HomeMy WebLinkAbout305095 11/14/16 �yi'"AMp
�; ... CITY OF CARMEL, INDIANA VENDOR: 359584
® ONE CIVIC SQUARE BRENNTAG MID SOUTH INC CHECK AMOUNT: $*****9,149.60*
9 ia` CARMEL, INDIANA 46032 3796 RELIABLE PARKWAY CHECK NUMBER: 305095
MilruNi�. CHICAGO IL 60686 CHECK DATE: 11/14/16
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
601 5023990 BMS501524 9,149.60 OTHER EXPENSES
VOUCHER# 163142 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
501524 01-6180-03 9,149M L10
Voucher Total 9,149.0 ( C
Cost distribution ledger classification if
claim paid under vehicle highway fund
BRENNTAG AM
BRENNTAG MID-SOUTH, INC.
1405 HIGHWAY 136 WEST
PO BOX 20
HENDERSON KY 42419-0020
INVOICE#: BMS501524 INV DATE: 10/26/16 ** PAGE 1 OF 1 *
DUE DATE: 11/25/16
SOLD TO: SHIP TO:
CITY OF CARMEL UTILITIES CARMEL UTILITIES PLT 1
3450 WEST 131ST STREET 4915 E 106 ST
CARMEL IN 46074 CARMEL IN 46033
FEDERAL ID #: 610504545 DATE SHIPPED: 10/26/16 TERMS NET 30 DAYS
3/L #. . . : 1562177-00 SHIP WHS: 29 SALESPRSN: 293
'.USTOMER # . : 407542 SHIP VIA: OUR TRUCK BULK
"USTOMER PO#: VERBAL FOB . . : DELIVERED
?RGT COMMENT: PREPAID TAX EX# : 356000972-001-9
?RO NUMBER . : 688909704
JNITS SHIPPED PROD # WGT/GAL TOTAL QTY UNIT PRICE EXTENDED
-------------------------------------------------------------------------------
27620.0000 437426 10.28000 27620 .0000# .3300 9,114.60
1 .0000 # BULK HYDROFLUOSILICIC ACID 23%
>A BLK
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JESTIONS, CALL 317-898-8632
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REMIT TO ADDRESS:
BRENNTAG MID-SOUTH, INC
3796 RELIABLE PARKWAY
CHICAGO IL 60686-0037 * MERCHANDISE 9,114.60
INS & SEC SURCHARGE 35.00
-----------------
PAID ON OR PRIOR TO 11/25/16 INVOICE TOTAL USD 9,149.60
PAID AFTER 11/25/16 INVOICE TOTAL USD 9,332.59
Original Document
?nt Receipt Continued from Previous Page *** Page 2 of 3
PHONE:-k7-898-'8632 10/25/16 7:24:14
FAX: B REN NTAG
26
IBN-# . : 1562177-00 Dely Date: "10' 26 16
3 PLT 1 Sold CITY OF CARMEL UTILITIES : Customer: 407542 Ship Tq: 11 Ship Date: 10/.26/16 0 Ship From: 29
To: 3450 WEST 131ST STREET ' Attn- = Frt Terms: PREPAID Frt Code
3 CARMEL„ IN 46074 FOD. . DELIVERED Taken By : BM29RAG Sls Per . : 293
Shap V, TRUCK BULK Placed By: JERRY
Recv Hr 7:30 AM- 4:00 PM Phone#. .: 317-571-2443
24.43 Ext: Phone: 317--571-2443 Ext: ( Terms. : : NET 30 DAYS Cust PO# VERBAL
PACKAGING HM DESCRIPTION M QUANTITY PRODUCT CONTAINER GROSS
I ORDERED BACK ORDERED CODE DEPOSIT WEIGHT
CURS DURING TRANSPORTATION: .
s
CCN3170 EMERGENCY CONTACT: CALL CHEMTREC TOLL FREE AT 1-800-424.93"00 WEIGHT .
- ` 24 HOURS / 7 DRYS IN LBS
X UN1778,
FLUOROSILICIC ACID,
8,PG II -
'ERG #: 154
1000 T/T H7-'DROFLUOSILI -C ACID 23". >A BLK 41120.0000 437426 41120
SEAL#: „,..„"..,, 4 �`�»� —/0'V
Loc:: ', TANK 25 OSCLT
;Qty: 78460.8400 153484.0800 �
:Lot #:
qty:
re ,ght Class, . . .
55
Weight Per Gallon: 10.2dOOO Net Weight: + 41120.dOO BULK
To be co p .ete�L before unloading: »_-___---__-----__ _
Hose conELe`Cted t correct compartment(s). 1 . rl
Driver-
----------------------------
river
__._---__---_-_ _-__-_---__----
;Hose connected to proper storage tainK,and gjantity,,shipped will fit into customer container. *>
;Customer: »,•_,„ „.»„_ », „,,,,,,.,.,»,...M„ „,„,"...` >:
ONLY PRODUCTS MANUFACTURED AT A NSF AUTHORIZED
*** Continubd on Nevxt Page *K* �vs.
I materials are properly classified,'described,packaged,marked,and labeled,and are in proper
tlip,applicable fegulations of the Department of Transportation. („daIjPd Dy• 15cKed By „
c1PtCK -- � J � Vehicle: sDriver:
IF THE GOODS COVERED BY THIS DOCUMENT SHALL CONSTITUTE ACCEPTANCE Miles: „„ „„ » »„ »»»" Time In/T3 me 041t,,,„„„„»»«„„„» »»»»”»»» »•»
'ERMS AND CONDITIONS OF SALE STATED ON THE REVERSE SIDE HEREOF. Wood -Pallets Dlvd Wood Pallets Rtn:„,„ , „„ •,„„,„,„„ „»,„”
:EBY ACKNOWLEDGES RECEIPT OF ALL kEQUIRED SDS(S).
�� ( Plastic Pallets Dlvd„, „„„,"..„„„„ Plastic Pallets
Date: CUSTOMER COPY