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Home My WebLink About302599 08/31/16 CITY OF CARMEL, INDIANA VENDOR: 36 571 ® it ONE CIVIC SQUARE HE ITAGE CRYSTAL CLEAN, LLC CHECK AMOUNT: S****"**170.00* ?� CARMEL, INDIANA 46032 1361 COLLECTIONS CENTER DRIVE CHECK NUMBER: 302599 ifor�° CHI AGO IL 60693-0136 CHECK DATE: 08/31/16 DEPARTMENT ACCOUNT PO NUMBER INVOICE NU OBER AMOUNT DESCRIPTION 651 5023990 14174886 85.00 OTHER EXPENSES 2201 4232100 14177521 85.00 GARAGE & MOTOR SUPPIE VOUCHER # 165995 WARRANT # ALLOWED 368571 IN SUM OF $ HERITAGE-CRYSTAL CLEAN, LLC 13621 COLLECTIONS CENTER DRIVE CHICAGO, IL 60693-0.136 Carmel Wastewater Utility ON ACCOUNT OF APPROPRIATION FOR Board members PO# INV# ACCT# AMOUNT Audit Trail Code 14174886 01-736H-08 85.00 Voucher Total 85.00 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 8/23/2016 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) Amount 8/23/2016 14174886 85.00 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 Herita a-Cr stal Clean LL Billing Inquiries: (877) 938-7948 9 Y � custsery@crystal-clean.com �- Invoice Page 1 of 1 Remit to: C Sta 13621 COLLECTIONS r Service Location: INDIANAPOLIS CENTER DRIVE C I oean® PO No.: CHICAGO, IL 60693-0136 http://www.crystal-clean.com Service Agreement: 756406 Invoice No: 14174886 Release Info: Date Issued: 08/12/2016 Account No: 153913 Item Total: $85.00 Itl.•I�Ilttlltt�ttllt�tl�lttt6lttllttlltt�t�lltlotll Pre-paid Amount: $0.00 CARMEL UTILITIES HOUSEHOLD Current Charges: $85.00 ATTN: ACCOUNTS PAYABLE Previous Amount Due: $82.50 30 W MAIN CARMEL, IN 46032-1361 Total Due: $167.50 Subject to finance charges If payment not received by 09/11/16 Svc Dt Work Order Product Description Comment Equip Qty Unit Price Tax Amt Total Cost 08/12/16 00-008W7X2 TRIP FEE-USED OIL SERVICE 1 $85.00 $0.00 $85.00-- Item 85.0 --Item Total $85.0 This form(invoice)is deemed part of the above referenced Service Agreement between Herita e-Crystal Clean,LLC and the irl—fir-A...�+ .ner enrl ell#er.oe en.l nnnr6Nnne enrl rorlirirohinnc nnnfeinerl Therein ere rlee,. A a-k hero..r Invoice Inform ion and Terms Service Location: Heritage-Crystal Clean location providing services listed. PO No: Your organization's purchase order number. Call or email for service if missing or incorrect. Service Agreement: Heritage-Crystal Clean service contract identifier. Release Info: Additional information provided for payment handling or processing. Date Issued: Date invoice was generated and sent to customer. Item Total: Charges incurred as itemized on the invoice. Pre-Paid Amount: Payments given at time of service. Current Charges: (Item total - Pre-Paid amount). Balance of charges and payments for items listed on invoice. Previous Amount Due: Previous charges for which payment has not been received. Total Due: Total and previous charges for which payment has not been received. Finance Charges: Refer to your service agreement/contract for information regarding application of finance charges. Svc Dt: Service date. Date services listed were provided to location. Work Order: Service document number for services and products delivered. Equip: Heritage-Crystal Clean equipment asset identifier. For questions regarding this invoice, account, or listed services, please contact the Heritage-Crystal Clean billing department. Additional information on products, services, and Heritage-Crystal Clean are available on our web site: I- http://www.crvstal-clean.com FnRnn 9nsC;R VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201 (Rev.1995) ALLOWED 20 ACCOUNTS PAYABLE VOUCHER HERITAGE CRYSTAL CLEAN, LLC 13621 COLLECTIONS CENTER DRIVE IN SUM OF$ CITY OF CARMEL An invoice or bill to be properly itemized must show:kind of service,where performed,dates service CHICAGO, IL 60693-0136 rendered,by whom,rates per day,number of hours,rate per hour,number of units,price per unit,etc. $85.00 Payee Purchase Order# ON ACCOUNT OF APPROPRIATION FOR Street Department Terms Date Due PO# ACCT# DATE INVOICE# DESCRIPTION DEPT# INVOICE# Fund# AMOUNT Board Members DEPT# FUND# (or note attached invoice(s)or bill(s)) AMOUNT 14177521 42-321.00 $85.00 1 hereby certify that the attached invoice(s),or 8/15/16 14177521 $85.00 2201 201 2201 201 bill(s)is(are)true and correct and that the materials or services itemized thereon for WhiGh charge-is-made-were-ordered and received except Tuesday,August 23,,2016 Dave Huffman Director 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 Cost distribution ledger classification if claim paid motor vehicle highway fund. Clerk-Treasurer Billing Inquiries: rystal- 938-7948 Heritage-Crystal Clean, LL custery c stal-clean.com Invoice Page 1 of 1 Remit to: 13621 COLLECTIONS C rysta l Service Location: INDIANAPOLIS CENTER DRIVE C 1 ean® PO No.: CHICAGO, IL 60693-0136 http://www.crystal-clean.com Service Agreement: P128713 Invoice No: 14177521 Release Info: Date Issued: 08/15/2016 Account No: 238097 Item Total: $85.00 It[o�l�ll®E[I®t®la'alt[��II�Lt[ Pre-paid Amount: $0.00 CARMEL STREET DEPT. Current Charges: $85.00 ATTN: ACCOUNTS PAYABLE Previous Amount Due: $0.00 3400 WEST 131 ST STREET CARMEL, IN 46074 Total Due: $85.00 Subject to finance charges if payment not received by 09/14116 Svc Dt Work Order Product Description Comment Equip oty Unit Price Tax Amt Total Cost 08/15/16 00-008XACY ,. TRIP FEE-USED OIL SERVICE 1 $85.0 $0.0 $85.0(-- Item $5.0 --Item Totall $85.0 This form(invoice)is deemed part of the above referenced Service Agreement between Heritag -Crystal Clean,LLC and the ^ Service Location: Heritage-Crystal Clean location providing services listed. PO No: Yourorganization's purchase order number. Call oremail for service ifmissing orincorrect. Service Agreement: Heritage-Crystal Clean service contract identifier. Release Info: Additional information provided for payment handling orprocessing. Date Issued: Date invoice was generated and sent tocustomer. Item Total: Charges incurred eaitemized nnthe invoice. Pre-Paid Amount: Payments given at time of service. Current Charges: (Item total - Pre-Paid amount). Balance ofcharges and payments for items listed oninvoice. 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. SncDt: Service date. Date services listed were provided tolocation. 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 nnour web site: