249032 08/26/15 r G.19 .
�' `� CITY OF CARMEL, INDIANA VENDOR: 368696
j; ® i'. ONE CIVIC SQUARE SOLENIS LLC CHECK AMOUNT: $****23,816.00*
f. r� CARMEL, INDIANA 46032 PO BOX 116232 CHECK NUMBER: 249032
9���ON�` ATLANTA GA 30368-6232 CHECK DATE: 08/26/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 130987318 23,816.00 OTHER EXPENSES
'®s encs INVOICE ORIGINAL
1 1 Page 1(1)
Invoice Number Invoice Date Due Date
0 130987318 13 Aug 2015 12 Sep 2015
00
_M Solenis LLC P.O.Number P
ayment Terms Payer Number
r 3 Beaver Valley Road 515362 441113
00 11 1
Suite 500
rn
Wilmington DE 19803 Shipped From Sales Order Num Bill-To Number
USA US GREENSBORO DOYLE ST PL PK 7280404 441113
Remittance instructions below Bill of Lading Number IncoterMS:DAP Dest Prepaid Ship-To Number
1000073668 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 Qty UoM Unit Price Amount
11 Number USD
8 IBC 657240 PRAESTOL K 274 FLX IBC 1000L 1507527 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 Payments Assoct Citibank NA
Bank-ID:021052053 Bank-ID:021000089
Please refer to the invoice number on the remittance.
Please return remittance advice with your payment. Ot SQLR1/�1i5
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 15 Aug 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
n' ,4h . 'r?V. ilUnlber O` UnIiS,
price per unit, etc.
Payee
358405
SOLENIS Purchase Order No.
PO BOX 116232 Terms
Atlanta, GA 30368-6232 Due Date 8/17/2015
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
8/17/2015 130987318 $23,816.00
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
VDUCH�� � 1��1�1 VVA�R�NT � � ALLDVVED _
|� SUK� {lFS
�584O5
8OLEN|S
FOBOX 11O232
Carmel Wastewater Utility .
|
{}NACCOUNT OFAPPROPRIATION FOR
Board members
PD# |NV# ACCT# AMOUNT Audit Trail Code
130987318 01'7182-05 $23.e10M `
�
/
Voucher Total 823.818.80
Cost distribution ledger classification if '
claim paid under vehicle highway fund ,
