221704 07/02/2013 CITY OF CARMEL, INDIANA VENDOR: 00351367 Page 1 of 1
J'a_ Mfi
ONE CIVIC SQUARE SHERRY LABORATORIES INC CHECK AMOUNT: $1,400.00
?o CARMEL, INDIANA 46032 PO BOX 7047,GROUP F
INDIANAPOLIS IN 46207-7047 CHECK NUMBER: 221704
CHECK DATE: 7/212013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 431244 1, 400 . 00 OTHER EXPENSES
Sherry Laboratories Louisiana,LLC
H ER RY PO Box 7047,Group F INVOICE
Indianapolis,IN 4620 7-704 7 Invoice#: 431244
LABORATORIES TEL:(337)235-0483
Date: 6/14/2013
+nExmentrtatnrialsTtrhmlovrrmpr y Website:wiru,.sherrvlabs.com
REMIT TO: Sherry Laboratories Louisiana, LLC
Kevin Dischler
1'0 Box 7047,Group F Work Order: 13060005
Date Received. 6/1/2013
Indianapolis, IN 46207-7047
Phone: : Routine
TEL:(337)235-0483
Phone:
INVOICE TO: ATTN: ACCOUNTS PAYABLE Acct.Code: 0003515 Fax:
City of Carmel W WTI' Project: Final Effluent
Teresa Lewis PO: 513598
9609 Flazel Dell Parkway CaseNo:
Indianapolis, IN 46280- Submitted By: Carmel WWTP
Teresa Lewis
Item Description Matrix Remarks Qty Unit Price Total
FW 7-DAY CHRONIC (P.promelas) Waste Water 1 700.00 700.00
FW 7-DAY CHRONIC(C.dubia) Waste Water 1 700.00 700.00
Sub Total: $1,400.00
Misc.Charges: $0.00
Surcharge: 0.00%
INVOICE Total: $1,400.00
Pre-Paid Amount: $0.00
TERMS: Total Payable Amount: $1,400.00
All invoices are due and payable net 30 days from receipt.
Page 1 of 1
Prescribed by State Board of Accounts
Form No.301-S(Rev.1997) ACCOUNTS PAYABLE VOUCHER
TO
ADDRESS
Invoice Date Invoice Number Item Amount
,I
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)-true and correct and I have audited same in accordance
with IC 5-11-10-1.6. 1'/v
Mo. Day Yr. 6picer Title
Voucher No.--� b�Warrant No. --
ACCOUNTS PAYABLE DETAILED ACCOUNTS
MUNICIPAL WASTEWATER UTILITY ACC .
NOT
1 Lek 1 CARMEL, INDIANA
S (rq 6 Favor Of
PO bo-/ _1 047, Gry 0� F
'-,,,J9 4,
Total Amount of Voucher $
Deductions
I
3) yy
0I -7359 L coo 00
Amount of Warrant $
Month of Yr
VOUCHER RECORD Amt.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
1