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Home My WebLink About259039 05/31/16 {°�`�A+, CITY OF CARMEL, INDIANA VENDOR: 368571 j; a• ONE CIVIC SQUARE HERITAGE CRYSTAL CLEAN, LLC CHECK AMOUNT: $*******132.50* 9 ,?�; CARMEL, INDIANA 46032 13621 COLLECTIONS CENTER DRIVE CHECK NUMBER: 259039 MiTON�. CHICAGO IL 60693-0136 CHECK DATE: 05/31/16 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 651 5023990 14033866 82.50 OTHER EXPENSES 601 5023990 14037209 50.00 OTHER EXPENSES VOUCHER # 161557 WARRANT # ALLOWED 368571 IN SUM OF $ HERITAGE CRYSTAL CLEAN, LLC 13621 COLLECTIONS CENTER DRIVE CHICAGO, IL 60693-0136 Carmel Water Utility ON ACCOUNT OF APPROPRIATION FOR Board members PO# INV# ACCT# AMOUNT Audit Trail Code 14037209 01-6360-06 $50.00 Voucher Total $50.00 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 368571 HERITAGE CRYSTAL CLEAN, LLC Purchase Order No. 13621 COLLECTIONS CENTER DRIVE Terms CHICAGO, IL 60693-0136 Due Date 5/16/2016 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) Amount 5/16/2016 14037209 $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 Heritage-Crystal Clean LLC Billing Inquiries: (877) 938-7948 � custsery@crystal-clean.com C Invoice Page 1 of 1 Remit to: C Sta 13621 COLLECTIONS Service Location: INDIANAPOLIS CENTER DRIVE C I ean® PO No.: CHICAGO, IL 60693-0136 http:/Nmw.crystal-clean.com Service Agreement: P137190 Invoice No: 14037209 Release Info: SA#P137190 Date Issued: 05/06/2016 Account No: 323299 Item Total: $50.00 IIttltllllttlttltltlltltl Pre-paid Amount: $0.00 CARMEL UTILITIES Current Charges: $50.00 ATTN: ACCOUNTS PAYABLE 3450 W 131 ST ST Previous Amount Due: $0.00 CARMEL, IN 46074 Total Due: $50.00 Subject to finance charges if payment not received by 06/05/16 Svc Dt Work Order Product Description Comment Equip Qty Unit Price Tax Amt Total Cost 05/6/16 00-008KW9Y TRUCK CHARGE-USED OIL SERVICE 1 $50.00 $0.0c $50.012-- 6V" Vv Item Total: ., $50.00 This form(invoice)is deemed part of the above referenced Service Agreement between Heritage-Crystal Clean,LLC and the Invoice Infigmatign and Ter !S Service Location: Heritage-Crystal Clean location providing services listed. PO filo: 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. Cb Additional information on products, services, and Heritage-Crystal Clean are available on our web site: _ httn•//unwnu r_rusta1-r_1Pnn r_nm S/A#: P1 371,90 } CORPORATE OFFICES C YS`a I 2175 Point Blvd.,Suite 375 Elgin,IL 60123 C I man® (877)938-7948 FED.TAX I.D.#35-2083150 Oil Collection VISA,MASTERCARD AND AMEX ACCEPTED Service Agreement Information for current Heritage-Crystal Clean, LLC(herein"HCC")Customers Only: HCC Customer#: Original Service Agreement#: Placement: :/7-7 "'' Service Request#: HCC Generator#: Emp. ID# Service: �.. Emp. ID# Make oil check payable to: (Company Name or Individual's Name) Send check to: Used Oil Paid (Street Address or PO BOX) By Credit Card (City) (State) (Zip) Check if Yes This Agreement is made this �- ' day of ,�-: , 20 ;` by and between HCC and: GENERATOR • •N/SHIPPER SEND INVOICE TO Name:(`� ,� fits t/p�/r Name: Address: r ;J ,f S �-� Address: / City: .r ,J;r State: f11 Zip: � r/�/ fi City: State: Zip: Telephone#:�I ! j c �-Contact: J� �� y'// l-Te"lephone#: Fax#: V State EPA ID#: Fed EPA ID#: FEIN#: E-mail: PLEASE SEE ADDITIONAL TERMS,CONDITIONS,AND CERTIFICATIONS ON THE REVERSE SIDE HEREOF AND/OR PROVIDED HEREWITH WHICH ARE PART OF THIS AGREEMENT. / Authorized Customer Representative Signature HCC Representative Signature . • � W-197,TIMM Product Code Qty Product Description Svc Int Unit Price 1)--?) 10�d/,1_ 2 ;: 4) Jr 5) DESTINATION: Per Phone Number: LIT- HCC/Carrier Dated f CARRIER: HERITAGE-CRYSTAL CLEAN, LLC EPAID#:ILR 000 130 062 PHONE NUMBER:(877)938-7948 Chlor-D-TectBill of Lading Results Proper Shipping /Name_ AT �✓/' Total Units EUnder 1000-Pass ✓` %�`� >..`^l��f f ,�s� � C%',! �� i`' Over 1000-Failed TOTALS COMMENTS Products $ Sales Tax $ TOTAL $ 5-0 . ✓o Pmnt Made/Rec'd $ VISA _AMEX _MasterCard Exp.Date / Check(Ck# ) _Cash On Acct This Svc Only Card Holder Name: Card#: P.O.