HomeMy WebLinkAbout303408 09/26/16 (9 CITY OF CARMEL, INDIANA VENDOR: 368571
ONE CIVIC SQUARE HERITAGE CRYSTAL CLEAN, LLC CHECK AMOUNT: $ 129.00*
CARMEL, INDIANA 46032 13621 COLLECTIONS CENTER DRIVE CHECK NUMBER: 303408
CHICAGO IL 60693-0136 CHECK DATE: 09/26/16
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 14206387 129.00 OTHER EXPENSES
VOUCHER # 166126 WARRANT # ALLOWED Prescribed by state Board of Accounts
ACCOUNTS PAYABLE VOUCI-
368571 IN SUM OF $ CITY OF CARMEL
HERITAGE-CRYSTAL CLEAN, LLC it
13621 COLLECTIONS CENTER DRIVE An invoice or bill to be properly itemized must show, kind of service
CHICAGO, IL 60693-0136 performed, dates of service rendered, by whom, rates per day, nun
price per unit, etc.
Carmel Wastewater Utility 368571 Payee
ON ACCOUNT OF APPROPRIATION FOR HERITAGE-CRYSTAL CLEAN, LLC Purchase Or
13621 COLLECTIONS CENTER DRIVE Terms
CHICAGO, IL 60693-0136 Due Date
Board members
I, Invoice Invoice Description
PO# INV# ACCT# AMOUNT Audit Trail Code Date Number (or note attached invoice(s) or t
i.
9/8/2016 14206387
14206387 01-7362-06 129.00
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Voucher Total 129.00 1 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
Cost distribution ledger classification if i
claim paid under vehicle highway fund
Date
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Herita a-Cr stal Clean LLC Billing Inquiries: (877) 938-7948
9 Y � 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 httpJ/www.crystal-clean.com
Service Agreement: 671811 Invoice No: 14206387
Release Info: SA#652667 _Date Issued: 08/2912016•
Account No: 222055
Item Total ..$129.00
Iflttlt{Itttt{tlltt{t{{tttllttt{ Pre-paid'Amount: $0.00
CITY OF CARMEL Current Charges: $129.00
ATTN: ACCOUNTS PAYABLE Previous Amount Due: $85.00
9609 HAZEL DELL PKWY
INDIANAPOLIS, IN 46280 Total Due: $214.00
Subject to finance charges if payment not received by 09/28/16
Svc Dt Work Order Product Description Comment Equip Qty Unit Price Tax Amt Total Cost
08129/1 00-008YWR4 WASTE PROFILE 1 $129.0 $0.0 $129.0&-
� - �-WASTE"i'ROFILE
(ABSORBENTj_ r � _ �.__ --- ----
Item Total 129.0
This form(invoice)is deemed part of the above referenced Service Agreement between Heritage-Crystal Clean,LLC and the
Service Location: Heritage-Crystal Clean location providing services listed.
PO No: Your organization's purchase order number. Call n/email for service ifmissing nrincorrect.
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 aeitemized onthe 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.
Tota! Due: Total and previous charges for which payment has not been received.
Finance Charges: Refer to your service agree ment/contract for information regarding application of finance charges.
Svc D8: Service date. Date services listed were provided tn location.
Work Order: Service documentnumber for aawioenand products delivered.
Equip: Heritage-Crystal Clean equipment asset identifier.
For questions regarding this invoice, account, orlisted services, please contact the Heritage-Crystal Clean billing department.
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Additiona information on products, services, and Heritage-Crystal Clean are available on our web site: