHWEST INDIANAPOLIS, IN 46280-2935
SUITE 110 USA
CARMEL,IN 46032
USA
Order Date: 5/15/2013 12:28:49 PM FOB: Pittsburgh,PA
Packing Slip: 430248 Currency Type: USD
Ship Method: FedEx Ground Service
Line Nbr Item ID/Item Name Unit of Shipped Unit Price Sales Tax Extra Extended
Cust Item ID Measure Qtv Charges Price
1 LC226002/SILVER NITRATE,0.0141N(0.0141M) EA 8.0000 $36.2000 $0.0000 $289.60
B/O Qty: 0.0000
Lot Number Expiration Date Lot Trans Otv
C074-17 09/20/2014 8
Line Item Total: $289.60
2 LC 148451/GLUCOSE-GLUTAMIC ACID EA 4.0000 $33.0000 $0.0000 $132.00
B/O Qty: 0.0000
Lot Number Expiration Date Lot Trans Otv
C085-20 04/10/2015 4
Line Item Total: $132.00
Subtotal: $421.60
Sales Tax: 50.00
Tracking Numbers: Shipping Charges: $36.95
015396465381559,015396465381573,015396465381566 Total: $458.55
Form#34.02 06/19/2012 See"www.labehem.com"for C of A and MSDS information All Products Made In USA
VOUCHER # 135641 WARRANT # ALLOWED
358238 IN SUM OF $
LABCHEM INC
200 WILLIAM PITT WAY
PITTSBURGH, PA 15238
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO# INV# ACCT# AMOUNT Audit Trail Code
828723 01-7202-05 $458.55
I
Voucher Total $458.55
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
358238
LABCHEM INC Purchase Order No.
200 WILLIAM PITT WAY Terms
PITTSBURGH, PA 15238 Due Date 5/29/2013
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
5/29/2013 828723 $458.55
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
Date il O cer