HomeMy WebLinkAbout236158 08/19/14 4+.u�.CggMF
v ,,. CITY OF CARMEL, INDIANA VENDOR: 368571
j; ONE CIVIC SQUARE HERITAGE-CRYSTAL CLEAN CHECK AMOUNT: $*******786.25*
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CARMEL, INDIANA 46032 13621 COLLECTIONS CENTER DRIVE CHECK NUMBER: 236158
9+r,�roN- CHICAGO IL 60693-0136 CHECK DATE: 08/19/14
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2201 4350900 12991890 786.25 OTHER CONT SERVICES
01
Service Location
Heritage-Crystal Clean InvoiceN Number
INDIANAPOLIS
http://www.crystal-clean.com 12991890
PO No.
Invoice Invoice Date
Release No.
SA#713008 Please remit payment to: 06/06/2014
13621 COLLECTIONS CENTER DRIVE Customer Id
Service Agreement CHICAGO, IL 60693-0136
P128713 Phone:(877)938-7948 238097
Customer Generator
CARMEL STREET DEPT. CARMEL STREET DEPT.
3400 WEST 131ST STREET 3400 WEST 131ST STREET
CARMEL, IN 46074 CARMEL, IN 46074
Contact Name: ACCOUNTS PAYABLE Phone Nbr: (317)733-2001
Svc Dt Work Order Product Description Eauip qty Unit Price Tax Amt Total Cost
6/6/14 00-006GVTY VAC LIQUID PICKUP 425 $1.15 $0.00 $488.75
6/6/14 00-006GVTY VAC SOLIDS PICKUP 10 $3.15 $0.00 $31.50
6/6/14 00-006GVTY VAC TRUCK STOP FEE(3 HR) 1 $230.00 $0.00 $230.00
6/6/14 00-006GVTY FUEL SURCHARGE-VAC 1 $36.00 $0.00 $36.00
Grand Total: $786.25
Paid Amount: $0.00
Invoice Total: $786.25
PAYMENT DUE UPON RECEIPT
Subject to finance charges if payment not
received by 07/06/14
Now accepting Mastercard,Visa,and American Express
This form(invoice)is deemed part of the above referenced Service Agreement between Heritage-Crystal Clean,LLC and the
Page 1 of 1 identified customer and all terms and conditions and certification contained therein are deemed a part hereof
VOUCHER NO. WARRANT NO.
ALLOWED 20
Heritage-Crystal Clean
IN SUM OF$
13621 Collections Center Drive
Chicago, IL 60693-0136
$786.25
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
2201 12991890 43-509.00 $786.25 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
FriWA 5, 2014
8treE6&WV8W9Wioner
Title
Cost distribution ledger classification if
claim paid motor 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 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))
06/06/14 12991890 $786.25
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
, 20 �
Clerk-Treasurer