HomeMy WebLinkAbout257922 04/26/16 / CITY OF CARMEL, INDIANA VENDOR: 368571
'l ONE CIVIC SQUARE HERITAGE-CRYSTAL CLEAN CHECK AMOUNT: $********50.00*
i' CARMEL, INDIANA 46032 13621 COLLECTIONS CENTER DRIVE CHECK NUMBER: 257922
9y�TON�. CHICAGO IL 60693-0136 CHECK DATE: 04/26/16
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 13964165 50.00 OTHER EXPENSES
Prescribed by State Board of Accounts City Form No.201 (Rev 1995)
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
j An invoice or bill to be properly itemized must show, kind of service, where
4 performed, dates of service rendered, by whom, rates per day, number of units,
price per unit, etc.
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Payee
368571
HERITAGE-CRYSTAL CLEAN, LLC Purchase Order No.
13621 COLLECTIONS CENTER DRIVE Terms
CHICAGO, IL 60693-0136 Due Date 4/19/2016 I
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Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
4/19/2016 13964165 $50.00
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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
Billing Inquiries: (877) 938-7948
Heritage-Crystal Clean, LLC custsery@crystal-clean.com
Page 1 of 1 Remit to-
Invoice 13621 COLLECTIONS C f'/Sta
Service Location: INDIANAPOLIS CENTER DRIVE C I sta
PO No.: CHICAGO, IL 60693-0136
hftn://www,crystal-clean.corr
Service Agreement: 756406 Invoice,No: 13954155.--
Release Info: .DateJssued? 03/24/2016.'
Acceu. t:No: =1;5391 3:,
Item�Total'._
I�I�tltll��lltr�� ILt�I�I��rII��ILrIl�ttt�ILl„II :Pre=paid Amount:.; '3$0:091
CARMEL UTILITIES HOUSEHOLD Current Charges: :$x0:00
ATTN: ACCOUNTS PAYABLE Previous Amount Due: $0.00
901 NORTH RANGELINE ROAD
CARMEL, IN 46032-1361 Total Due: $50.00
Subject to finance charges if payment not received by 04/27116
Svc Dt Work Order Product Description Comment Equip Qty Unit Price Tax Amt Total Cost
03/24/16 00-008E55Y TRIP FEE-USED OIL SERVICE 1 $50.00 $0.00 $50.00
Item Tota:: 'C'e0
This form(invoice)is deemed part of the above referenced Service Agreement between Heritage-Crystal Clean,LLC and the
Invoice Information and Ter
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 Clean equipment 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:
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