#: m+ Every Svc THIS IS NOT AN INVOICE ©2011 REV 5/13 CUSTOMER FORM NO.2011-010 1. Customer grants HCC,its employees and agents reasonable access to Customer's premises to perform the services under this Agreement and to perform such on site and other testing as,it may deem appropriate;provided that HCC shall,however,have no responsibility for testing any materials and/or product and shall have the option of returning any materials or products,which in the sole discretion of HCC do not conform.to the teras and conditionsand certifications in this Agreement.:HCC shall have the right,in its sole discretion,to resell,manage,treat,handle and/or dispose of any materials or products it takes possession of. 2. Customer agrees to indemnify,and defend HCC,including its directors,officers,employees,contractors,and agents,from and against all claims,demands,actions,lawsuits,penalties,fines,damages, losses,expenses and other liabilities'of whatever nature,including clean-up,investigation,and monitoring costs,indirect,incidental,special,and consequential damages and lost profits(and reasonable attorney's and consultants'fees)arisingout of or caused by(a)Customer's violation or alleged violation of any environmental law relating to the protection of human health or the environment(includ- ing air,water,soil and natural resources)or the use,storage,handling,release or disposal of any hazardous substances(as defined at 42 U.S.C.§d601(14)),including without limitation,RCRA,42 U.S.C.§§6901 et seg,Superfund,42 U.S.C.§§9601 et seg.,and their state counterparts;(b)Customer's breach of any certification or other term of this Agreement;(c)Customer's negligent acts or omissions;or(d)the commingling of a third party's materials with Customer's materials which are in breach of this Agreement.Without limitation,this indemnity shall include and HCC shall bill Customer for all emergency and other remedial services performed by HCC or its contractors,the rates for which are provided at HCC's website www.crystal-clean.com/cleaning_ratesheet,subject to its terms. Customer acknowledges that an indemnity claim hereunder will cause HCC to incur administrative and operational costs not contemplated by this Agreement,the exact amount of which will be extremely difficult to ascertain.Accordingly,an additional ten percent(10%)of third party charges and inventory loss shall be paid by Customer and such additional charges represent a fair and reasonable estimate of the actual cost that HCC will incur by reason of the indemnity claim. Notwithstanding this indemnity,HCC reserves the right to pursue any and all additional remedies available under federal,state and local laws relating to HC Cs services rendered on behalf of Customer hereunder. 3. IN NO EVENT SHALL HCC BE RESPONSIBLE TO THE CUSTOMER FOR ANY INDIRECT, INCIDENTAL, SPECIAL OR CONSEQUENTIAL DAMAGES (INCLUDING WITHOUT LIMITATION LOST PROFITS) EVEN IF A PARTY HERETO HAS BEEN PREVIOUSLY'ADVISED OF THE POSSIBILITY OF SUCH DAMAGES. 4. Any work order is deemed part of this Service Agreement.None of the covenants,terms or conditions of this Agreement,to be kept and performed by either party,shall in any manner be altered, waived,modified,changed or abandoned,except by written instrument duty signed and delivered by the other party.If any term or provision of this Agreement shall to any extent be held invalid ' or unenforceable,then such provisions shall be deemed modified to the extent and in the manner necessary to render it valid and enforceable,or if the provision cannot be so modified,it shall. be deemed stricken from this Agreement and the remaining terms and provisions of this Agreement shall not be affected thereby.Each term and provision of this Agreement shall be valid and be enforced to the fullest extent permitted by law.The party signing this Agreement on behalf of the Customer is duly authorized.This Agreement constitutes the valid and legal obligation of the Customer,enforceable in accordance with its terms and does not violate any other agreement,oral or written,of the Customer.Customer represents and warrants that it is and will remain in full compliance with all requirements of applicable laws,regulations and orders relating to the waste materials specified herein.Customer has not been advised or encouraged by HCC to breach or fail to fulfill any of its contracts or obligations. 