227306 12/17/2013 CITY OF CARMEL, INDIANA VENDOR: 00352978 Page 1 of 1
ONE CIVIC SQUARE CHEMSEARCH CHECK AMOUNT: $173.03
CARMEL, INDIANA 46032 23261 NETWORK PLACE
CHICAGO IL 60673-1232 CHECK NUMBER: 227306
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CHECK DATE: 12/17/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
601 5023990 1323498 173 . 03 OTHER EXPENSES
�eaEw�es�.rzeea-m INVOICE Page: 1 of 1
CORRESPONDENCE TO
ORIGINAL COPY Remittance Address
PO BOX 152170 CHEMSEARCHFE
IRVINGTX75o15 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
Attn: ACCOUNTS PAYABLE We are going green!
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 27-NOV-13 10 NET 07-DEC-13 27-NOV-13 1402461
invoice No'. Purchase Order_'No "Sales�Re` No Sales Rep.Name
_ _., _ .,. .�._ .r._ . .. _. ._ �_,
1323498 DAN 112613 A USFEF001 DUNSCOMB.Mr.JAMES L
Product '.Qty'Ordeired7fz -'" '", x uescrippon i'^ " .. Yackagiug „"l1ty"F3died Unif Yrice "AFnount.:
12039404 I PENTRA-FOAM AEROSOL,DZ,NAC MM DZ 1.00 157.50 157.50
`Merchandise_ .` State Tax:. �' local Tax`s r Shipping Split-Inv.No. Currency" Total.AmounG
�, as» .,, ,,..
157.50 0.00 0.00 15.53 USD 173.03
IN Tax ID#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 RFCEIPT OF GOODS MRRCHANDISE NOT ACCEPTED FOR('R—'-L)!T WITHOUT OUR-PP1CR_WRITFEN GONISENT x
VOUCHER # 133576 WARRANT # ALLOWED
352978 IN SUM OF $
CHEMSEARCH
23261 NETWORK PLACE
CHICAGO, IL 60673-1232
Carmel Water Utility
ON ACCOUNT OF APPROPRIATION FOR
i
Board members
PO # INV# ACCT# AMOUNT Audit Trail Code
1323498 01-6200-03 $173.03
Voucher Total $173.03
Cost distribution ledger classification if
claim paid under vehicle highway fund
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 12/10/2013
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
12/10/201: 1323498 $173.03
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