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Home My WebLink About253085 01/11/16 CITY OF CARMEL, INDIANA VENDOR: 368571 ONE CIVIC SQUARE HERITAGE-CRYSTAL CLEAN CHECK AMOUNT: $***"*"*85.00* CARMEL, INDIANA 46032 13621 COLLECTIONS CENTER DRIVE CHECK NUMBER: 253085 CHICAGO IL 60693-0136 CHECK DATE: 01/11/16 ETON� DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 651 5023990 13812393 50.00 OTHER EXPENSES 2201 4232100 238097 35.00 GARAGE & MOTOR SUPPIE 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 Date Invoice# Description Amount Dept. Fund# (or note attached invoice(s) or bill(s)) 12/28/15 0 $35.00 2201 201 I hereby certify that the attached invoice(s),or bill(s), is(are)true and correct and I have audited same in accordance with IC 5-11-10-1.6 20 Clerk-Treasurer VOUCHER NO. WARRANT NO. HERITAGE-CRYSTAL CLEAN ALLOWED 20 13621 COLLECTIONS CENTER DRIVE IN SUM OF$ CHICAGO, IL 60693-0136 $35.00 ON ACCOUNT OF APPROPRIATION FOR PO#/Dept. INVOICE NO. ACCT#/Fund AMOUNT Board Member I 0 I 42-321.00 I $35.00 1 hereby certify that the attached invoice(s), or 2201 201 Prior Year 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 A , r 17 ITh a rsd , Dece b�r 3 , f . stmel Cost distribution ledger classification if claim paid motor vehicle highway fund S6`6 0 l� Billing Inquiries: ry877 ) 938-7948 Heritage-Crystal Clean, LLC custseseryG�c stat-clean.com C Invoice Page 1 of 1 Remit to: C Sta 1 13621 COLLECTIONS Service Location: INDIANAPOLIS CENTER DRIVE C 1 ean® PO No.: CHICAGO, IL 60693-0136 httpJ/wm.crystal-clean.com Service Agreement: P102474 Invoice No: 13812393 Release Info: PO#515650 Date Issued: 12/07/2015 Account No: 222055 Item Total: $50.00 Itlttltllttttltllttltlltttlltttl Pre-paid Amount: $0.00 CITY OF CARMEL Current Charges: $50.00 ATTN: ACCOUNTS PAYABLE 9609 HAZEL DELL PKWY Previous Amount Due: $0.00 INDIANAPOLIS, IN 46280 Total Due: $50.00 Subject to finance charges If payment not received by 01/06/16 Svc Dt Work Order Product Description Comment Equip Qty Unit Price Tax Amt Total Cost M= 12/7/15 00-007LLT2 96G TOTER USED OIL FILTER PICK-UP This form(invoice)is deemed part of the above referenced Service Agreement between Heritage-Crystal Clean,LLC and the Item Total: Invoice lnfor atjj end Terms Service Location: Heritage-Crystal Clean location providing services listed. PO No: Your organization's purchase order number. Call or email for service if missing or incorrect. Service Agreement: Heritage-Crystal Clean service contract identifier. Release Info: Additional information provided for payment handling or processing. Date Issued: Date invoice was generated and sent to customer. Item Total: Charges incurred as itemized on the invoice. Pre-Paid Amount: Payments given at time of service. Current Charges: (Item total - Pre-Paid amount). Balance of charges and payments for items listed on invoice. 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. Svc Dt: Service date. .Date services listed were provided to location. Work Order: Service document number for services and products delivered. Equip: Heritage-Crystal Cleanequipment asset identifier. For questions regarding this invoice, account, or listed services, please contact the Heritage-Crystal Clean billing_department. Additional information on products, services, and Heritage-Crystal Clean are available on our web site: _.11� httn://www.crvstal-clean.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 performed, dates of service rendered, by whom, rates per day, number of units, price per unit, etc. Payee 368571 HERITAGE-CRYSTAL CLEAN, LLC Purchase Order No. 13621 COLLECTIONS CENTER DRIVE Terms CHICAGO, IL 60693-0136 Due Date 12/18/2015 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) Amount 12/18/201; 13812393 $50.00 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 # 156892 WARRANT # I ALLOWED 368571 i IN SUM OF $ HERITAGE-CRYSTAL CLEAN, LLC 13621 COLLECTIONS CENTER DRIVE CHICAGO, IL 60693-0136 Carmel Wastewater Utility ON ACCOUNT OF APPROPRIATION FOR Board members PO# INV# ACCT# AMOUNT Audit Trail Code 13812393 01-7502-06 $50.00 ,I r I I, s Voucher Total $50.00 Cost distribution ledger classification if claim paid under vehicle highway fund