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300922 07/25/16
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CITY OF CARMEL, INDIANA VENDOR: 359584 ® ONE CIVIC SQUARE BRENNTAG MID SOUTH INC CHECK AMOUNT: $*****1,892.00* '9� ,?� CARMEL, INDIANA 46032 3796 RELIABLE PARKWAY CHECK NUMBER: 300922 y�iTON moo, CHICAGO IL 60686 CHECK DATE: 07/25/16 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 601 5023990 BMS409651 228.50 OTHER EXPENSES 601 5023990 BMS409652 928.50 OTHER EXPENSES 601 5023990 BMS410787 735.00 OTHER EXPENSES VOUCHER # 162048 WARRANT# ALLOWED 359584 IN SUM OF $ BRENNTAG MID-SOUTH INC 3796 RELIABLE PARKWAY CHICAGO, IL 60686-0037 Carmel Water Utility ON ACCOUNT OF APPROPRIATION FOR Board members PO# INV# ACCT# AMOUNT Audit Trail Code 409651 01-6180-03 228.50 //, Voucher Total fS7 Cost distribution ledger classification if claim paid under vehicle highway fund BREN TAG BRENNTAG MID-SOUTH, INC. 1405 HIGHWAY 136 WEST PO BOX 20 HENDERSON KY 42419-0020 [NVOICE#: BMS409652 INV DATE: 7/07/16 ** PAGE 1 OF 1 DUE DATE: 8/06/16 SOLD TO: SHIP TO: CARMEL WATER CARMEL WATER, PLANT 5 3450 WEST 131ST STREET 5484 E. 126TH STREET CARMEL IN 46074 CARMEL IN 46032 FEDERAL ID #: 610504545 DATE SHIPPED: 7/07/16 TERMS NET 30 DAYS 3/L #. . . : 1453968-00 SHIP WHS : 29 SALESPRSN: 299 :USTOMER # 407542 SHIP VIA: OUR TRUCK - PKG .USTOMER PO#: VERBAL FOB . . : DELIVERED :RGT COMMENT: PREPAID TAX EX# : 356000972-001-9 ?RO NUMBER . : 645834458 JNITS SHIPPED PROD # WGT/GAL TOTAL QTY UNIT PRICE EXTENDED ------------------------------------------------------------------------------- 1 . 0000 253418 11 .87000 2000 . 0000# .3500 700 .00 2000 .0000 ## CYL CHLORINE, LIQUID (BMS ONLY) >A RPK ------------------------------------------------------------------------------- 3 . 0000 873311 11 .87000 450 . 0000# .4300 193 . 50 150 .0000 # CYL CHLORINE, LIQUID (BMS ONLY) >A RPK ------------------------------------------------------------------------------- JESTIONS, CALL 317-898-8632 F� F F�9e9e� Fk�eFk9eFk Y9eFF9e�:Fk9e9e�F9F�9r9Fk� FF9ekk REMIT TO ADDRESS: BRENNTAG MID-SOUTH, INC 3796 RELIABLE PARKWAY CHICAGO IL 60686-0037 * MERCHANDISE 893 .50 INS & SEC SURCHARGE 35 .00 ----------------- _ PAID ON OR PRIOR TO 8/06/16 INVOICE TOTAL USD 928 . 50 PAID AFTER 8/06/16 INVOICE TOTAL USD 947 .07 Original Document BRENNTAG BRENNTAG MID-SOUTH, INC. 1405 HIGHWAY 136 WEST PO BOX 20 HENDERSON KY 42419-0020 [NVOICE#: BMS409651 INV DATE: 7/07/16 * PAGE 1 OF 1 DUE DATE: 8/06/16 SOLD TO: SHIP TO: CARMEL WATER CARMEL WATER, -PLANT 3 3450 WEST 131ST STREET 4425 E. 126TH STREET - CARMEL IN 46074 CARMEL IN 46032 FEDERAL ID #: 610504545 DATE SHIPPED: 7/07/16 