HomeMy WebLinkAbout301392 07/28/16 i
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CITY OF CARMEL, INDIANA VENDOR: 3685171
ONE CIVIC SQUARE HERITAGE CRYSTAL CLEAN, LLC CHECK AMOUNT: $********82.50*
�„ =Q CARMEL, INDIANA 46032 136211 COLLECTIONS CENTER DRIVE CHECK NUMBER: 301392
CHICAGO IL 60693-0136 CHECK DATE: 07/28/16
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DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 14133056 1 82.50 OTHER EXPENSES
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VOUCHER # 165795 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
14133056 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 7/26/2016
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
7/26/2016 14133056 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
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LC Billing Inquiries: (/877)938-7948
Heritage-Crystal Clean, L
custery c stal-clean.com C
Invoice Page 1 of 1 Remit to: CSta 1
13621 COLLECTIONS
Service Location: INDIANAPOLIS CENTER DRIVE C 1 ean®
PO No.: I CHICAGO, IL 60693-0136 http://www.crystal-clean.com
Service Agreement: 756406 Invoice No: 14133056
Release Info: Date Issued: 07/15/2016
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Account No: 153913
Item Total: $82.50
ItlttlIlt11tIlttLlattllttllellttttIlJttll Pre-paid Amount: $0.00
CARMEL UTILITIES HOUSEHOLD Current Charges: $82.50
ATTN: ACCOUNTS PAYABLE Previous Amount Due: $0.00
30 W MAIN
CARMEL, IN 46032-1361 Total Due: $82.50
Subject to finance charges If payment not received by MUM
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Svc Dt Work Order Product Description Comment Equip Qty Unit Price Tax Amt Total Cost
07/15/16 00-008T303 USED ANTIFREEZE 165 $0.5c $0.00 $82.50--
Item
82.50--Item Total: $82.50
This form(invoice)is deemed part of the above referenced Service Agreement between Heritage-Crystal Clean,LLC and the
Inv®wce Infprmati®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:
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