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225780 11/05/2013 CITY OF CARMEL, INDIANA VENDOR: 358403 Page 1 of 1 o ` ONE CIVIC SQUARE CHARDON LABORATORIES INC CARMEL, INDIANA 46032 ACCTS RECEIVABLE CHECK AMOUNT: $1,750.00 •, ,0�.�0 7300 TOSSING ROAD CHECK NUMBER: 225780 REYNOLDSBURG OH 43068 CHECK DATE: 11/512013 DEPARTMENT ACCOUNT PO NUMBER, INVOICE NUMBER AMOUNT DESCRIPTION 1208 4350900 26741 I0102408 1, 750 . 00 LAB TEST OF WATER-ENE . .ALA I I2-A 9 - CHARDON LABORATORIES Corporate Service&Research Center Invoice No. 10102408 7300 Tussing Road Reynoldsburg,Ohio 43068 1.800.848.9526 Fax: 614.759.2558 Web: www.chardonlabs.com e • • • ACCOUNTS PAYABLE JOHN DUFFY CARMEL REDEVELOPMENT COMM CARMEL ENERGY CENTER 30 W MAIN STREET 777 THIRD AVENUE SW SUITE 220 CARMEL, IN 46032 CARMEL, IN 46032 To include the applicable chemicals&service outlined in Schedule 12 for Cooling Towers,Schedule 13 for Steam Boilers and/or Schedule 14 for Closed Systems. For detailed information on these schedules,please see you Master Service Agreement. NET 30 297709 10/16/2013 • . • • • . - ZFUEL Fuel Surcharge 0.00 1.00 0.00 ZSERVICE PowerPure/Tower/Loop service 1,750.00 1.00 1,750.00 ]DJ a NOV 4 2013 By- REMIT TO: CHARDON LABORATORIES, INC. ACCOUNTS RECEIVABLE Sales Total 1,750.00 7300 TUSSING ROAD Trade Discount 0.00 REYNOLDSBURG, OHIO 43068 Shipping&Handling 0.00 Misc.Charges 0.00 We hereby certify that goods used in conjunction with these services were produced in compliance with all applicable Tax Total 0.00 requirements of Sections 6,7 and 12 of the Fair Labor Standards Act,as amended and on regulation and orders of the 1,750.00 United States Department of Labor issued under Section 14,thereof. Afinance charge of 1.5%per month, 18%annum,will be added to overdue invoices. Less Paid Amount 0.00 • 1,750.00 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 service rendered, by whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc. Payee Purchase Order No. Terms Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) 10/16/13 10102408 Energy Center $1,750.00 1 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 20 Clerk-Treasurer VOUCHER NO. WARRANT NO. Chardon Laboratories ALLOWED 20 IN SUM OF $ 7300 Tussing Road Reynoldsburg, OH 43068 $1,750.00 ON ACCOUNT OF APPROPRIATION FOR Buildinq Operations Account PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members 26741 I 10102408 I -509.00 I $1,750.00 1 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 Monday, November 04, 2013 / Director, Adminstration Title Cost distribution ledger classification if claim paid motor vehicle highway fund