221926 07/17/2013 CITY OF CARMEL, INDIANA VENDOR: 00352978 Page 1 of 1
ONE CIVIC SQUARE CHEMSEARCH
CARMEL, INDIANA 46032 23261 NETWORK PLACE CHECK AMOUNT: $682.25
CHICAGO IL 60673-1232
„p„ o CHECK NUMBER: 221926
CHECK DATE: 7/17/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
601 5023990 1146106 682 . 25 OTHER EXPENSES
INVOICE Page: 1 of 1
CORRESPONDENCE TO
ORIGINAL COPY Remittance Address
PO BOX 152170 CHEMSEARCHFE
IRVING TX 75015 REORDERS CALL #1-800-527-9921 23261 NETWORK PLACE
FAX #1-972-438-0634 CHICAGO,IL 60673-1232
W W W.CHEMSEARCHFE.COM
Sold To ' Ship To We are going green!
Attn: ACCOUNTS PAYABLE
CITY OF CARMEL To pay electronically or
CITY OF CARMEL UTILITIES / OPERATIONS
UTILITIES FOREMAN receive invoices via
3450 W 131ST ST 4915 E 106TH ST
WESTFIELD IN 46074 CARMEL IN 46033 emailorfax-
simply contact us at
cac.credit @nch.com
Customer No. Billing Date. Terms Due Date Ship Date Sales Order
441468 20-JUN-13 10 NET 30-JUN-13 20-JUN-13 1205772
! Invoice No. Purchase Order No. Sales Rep:No: Sale§'Rep:Name
1]46106 DAN 061813 A USFEF001 DUNSCOMB.Mr.JAMES L
—Product---� -Qty Ordered :r-- -- -------- - Description. Packaging Qty Billed- Unit Price'. -- mount"!
12039394 1 DRI-LUBE PLUS AEROSOL.DZ_,NAC MM DZ 1.00 210.00 210.00
12032729 1 MEND-CON RTU.DZ,US MM DZ 1.00 372.00 372.00
12030698 1 MEND-CON RTU/EZ-FILL RTU DISPENSING GUN EA 1.00 34.64 34.64
12032731 1 MEND-CON RTU NOZZLES DZ 1.00 20.36 20.36
12030698 1 MEND-CON RTU/EZ-FILL RTU DISPENSING GUN EA 1.00 0.00 0.00
/ Merchandise State Tax Local Tax **Shipping Split Inv.No. I Currency;,, -Total Amount
637.00 0.00 0.00 1 45.25 USE) 682,25
IN Tax 1D#0003512371-001-3 Federal ID#75-0457200
CHEMSEARCH FE.DIVSION OF NCH CORPORATION.ALL RETURNS CLAIMS FOR ERRORS.OR ADJUSTMENTS OF ANY KIND MUST BE MADE
WITHIN 15 DAYS AFTER RECEIPT OF GOODS.MERCHANDISE NOT ACCEPTED FOR CREDIT WITHOUT OUR PRIOR WRI17EN CONSENT. -
DISTRIBUTION SERVICES INCLUDE SHIPPING&HANDLING CHARGES—F.O.B.INDIANAPOLIF
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
352978
CHEMSEARCH Purchase Order No.
23261 NETWORK PLACE Terms
CHICAGO, IL 60673-1232 Due Date 7/8/2013
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
7/8/2013 1146106 $682.25
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
•710/3 -c�A"`
Date Officer
i
VOUCHER # 132031 WARRANT # ALLOWED
352978 IN SUM OF $
CHEMSEARCH
23261 NETWORK PLACE
CHICAGO, IL 60673-1232
Carmel Water Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO# INV# ACCT# AMOUNT Audit Trail Code
1146106 01-6200-04 $682.25
Voucher Total $682.25
Cost distribution ledger classification if
claim paid under vehicle highway fund