TERMS NET 30 DAYS 3/L #. . . . : 1453972-00 SHIP WHS : 29 SALESPRSN: 299 'USTOMER # . : 407542 SHIP VIA: OUR TRUCK - PKG :USTOMER PO#: VERBAL FOB : .DELIVERED ?RGT COMMENT: PREPAID TAX EX# : 35600972-001-9 ?RO NUMBER . : 645834490 JNITS SHIPPED PROD # WGT/GAL TOTAL QTY UNIT PRICE EXTENDED ------------------------------------------------------------------------------- 3 .0000 873311 11 .87000 450 .0000# .4300 193 .50 150 . 0000 # CYL CHLORINE, LIQUID (BMS ONLY) >A RPK -------------------------------------------.------------------------------------ JESTIONS, CALL 317-898-8632 REMIT TO ADDRESS: BRENNTAG MID-SOUTH, INC 3796 RELIABLE PARKWAY CHICAGO IL 60686-0037 MERCHANDISE 193 .50 INS & SEC SURCHARGE 35 .00 ----------------- PAID ON OR PRIOR TO 8/06/16 INVOICE TOTAL USD 228.50 PAID AFTER 8/06/16 INVOICE TOTAL USD 233 .07 Original Document LadiM11-Sh .roment Receipt * * BRENNTAG MID-SOUTH PHONE: 317-898-8632 3111 N POST RD FAX m * REPF� DEA REG NO. 00660IBNV � ` r INDIANAPOLIS, IN 46226 ^ Ship CARMEL WATER, PLANT 3 Sold CARMEL WATER To: 4425 E. 126TH STREET To: 3450 WEST 131ST STREET- CARMEL, IN 46032 �-'\ CARMEL, IN 46074 RE Phone: 317--847-8834 C# "Ext: Phone: 317-571--2443 . Ext: Tet QUANTITY SHIPPED PACKAGING HM DESCRIPTION IF LEAK OR SPILL OCCURS DURING TRANSPORTATION: CCN3170 EMERGENCY CONTACT: CALL CHEMTREC , _.- 24 HOURS / 7 DAYS RQ !UN10179 CHLORINE,. 'RQ,MARINE POLLUTANT 'POISON--INHALATION HAZARD ZONE B t !ERG #: 124 v `CHLORINE 3.0000 150,0000 LB CYL ICHLORINE, LIQUID (BMS ONLY) >A RPK ILoc: A2R2A `Qty: 94.0000 ;Product picked from: �- Lot: 2 Loc: A2R2A Qty: Freight Class.. . . 200 _____________ __�_�_.„___..________ "Weigh�t�Per�Gallon: 11.87000 Net Weight: 450.000 -� ______.._______ CVL :i aTotal Nei Wei F I ' s is to certify that the above named m , n aateria —are properly classffied,described,packaged,marked,and labeled,and are in proper u tion for transportatio ��o din'glt the applica le regulations of the Department of Transportation. tare of Shippe ,, �, ��r Loaded By: " MASER'S ACLEPTANCE OF THE GOODS COVERED BY THIS DOCUMENT SHALL CONSTITUTE ACCEPTANCE Vehicle: ""," PURCHASER OF ALL TE%NtS AND CONDITIONS OF SALE STATED ON THE REVERSE SIDE HEREOF. miles: OVER,PURCHASER,HEnIMN ACKNOWLEDGES RECEIPT OF ALL REQUIRED SDS(S). "'""'"""""""" """"•••»...," ,,,,",. ! Wood Pal1e•ts Dl Vd Eby; Date: Plastic Pallets CUSTOMER COPY 1 I I' L�dir�g/Shi m�E�t ��e�;e:�t 8 �$ , -:'' . ' PHONE: 17-898-8632 BREW !A�a MTB-SOUTH �** REP} 3111 N POST RD FAX: , DEA .REG NO. 006601BNY INDIANAPOLIS, IN 46226 Shap CARMEL WATER, PLANT 5 Sold CARMEL WATER To: 5484 E. 126TH STREET To: 3450 WEST. 131ST STREET CARMEL, IN 46.032 CARMEL, IN 