HomeMy WebLinkAbout302916 09/12/16 +u�.GggM
gig/ �� CITY OF CARMEL, INDIANA VENDOR: 368571
�l ONE CIVIC SQUARE HERITAGE CRYSTAL CLEAN, LLC CHECK AMOUNT: $********85.00*
x•, ,a4 CARMEL, INDIANA 46032 13621 COLLECTIONS CENTER DRIVE CHECK NUMBER: 302916
9M�iON��` CHICAGO IL 60693-0136 CHECK DATE: 09/12/16
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 14193993 85.00 OTHER EXPENSES
VOUCHER # 166065 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
14193993 01-7362-06 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 8/31/2016
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
8/31/2016 14193993 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
Heritage-Crystal C I 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://www.crystal-clean.com
Service Agreement: P102474
Release Info: Invoice No: 14193993
Date Issued: 08/25/2016 .
Account No: 222055
Item Total: $85.00
Itlttltllttttltllttltlltttlltttl Pre-paid Amount: $0.00
CITY OF CARMEL Current Charges: $85.00
ATTN: ACCOUNTS PAYABLE
9609 HAZEL DELL PKWY Previous Amount Due: $0.00
INDIANAPOLIS, IN 46280 Total Due' $85.00
Subject to finance charges if payment not received by 09124/16
Svc Dt Work Order •• Description I C• • • Qty Unit Price Tax Amt Total •
08/25/16 00-008Y5T5 TRIP FEE-USED OIL SERVICE 1 $85.00 $0.00 $85.00--
Item
This form(invoice)is deemed part of the above referenced Service Agreement between Heritage-Crystal Clean,LLC and the
Invoice InfQrmationjand 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:
.... htto://www.crvstal-clean.com cnonn onoco