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HomeMy WebLinkAbout235066 07/22/14 i or_c�q� �/ �� CITY OF CARMEL, INDIANA VENDOR: 359584 �`® 1 ONE CIVIC SQUARE BRENNTAG MID SOUTH INC CHECK AMOUNT: $"""*"""575.00• f? ;_�, CARMEL, INDIANA 46032 3796 RELIABLE PARKWAY CHECK NUMBER: 235066 v,�,_ CHICAGO IL 60686 CHECK DATE: 07/22/14 4rod�' DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 651 5023990 BMS765007 575.00 OTHER EXPENSES BRENNTA:G AME: BRENNTAG MID-SOUTH, INC. 1405 HIGHWAY 136 WEST PO BOX 20 HENDERSON KY 42419-0020 INVOICE#: BMS765007 INV DATE: 6/20/14 * * PAGE 1 OF 1 *** DUE DATE: 7/20/14 SOLD TO: SHIP TO: CITY OF CARMEL UTILITIES HAZEL DELL 3450 WEST 131ST STREET 9609 HAZEL DELL CARMEL IN 46074 CARMEL IN 46280 FEDERAL ID #: 610504545 DATE SHIPPED: 6/20/14 TERMS NET 30 DAYS B/L #. • • . 708819-00 SHIP WHS: 29 SALESPRSN: 299 CUSTOMER # . : 407542 SHIP VIA: OUR TRUCK - PKG CUSTOMER PO#: S14074 FOB . . : DELIVERED TAX EX# : 356000972-001-9 UNITS SHIPPED PROD # WGT/GAL TOTAL QTY UNIT PRICE EXTENDED -------------------------------------------------------------------------------- 1 .0000 253418 11 .87000 2000.0000# .2700 540.00 2000.0000 # CYL CHLORINE, LIQUID (BMS ONLY) >A RPK -------------------------------------------------------------------------------- QUESTIONS, CALL 317-898-8632 * REMIT TO ADDRESS: * BRENNTAG MID-SOUTH, INC * 3796 RELIABLE PARKWAY * CHICAGO IL 60686-0037 * MERCHANDISE 540.00 *************************************** INS & SEC SURCHARGE 35.00 ----------------- PAID ON OR PRIOR TO 7/20/14 INVOICE TOTAL USD (=-575-00> PAID AFTER 7/20/14 INVOICE TOTAL USD 586.50 Original Document .1FiF VOUCHER # 145118 WARRANT# ALLOWED 359584 IN SUM OF $ BRENNTAG (ULRICH) 3796 Reliable Parkway CHICAGO, IL 60686 Carmel Wastewater Utility ON ACCOUNT OF APPROPRIATION FOR Board members PO# INV# ACCT# AMOUNT Audit Trail Code BMS765007 01-7182-05 $575.00 'i 5 l Voucher Total $575.00 Cost distribution ledger classification if claim paid under vehicle highway fund fA �Isly 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 359584 BRENNTAG (ULRICH) Purchase Order No. 3796 Reliable Parkway Terms CHICAGO, IL 60686 Due Date 7/16/2014 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) Amount 7/16/2014 BMS765007 $575.00 I 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 -7 e4l Date Officer