46074 Phone: 31.7-571.2634 Ext: Phone: 317-571-2443 Ext: T ` QUANTITY PACKAGING HM DESCRIPTION j SHIPPED IF _LFIRK OR SPILL OCCURS DURING TRANSPORTATION: CCN3170 EMERGENCY CONTACT: CALL CHEMTRE } E 24 HOURS / 7 DAYS' RQ �UN1.017_, 'CHLORINE, RQ,MARINE -POLLUTANT 'POISON-INHALATION HAZARD, ZONE B } ERG #: 12.4 (CHLORINE 1.0000: 2000.0000 LB CYL E 'CHLORINE, LIQUID DBMS ONLY) :Loa: OSE04 OSE05 >A RF 1 ;Qty: 11.0000 4,0000 z !Product picked from: . r Lot: 2 I lFreight Class. ., : 200 Loc OSE04 Qty: { -------- h -{f Weight PeGallon: _ -__ ____ 11.87000 Net We�ghti 2Ogq.ppp---------------- ------------;_-__d___ ---------------------- This CY(��a-- . This is to'certify that the above named in esial are properly classified,described,packaged,marked,and labeled,and are in proper condition for trans ortation ac o Contin an P c the aI-able regulations of the Department of Transportation. P Next �a 'e �k ignature of Shipper'. Loaded By: ) URCHASER'S ACCEPTANCE OF THE GOODS COVERED BY THIS DOCUMENT SHALL CONSTITUTE ACCEPTANCE THE PURCHASER OF ALL TERMS AND CONDIOF SALE STATED ON THE REVERSE SIDE HEREOF. M1�OS w TEENER,PURCHASER Vehicle- TIONS » HE BY ACKNOWLEDGES »»•»» t RECEIPT OF REQUIRED SDS(S). »»» eived by: 1n. »,...» . ,Toad Pallet" ».., J Date: 'Plastic D »», Cl1STCY ». al2 �'le `O. � oo'o-a7ot 1Fc1 `- .4ce eGvre_ �cey�. e'`ti�e;\caJaccao,� c�r�ae\aq`aa0 ea c .n o��E,cScocca' Goccva oraAbaDr�ee`a. e�C� <�' - � e°Qo�otccca�wQ�rU� ;.a VOUCHER # 162063 WARRANT# ALLOWED 359584 IN SUM OF $ BRENNTAG MID-SOUTH INC 3796 RELIABLE PARKWAY CHICAGO, IL 60686-0037 Carmel Water Utility ON ACCOUNT OF APPROPRIATION FOR Board members PO# INV# ACCT# AMOUNT Audit Trail Code 410787 01-6180-03 735.00 Voucher Total 735.00 Cost distribution ledger classification if claim paid under vehicle highway fund BRENNTAG BRENNTAG MID-SOUTH, INC. 1405 HIGHWAY 136 WEST PO BOX 20 HENDERSON KY 42419-0020 [NVOICE#: BMS410787 INV DATE: 7/11/16 PAGE 1 OF 1 DUE DATE: 8/10/16 30OLD TO: SHIP TO: CARMEL WATER CARMEL UTILITIES PLT 1 3450 WEST 131ST STREET 4915 E 106 ST CARMEL IN 46074 CARMEL IN 46033 ?EDERAL ID #: 610504545 DATE SHIPPED: 7/11/16 TERMS NET 30 DAYS 3/L #. . . . : 1459229-00 SHIP WHS : 29 SALESPRSN: 299 '.USTOMER # . : 407542 SHIP VIA: OUR TRUCK - PKG ".USTOMER PO#: VERBAL FOB . . : DELIVERED ?RGT COMMENT: PREPAID TAX EX# : 356000972-001-9 ?RO NUMBER . : 647033083 JNITS SHIPPED PROD # WGT/GAL TOTAL QTY UNIT PRICE EXTENDED ------------------------------------------------------------------------------- 1 .0000 253418 11 .87000 2000 .0000# .3500 700 .00 2000 .0000 # CYL CHLORINE, LIQUID (BMS ONLY) >A RPK ------------------------------------------------------------------------------- JESTIONS, CALL 317-898-8632 REMIT TO ADDRESS: BRENNTAG MID-SOUTH, INC 3796 RELIABLE PARKWAY CHICAGO IL 60686-0037 * MERCHANDISE 700 .00 k * * * * * * * *** INS & SEC SURCHARGE 35 .00 ----------------- PAID ON OR PRIOR TO 8/10/16 INVOICE TOTAL USD 735 .00 PAID AFTER 8/10/16 INVOICE TOTAL USD 749 . 