5. HCC shall provide the services described in the reverse side herein,subject to the other terms and conditions hereof.The term of this Agreement shall be for a period of one(1)year from the date hereof,which period shall be automatically extended for periods of one(1)year from the date of each service hereunder;subject to(a)written notice of termination by Customer which would be effective as of the end of the then current one(1)year period or(b)termination by HCC at any time in the event of Customer's breach of this Agreement.Unit price is subject to change by HCC at the time of each service,in its sole discretion,based on crude oil market pricing. 6. Customer hereby certifies that(a)the material tendered to HCC shall meet the definition of`used oil"as defined at 40 CFR 279.1,and shall meet the"used oil specifications'defined at 40 CFR 279.11, and(b)the material tendered to HCC as used oil shall not have been mixed with any materials regulated under the Toxic Substances Control Act(TSCA),including but not limited to polychlorinated biphenyls(PCBs).HCC reserves the right to account for bottoms,sediment,and water when determining quality and quantity of used oil collected,which determination shall govern said issues. 7. In the event Customer receives a good faith(written)offer for used oil collection services from a third party(`Third Party Offer")and as a result thereof wishes to terminate this Agreement in accordance with its terms,Customer shall notify HCC of the Third Party Offer and its terms("Notice")and HCC shall have 60 days from receipt of the Notice to match the terms of the Third Party Offer,in which case this Agreement shall remain in full force and effect and HCC shall continue to provide services hereunder in accordance with the Third Party Offer. VOUCHER # 165349 WARRANT# ALLOWED 368571 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 14033866 01-736H-08 $82.50 ✓�-- Voucher Total $82.50 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 368571 HERITAGE-CRYSTAL CLEAN, LLC Purchase Order No. 13621 COLLECTIONS CENTER DRIVE Terms CHICAGO, IL 60693-0136 Due Date 5/16/2016 Invoice' Invoice Description Date Number (or note attached invoice(s) or bill(s)) Amount 5/16/2016 14033866 $82.50 hereby certify that the attached invoice(s), or bill(s) is (are) true and ;orrect and I have audited same in accordance with IC 5-11-10-1.6 Date Officer Billing Inquiries: ry877) 938-7948 Heritage-Crystal Clean, LLC custseservUec stat-clean.com � Invoice Page 1 of 1 Remit to: C i"ySta 1 13621 COLLECTIONS Service Location: INDIANAPOLIS ' CENTER DRIVE C I ean® PO No.: CHICAGO, IL 60693-0136 http://www.crystal-clean.com Service Agreement: 756406 Invoice No: 14033866 Release Info: Date Issued: 05/10/2016 Account No: 153913 Item Total: $82.50 IIIIlllllllrlllllllllll Pre-paid Amount: $0.00 CARMEL UTILITIES HOUSEHOLD Current Charges: $82.50 ATTN: ACCOUNTS PAYABLE 30 W MAIN Previous Amount Due: $50.00 CARMEL, IN 46032-1361 Total Due: $132.50 Subject to finance charges if payment not received by 06/09/16 Svc Dt Work Order Product Description Comment Equip oty Unit Price Tax Amt Total Cost 05/10/1 00-008KV6Y USED ANTIFREEZE 16 $0.50 $0.00 $82.50- I Item Total: $82.5 This form(invoice)is deemed part of the above referenced Service Agreement between Heritage-Crystal Clean,LLC and the Invoice Inf rmati n and 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 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: h*f"-/AM11AfXA/ 1-nM