239212 11/19/14 CITY OF CARMEL, INDIANA VENDOR: 359584
® I ONE CIVIC SQUARE BRENNTAG MID SOUTH INC CHECK AMOUNT: $*****3,856.50*
CARMEL, INDIANA 46032 3796 RELIABLE PARKWAY CHECK NUMBER: 239212
CHICAGO IL 60686 CHECK DATE: 11/19/14
t ETON�
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
601 5023990 873359 301.25 OTHER EXPENSES
601 5023990 873360 3,555.25 OTHER EXPENSES
BRENNTAG
BRENNTAG MID-SOUTH, INC.
1405 HIGHWAY 136 WEST
PO BOX 20
HENDERSON KY 42419-0020
INVOICE#: BMS873359 INV DATE: 10/30/14 * PAGE 1 OF 1
DUE DATE: 11/29/14
SOLD TO: SHIP TO:
CITY OF CARMEL UTILITIES CARMEL WATER, PLANT 3
3450 WEST 131ST STREET 4425 E. 126TH STREET
CARMEL IN 46074 CARMEL IN 46032
FEDERAL ID #: 610504545 DATE SHIPPED: 10/30/14 TERMS NET 30 DAYS
B/L #. . . . . 844560-00 SHIP WHS: 29 SALESPRSN: 299
CUSTOMER # . : 407542 SHIP VIA: OUR TRUCK - PKG
CUSTOMER PO#: VERBAL FOB . . : DELIVERED
TAX EX# : 35600972-001-9
UNITS SHIPPED PROD # WGT/GAL TOTAL QTY UNIT PRICE EXTENDED
-------------------------------------------------------------------------------
5.0000 873311 11 .87000 750.0000# .3550 266 .25
150.0000 # 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 266 .25
******** **** * * *** * ** * * *** * INS & SEC SURCHARGE 35.00
-----------------
PAID ON OR PRIOR TO 11/29/14 INVOICE TOTAL USD 301 .25
PAID AFTER 11/29/14 INVOICE TOTAL USD 307 .28
Original Document
BRENNTAG
BRENNTAG MID-SOUTH, INC.
1405 HIGHWAY 136 WEST
PO BOX 20
HENDERSON KY 42419-0020
INVOICE#: BMS873360 INV DATE: 10/30/14 ** PAGE 1 OF 2
DUE DATE: 11/29/14
SOLD TO: SHIP TO:
CITY OF CARMEL UTILITIES CARMEL WATER, PLANT 5
3450 WEST 131ST STREET 5484 E. 126TH STREET
CARMEL IN 46074 CARMEL IN 46032
FEDERAL ID #: 610504545 DATE SHIPPED: 10/30/14 TERMS NET 30 DAYS
B/L #. . 844581-00 SHIP WHS : 29 SALESPRSN: 299
CUSTOMER # . : 407542 SHIP VIA: OUR TRUCK - PKG
CUSTOMER PO#: VERBAL FOB . . : DELIVERED
TAX EX# : 356000,972-001-9
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
-----------------------------------------.--------------------------------------
40.0000 805002 1 .00000 2000.0000# 1 .3570 2,714.00
50.0000 # BAG SODIUM FLUORIDE GRAN
>A F/S
-------------------------------------------------------------------------------
5.0000 873311 11 .87000 750.0000# .3550 266.25
150.0000 # CYL CHLORINE, LIQUID (BMS ONLY) -
>A RPK
-------------------------------------------------------------------------------
Original Document
BRFNNTAG
BRENNTAG MID-SOUTH, INC.
1405 HIGHWAY 136 WEST
PO BOX 20
HENDERSON KY 42419-0020
INVOICE#: BMS873360 INV DATE: 10/30/14 * PAGE 2 OF 2 **
DUE DATE: 11/29/14
SOLD TO: SHIP TO:
Attach to Invoice# BMS873360 CARMEL WATER, PLANT 5
UNITS SHIPPED PROD # WGT/GAL TOTAL QTY UNIT PRICE EXTENDED
-------------------------------------------------------------------------------
* CONTINUED FROM PREVIOUS PAGE **
QUESTIONS, CALL 317-898-8632
* REMIT TO ADDRESS:
* BRENNTAG MID-SOUTH, INC
* 3796 RELIABLE PARKWAY
CHICAGO IL 60686-0037 MERCHANDISE 3,520.25
INS & SEC SURCHARGE 35.00
-----------------
PAID ON OR PRIOR TO 11/29/14 INVOICE TOTAL USD 3,555.25
PAID AFTER 11/29/14 INVOICE TOTAL USD 3,626. 36
Original Document
VOUCHER # 142251 WARRANT# ALLOWED
359584 IN SUM OF $
BRENNTAG MID-SOUTH INC
3796 RELIABLE PARKWAY
CHICAGO, IL 60686-0037
Carmel Water Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO# INV# ACCT# AMOUNT Audit Trail Code
873360 01-6180-03 $3,555.25
Voucher Total 3 $ a 5
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
359584
BRENNTAG MID-SOUTH INC Purchase Order No.
3796 RELIABLE PARKWAY Terms
CHICAGO, IL 60686-0037 Due Date 11/10/2014
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
11/10/201, 873360 $3,555.25
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
Date Officer