HomeMy WebLinkAbout251010 11/04/15 is CSAyf .
CITY OF CARMEL, INDIANA VENDOR: 359584
ONE CIVIC SQUARE BRENNTAG MID SOUTH INC CHECK AMOUNT: $"'"13,756.40"
CARMEL, INDIANA 46032 3796 RELIABLE PARKWAY CHECK NUMBER: 251010
CHICAGO IL 60686 CHECK DATE: 11/04/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
601 5023990 210417 13,756.40 OTHER EXPENSES
BRENNTAG x
MAW
BRENNTAG MID-SOUTH, INC.
1405 HIGHWAY 136 WEST
PO BOX 20
HENDERSON KY 42419-0020
INVOICE#: BMS210417 INV DATE: 10/16/15 *** PAGE 1 OF 1 ***
DUE DATE: 11/15/15
SOLD TO: SHIP TO:
CARMEL WASTE WATER CARMEL UTILITIES PLT 1
9609 HAZEL DELL PARKWAY 4915 E 106 ST
INDIANAPOLIS IN 46280 CARMEL IN 46033
FEDERAL ID #: 610504545 DATE SHIPPED: 10/16/15 TERMS. NET 30 DAYS
B/L #. . 1197686-00 SHIP WHS : 29 SALESPRSN: 299
CUSTOMER # . : 407542 SHIP VIA: OUR TRUCK BULK
CUSTOMER PO#: VERBAL FOB . . : DELIVERED
FRGT COMMENT: PREPAID TAX EX# : 356000972-001-9
PRO NUMBER
UNITS SHIPPED PROD # WGT/GAL TOTAL QTY UNIT PRICE EXTENDED
--------------------------------------------------------------------------------
.41580 .0000 437426 10 . 28000 41580 .0000# . 3300 13, 721 .40
1 .0000 # BULK HYDROFLUOSILICIC ACID 23%
>A BLK
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QUESTIONS, CALL 317-898-8632
* REMIT TO ADDRESS:
* BRENNTAG MID-SOUTH, INC
* 3796 RELIABLE PARKWAY
* CHICAGO IL 60686-0037 * MERCHANDISE 13, 721 .40
INS & SEC SURCHARGE 35 . 00
-----------------
PAID ON OR PRIOR TO 11/15/15 INVOICE TOTAL USD 13, 756 .40
PAID AFTER 11/15/15 INVOICE TOTAL USD 14,031 . 53
Original Document
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 10/27/2015
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
10/27/201! 210417 $13,756.40
I hereby certify that the attached invoice(s), or bill(s) is (are) true and
correct and I have audited same in accordance
�with
pIC 5-11-10-1.6
Date Officer
VOUCHER # 153382 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
210417 01-6180-03 $13,756.40
Voucher Total $13,756.40
Cost distribution ledger classification if
claim paid under vehicle highway fund