HomeMy WebLinkAbout249289 09/09/15 °�"qb
t CITY OF CARMEL, INDIANA VENDOR: 368571
® it ONE CIVIC SQUARE HERITAGE-CRYSTAL CLEAN CHECK AMOUNT: $ ...."15.00"
CARMEL, INDIANA 46032 13621 COLLECTIONS CENTER DRIVE CHECK NUMBER: 249289
+'�&p.i 2o,g CHICAGO IL 60693-0136 CHECK DATE: 09/09/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2201 4350900 13639050 15.00 OTHER CONT SERVICES
Billing Inquiries: (877) 938-7948
Heritage-Crystal Clean LLC custsery@crystal-clean.com
Invoice Page 1 of 1 Remit to:
13621 COLLECTIONS C rySta
Service Location: INDIANAPOLIS CENTER DRIVE C 1 ean®
PO No.: CHICAGO, IL 60693-0136 http://www.crystal-clean.com
Service Agreement: P128713 Invoice No: 13639050
Release Info: Date Issued: 08/26/2015
Account No: 238097
Item Total: $15.00
Itlrrllllrtllltlllrrltlrrlltltri Pre-paid Amount: $0.00
CARMEL STREET DEPT. Current Charges: $15.00
ATTN: ACCOUNTS PAYABLE
3400 WEST 131ST STREET Previous Amount Due: $0.00
CARMEL, IN 46074 Total Due: $15.00
Subject to finance charges if payment not received by 09125115
08/26/15 00-007RSGE TRUCK CHAR1 0
This form(invoice)is deemed part of the above referenced Service Agreement between Heritage-Crystal Clean,LLC and the Item I O a
identified customer and all terms and conditions and certifications contained therein are deemed a part hereof.
Service Location: Heritage-Crystal Clean location providing services listed.
PO No: Your organization's purchase order number. Call oremail for service ifmissing orincorrect.
Service Agreement: Heritage-Crystal Clean service contract identifier.
Release Info: Additional information provided for payment handling orprocessing.
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Date Issued: Date invoice was generated and sent tocustomer.
�
Item Total: Charges incurred ositemized onthe invoice.
Pre-Paid Amount: Payments given attime ufservice.
�
Current Charges: (Item total Pne'Paidamount>. Balance ofcharges and payments for items listed nninvoice.
Previous Amount Due: Previous charges for which payment has not been received.
Total Due: Total and previous charges for which payment has not been received.
Finance Charges: Refer to your service agreement/contract for information regarding application of finance charges.
SncO1: Service date. Date services listed were provided tnlocation.
|
Work Order: Service document number for services and products delivered.
� Equip: Heritage-Crystal Clean equipment asset identifier.
For questions regarding this invoice, account, or listed services, please contact the Heritage,Crysta,'Clean billing departmeo". �
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Additional information on products, services, and Heritage-Crystal Clean are available on our web site:
| ��2u04Printed mUSA httu»YVv««««'oryatn|-c|eon'corn FORM 20358 |
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))
08/26/15 13639050 $15.00
1 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
i
t
VOUCHER NO. WARRANT NO. '.
ALLOWED 20
Heritage-Crystal Clean
IN SUM OF $
13621 Collections Center Drive
Chicago, IL 60693-0136
$15.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO#/Dept. INVOICE NO. I ACCT#/TITLE I AMOUNT Board Members
2201 I 13639050 I 43-509.001 $15.00 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
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