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HomeMy WebLinkAbout252236 1 2/08/1 5 >i ��`'� CITY OF CARMEL, INDIANA VENDOR: 359584 ® ONE CIVIC SQUARE BRENNTAG MID SOUTH INC CHECK AMOUNT: $""*"'793.00' �. r' CARMEL, INDIANA 46032 3796 RELIABLE PARKWAY CHECK NUMBER: 252236 oy,,oN,�, CHICAGO IL 60686 CHECK DATE: 12/08/15 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 651 5023990 BMS176980 793.00 OTHER EXPENSES BRENNTAG W 41% BRENNTAG MID-SOUTH, INC. 1405 HIGHWAY 136 WEST PO BOX 20 HENDERSON KY 42419-0020 INVOICE#: BMS176980 INV DATE : 9/04/15 *** PAGE 1 OF 1 *** DUE DATE : 10/04/15 SOLD TO: SHIP TO: CARMEL WASTE WATER HAZEL DELL 9609 HAZEL DELL PARKWAY 9609 HAZEL DELL INDIANAPOLIS IN 46280 CARMEL IN 46280 FEDERAL ID #: 610504545 DATE SHIPPED: 9/04/15 TERMS NET 30 DAYS B/L #. : 1159360-00 SHIP WHS : 29 SALESPRSN: 299 CUSTOMER # . : 407542 SHIP VIA: OUR TRUCK - PKG CUSTOMER PO#: 515421 FOB . . : DELIVERED FRGT COMMENT: PREPAID TAX EX# : 356000972-001-9 PRO NUMBER . : 531730018 UNITS SHIPPED PROD # WGT/GAL TOTAL QTY UNIT PRICE EXTENDED -------------------------------------------------------------------------------- 1 .0000 253418 11 .87000 2000 .0000# . 3790 758.00 2000 .0000 # CYL CHLORINE, LIQUID (BMS ONLY) >A RPK -------------------------------------------------------------------------------- QUESTIONS, CALL 317-898-8632 * REMIT TO ADDRESS : * BRENNTAG MID-SOUTH, INC * 3796 RELIABLE PARKWAY * CHICAGO IL 60686-0037 * MERCHANDISE 758.00 *************************************** INS & SEC SURCHARGE 35 .00 ----------------- PAID ON OR PRIOR TO 10/04/15 INVOICE TOTAL USD 793 .00 PAID AFTER 10/04/15 INVOICE TOTAL USD 808.86 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 (ULRICH) Purchase Order No. 3796 Reliable Parkway Terms CHICAGO, IL 60686 Due Date 12/3/2015 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) Amount 12/3/2015 BMS176980 $793.00 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 Date Officer VOUCHER # 156777 WARRANT # ALLOWED 359584 ,I IN SUM OF $ B R E N N TAG-(USI ) f"�C>i• �ti� �- 3796 Reliable Parkway CHICAGO, IL 60686 Carmel Wastewater Utility ON ACCOUNT OF APPROPRIATION FOR. Board members PO# INV# ACCT# AMOUNT Audit Trail Code BMS176980 01-7182-05 $793.00 Voucher Total $793.00 Cost distribution ledger classification if claim paid under vehicle highway fund