241381 01/22/15 o.° "?y„ CITY OF CARMEL, INDIANA VENDOR: 358405
ONE CIVIC SQUARE SOLENIS CHECK AMOUNT: S""`23,816.00'
CARMEL, INDIANA 46032 PO BOX 116232 CHECK NUMBER: 241381
"oNc� ATLANTA GA 30368-6232 CHECK DATE: 01/22/15
a..
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 130936458 23,816.00 OTHER EXPENSES
l�soLef is INVOICE ORIGINAL
Page 1(1)
Invoice Number Invoice Date Due Date
0 130936458 12 Jan 2015 11 Feb 2015
00 11 11 1
Ln Solenis LLC P.O.Number Payment Terms Payer Number
tD
500 Hercules Rd IS14687 Net 30 Days 441113
rn Wilmington DE 19808
USA Shipped From Sales Order Num Bill-To Number
US GREENSBORO DOYLE ST PL PK 11 7194802 441113
Remittance instructions below
Bill of Lading Number Incoterms:DAP Dest Prepaid Ship-To Number
M1000030945 442287
Billing address Shipping address
CITY OF CARMEL CITY OF CARMEL
WATER-WASTEWATER UTILITIES WATER-WASTEWATER UTILITIES
9609 HAZEL DELL PKWY 9609 HAZEL DELL PKWY
INDIANAPOLIS IN 46280 INDIANAPOLIS IN 46280
Qty. UOM Material Number Material Description Batch Billing Oty UOM Unit Price Amount
11 11 Number USD
8 IBC 657240 PRAESTOL K 274 FLX IBC 1000L 1412551 18,320 LB 1.3000 23,816.00
Should you have any questions regarding this Invoice Total
invoice,please contact USD 23,816.00
NANCY SANDS
at 866-293-8897
Remit to ACH Credit Wire transfer
P.O.Box 116232 Solenis LLC Solenis LLC
ATLANTA GA 30368-6232 Account Number:71522253 Account Number:30960491
Clearing House-EPN(Electron Citibank NA
Bank-ID:021052053 Bank-ID:021000089
Please refer to the invoice number on the remittance.
Please return remittance advice with your payment. ��smen is
Comments:
Federal ID number 46-5612095 D-U-N-S number 07-943-6434
The terms and conditions of this sale are set forth at http://www.solenis.com/
Print date 13 Jan 2015
visit us at www.solenis.com
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
358405
SOLENIS Purchase Order No.
PO BOX 116232 Terms
Atlanta, GA 30368-6232 Due Date 1/15/2015
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
1/15/2015 130936458 $23,816.00
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
f�
Date Officer
VOUCHER # 146500 WARRANT # ALLOWED
i
358405 IN SUM OF $
SOLENIS
PO BOX 116232
Atlanta, GA 30368-6232
,
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO# INV# ACCT# AMOUNT Audit Trail Code
130936458 01-7182-05 $23,816.00
Voucher Total $23,816.00
Cost distribution ledger classification if
claim paid under vehicle highway fund