70 Original Document Bill of Lading/Shipment Receipt .:£ * * Continued from Previous Page * Page 2 of 3 BRENNNAP05TMID SOUTH PHONE: 317-898-8632 7/07/16 18:37:033111 FAX: 6 R E N N T DEA REG NO, 00660IBNY r ;> INDIANAPOLIS, IN 46226 a BODE , : 1459229--00 Delv Date: 7/08/16 Ship CARMEL UTILITIES PLT 1 Sold CARMEL WATER Customer: 407542 Ship To: 11 Ship Date: 7/08/16 0 Shir To: ' 4,915 E 106 5T To: 3450 WEST 131ST STREET A't•tn-a Frt Terms: PREPAID Frt CARMEL, IN 46033 CARMEL, IN 46074 FO`B, DELIVERED Taken By : BM29CLF Sts 5hlip Via: OUR TRUCK _ PKG Placed By: JERRY CLOUD *Re,ev Hrs: 8:00 AM- 3:00 PM Phone#. , : 317-571-2443 Phone: 317-571 -2443 Ext:_ Phone: 317-571--2443 Ext: Te,rms._. ,: NET 30' DAYS Cust P0# -' VERBAL QUANTITY PACKAGING HM DESCRIPTION I M QUANTITY PRODUCT CON' SHIPPED � ORDERED BACKORDERED CODE DEI IF LEAK OR SPILL OCCURS DURING TRANSPORTATION: CCN3170 EMERGENCY CONTACT: CALL CHEMTREC T FREE AT 1-8.00^-424--9300 24 HOURS / 7 DAYS Received : k; 3RQ uN1017, Date : CHLORINE, 2.3p(5w1)9(8)7 P O # : RQ,MARINE POLLUTANT ACCT # : POISON-INHALATION HAZARD, ZONE B ERG #: 124 �I Use : 1 j, CHLORINE , •}- 1.0000 2000.0000 LB CYL CHLORINE, LIQUID (BMS ONLY) >A RPK 1.UU 253418 Loc: OSE04 OSE05 Qty: 14.0000 4.0000 Product picked from: Lot: 2 Loc: b5E04- Qty: 1,0060 'Freight Clans. . . : 200 WeiVht Per Gallon: 11'. 7000 Net Weight: 2000.000 CYL --------------------------- _i_________________ __a___________________ _..__------------------------------------------ Total N- ght: 2,000Total �-rossAr Weight: 1 - k This is to certify that the above named materials are properly classified,described,packaged,marked,and labeled,and are in proper condition for transportation alcor n oto the pa pIV jable regulations of the Department of Transportation. Signature of Shipper. �- _ s G� GGc C�-2 Loaded By: "" " Checked By " "« Vehicle: „ Vi a Driver: r tic PURCHASER'S ACCEPTANCE OF THE GOODS COVERED BY THIS DOCUMENT SHALL CONSTITUTE ACCEPTANCE BY THE PURCH?r-FR OF ALL TERMS AND CONDITIONS OF SALE STATED ON THE REVERSE SIDE HEREOF. miles- BY w"° •"«•«•««••«•««••«•««• •..,..."«,.."«,.,,.,. Time In/Time MOREOVER,PURCHASER-H Y ACKNOWLEDGES RECEIPT OF ALL REQUIRED SDS(S).; Wp©d Pa a t5 D1Vd _" «" Wood Pallets Rtn:_..., 11 Received by: `' �' Date: //`°'/�' Plastic Pallets D1vd", ..."«" "" Plastic Pallets Rtn: Od1STOMER COPY