225835 11/05/2013 C ARMEL, INDIANA VENDOR: 118000 Page 1 of 1
ONE CI SQUARE HACH COMPANY
CARMEL, INDIANA 46032 2207 COLLECTIONS CENTER DRIVE CHECK AMOUNT: $201.07
4� CHICAGO IL 60693 CHECK NUMBER: 225835
CHECK DATE: 11/5/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
601 5023990 8536777 201 . 07 OTHER EXPENSES
INVOICE NO 8536777 DATE: 1 10/2272013
S I�"�1�11��' 'll��l'll��llll'II.IIIII��II��II'I'll��l"I'�I��III' PURCHASE JF102113A
o ORDER
L CARMEL UTILITIES NUMBER
D LOVEALL,KERRI Net 30 Days From Invoice Date
3450 W 131st St TERMS
T Carmel, IN 46074-8267
O United States FREIGHT Prepay And Bill Customer
CARRIER RPS-RPS*"FedEx--Ground
S
H CARMEL UTILITIES 1 ACCOUNT 1052653
1 FOREMAN,JAIMIE I REF. NO. 13128941 37-1 Remit to:
P 4915 E 106TH ST Hach Company
CARMEL,IN 46033 2207 Collections Center Dr
T United States Chicago,IL 60693
0 - Phone:(800)227-4224
These commodities are sold,packaged,marked,and labeled for destinations in the United States Exportation of these commodities may require special licensing,packaging,marking or labeling
LN# PRODUCT DESCRIPTION ITEM NO. QUANTITY UNIT PRIC EXT. PRICE
2 KTO: FERROVER IRON RGT PP PK/1000 2105728 1 184.00 184.00
ORDER CONTACT: SUBTOTAL 184.00
JAIMIE FOREMAN FREIGHT CHARGES 17.07
(317) 571-2639 TAX 0.00
Notes: INVOICE TOTAL 201.07
*ATTN:GREG HOLLANDER(DIST)
PURCHASE AND ACCEPTANCE OF PRODUCT(S)SUBJECT TO HACH COMPANY'S TERMS AND CONDITIONS OF SALE,
PUBLISHED ON HACH COMPANY'S WEBSITE AT WWW.HACH.COM/TERMS
For order discrepancies or product exchanges please call 800-227-4224 or 970-669-3050 to obtain Return Authorization.
FEDERAL TAX ID#42-0704420
Environmental /,Q a Other brands
®�.. Test Systems
„., a from Hach
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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
118000
HACH CHEMICAL CO. CORP Purchase Order No.
2207 Collections Center Dr. Terms
Chicago, IL 60693 Due Date 10/30/2013
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
10/30/201: 8536777 $201.07
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 Officer
VOUCHER # 133201 WARRANT # ALLOWED
118000 IN SUM OF $
HACH CHEMICAL CO. CORP
2207 Collections Center Dr.
Chicago, IL 60693
Carmel Water Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO# INV# ACCT# AMOUNT Audit Trail Code
8536777 01-6200-06 $201.07
Voucher Total $201.07
Cost distribution ledger classification if
claim paid under vehicle highway fund