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251255 11/04/15 '1��r C�p�f CITY OF CARMEL, INDIANA VENDOR: 368696 it ONE CIVIC SQUARE SOLENIS LLC CHECK AMOUNT: $****23,816.00* ?� CARMEL, INDIANA 46032 PO BOX 116232 CHECK NUMBER: 251255 . '°:y«oN�` ATLANTA GA 30368-6232 CHECK DATE: 11/04/15 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 651 5023990 131003826 23,816.00 OTHER EXPENSES ��sme is INVOICE ORIGINAL Page 1(1) rj Invoice Number Invoice Date Due Date 0 131003826 21 Oct 2015 20 Nov 2015 �o 00 Solenis LLC P.O.Number Payment Terms Payer Number r t 3 Beaver Valley Road S15536 Net 30 Days 441113 c Suite 500 Wilmington DE 19803 Shipped From Sales Order Num Bill-To Number USA US GREENSBORO DOYLE ST PL PK 7307494 1441113 Remittance instructions below Bill of Lading Number Incoterms:DAP Dest Prepaid Ship-To Number 1000087139 1442287 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 Number USD 8 IBC 657240 PRAESTOL K 274 FLX IBC 1000L 1509532 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 Cc L.L Citibank NA Bank-ID:021052053 Bank-ID:021000089 Please refer to the invoice number on the remittance. Please return remittance advice with your payment. SOU-Pnis 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 22 Oct 2015 visit us at www.solenis.com VOUCHER # 156559 WARRANT # ALLOWED 358405 IN SUM OF $ SOLENIS PO BOX 116232 i Atlanta, GA 30368-6232 Carmel Wastewater Utility ON ACCOUNT OF APPROPRIATION FOR Board members PO# INV# ACCT AMOUNT Audit Trail Code 131003826 01-7182-05 $23,816.00 I I I j 1� f I 1 I I; Voucher Total $23,816.00 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 358405 SOLENIS Purchase Order No. PO BOX 116232 Terms Atlanta, GA 30368-6232 ; Due Date 10/29/2015 Invoice Invoice Description Date Number (or note attached i.nvoice(s) or bill(s)) Amount 10/29/201: 131003826 I $23,816.00 I t i i 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