221471 07/02/2013 CITY OF CARMEL, INDIANA VENDOR: 361475 Page 1 of 1
ONE CIVIC SQUARE DAILY LABORATORIES
CARMEL, INDIANA 46032 CHECK AMOUNT: $125.00
2200 W ALTORFER SUITE 8
PEORIA IL 61615 CHECK NUMBER: 221471
CHECK DATE: 7/2/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 5759 125 . 00 CONT SVS-TESTING-S PL
Daily Laboratories
Division of Mobilab, Inc. I nvoice
2200 W. Altorfer Dr. Suite B Number:5759
Peoria, U61615
(309) 691-4513 Date.- June 13, 2013
Bill To: Ship To:
Tara Washington
City of Carmel WWTP
9609 Hazel Dell Pkwy
Indianapolis, IN 46280
Number-
Details
TARA 30 days 06/05/13
Date Quantity Description Price Each Amount
06/10 1 Suitability test on distilled water 125.00 125.00
(D -7 o
Total $125.001
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Prescribed by State Board of Accounts
Form No.301-S(Rev.1997) ACCOUNTS PAYABLE VOUCHER
TO
ADDRESS
Invoice Date Invoice Number Item Amount
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
Mo. Day Yr. Signature Title
I hereby certify that the attached invoice(s), or bill(s), is (are)tr e and correct and I have audited same in accordance
with IC 5-11-10-1.6.
Mo. Day Yr. V Officer Title
Voucher No. Warrant No.
ACCOUNTS PAYABLE DETAILED ACCOUNTS
MUNICIPAL WASTEWATER UTILITY ACCT.
NO.
CARMEL, INDIANA
Oct;ty LAs Favor Of
99m w, A l+, er Dr. So,-Ie
Peoc;C,, :17L (1((S
Total Amount of Voucher $
Deductions
b II OS 5 oa
Amount of Warrant $
Month of Yr
VOUCHER RECORD Acct.No.
Collection System
Pumping
Treatment&Disposal
Customer Accounts
Administrative&General
Reclaimed Water Treatment
Reclaimed Water Distribution
Total
Allowed
Board Members
Filed
BOYCE FORMS•SYSTEMS 1-800-382-8702 325