HomeMy WebLinkAbout305320 11/14/16 �m..4�A,y
�/ `} CITY OF CARMEL, INDIANA VENDOR: 367211
t ONE CIVIC SQUARE WATER SOLUTIONS UNLIMITED INC CHECK AMOUNT: $*****4,787.00*
r. ?� CARMEL, INDIANA 46032 PO BOX 347 CHECK NUMBER: 305320
9.t„iioN.�` FRANKLIN IN 46131 CHECK DATE: 11/14/16
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
601 5023990 40112 4,787.00 OTHER EXPENSES
VOUCHER# 163179 WARRANT# ALLOWED
367211 IN SUM OF $
WATER SOLUTIONS UNLIMITED INC
PO BOX 347
FRANKLIN, IN 46131-0347
Carmel Water Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO* INV# ACCT# AMOUNT Audit Trail Code
40112 01-6180-03 4,787.00
Voucher Total 4,787.00
Cost distribution ledger classification if
claim paid under vehicle highway fund
WATER
SOLUTIONSINVOICE:
:UNLIMITED
.: Invoice Number:: 40112
.P. 0. Box 347
295 Industrial Drive
Invoice Date: : Oct 27, 2016
Franklin, IN 46131 Page: : : 1
Voice: (317) 736-6868
Fax: (317)736-4322..
Bill TShip to
CARMEL UTILITIES CARMEL UTILITIES .
3450.W. 131ST STREET 4915 E. 106TH ST..:
:CARMEL, IN 46074
PLANT 1.
USA CARMEL, IN 46033
USA . ...
customer,ID WSU Delivery Receipt No.' Payment farms'.
� �
CARMEL- - SO 16100702 Net'30 Days' :
Sales Rep ID, Shipping Method Ship';Date' Due Date
DH DAVID HARVEY WSU-FR. - 10/26/16 11/26/16
.r
Quantity- Item Description " Un�f Price Amount
4;400:00 FLUORIDE . LBS;:SODI:UM FLUORIDE:50#'BAG 1.08 4,752.00
_. .
1.00 DELIVERY CHG : .: -: 35.00: 35.00
Subtotal 4,787.00
Sales Tax
Subtotal Invoice Amount 4,787..00
Frei ht Amount
Check/Credit Memo No: 9.. .
.. a,.,
TOTAL r 4;787.00
Please remit payment to:. Please include your invoice number on your check.
Water Solutions Unlimited, Inc.
P.O. Box 347
Franklin, IN 46131
WATER
SOLUTIONS STRAIGHT BILL OF LADING-ORIGINAL-NOT NEGOTIABLE
=T' UNLIMITED
FROM: - WATER SOLUTIONS UNLIMITED SOLD TO: CARMEL ..
FRANKLIN,IN USA CARMEL UTILITIES.
317-736-6868
www.getwsu.corn
SHIP TO: CARMEL UTILITIES
US DOT HAZMAT REG NO.:0610816 551 020Y ATTN: _JERRY CLOUD
- 4915 E.106TH ST.
CARMEL,IN 46033
317-716-3909
CUSTID DELIVERY RECEIPT NO .SALESID SHIP VIA PO NUMBER SHIP DATE - DELIVERY DATE
CARMEL 16100702 - DH WSU-FR AM5935 10/26/2016 - 10/26/2016
QTY SHIPPED PACKAGING HM DESCRIPTION NET WT(LB) GROSS WT(LB) CLASS
88 50 LB BAG X UN1690,SODIUM FLUORIDE SOLID,6.1,III 4400 4400
OCEM
DATti 0,�_ 41�A ,
PO#..,..,.:.I,:., �..
ACCT
A
USE .
F
For Chemical Emergency Spill,Leak,Fire,Exposure,or Accident,Call CHEMTREC Day or Night-Within
USA and Canada: 1-800424-9300
Subtotal(Weightsubject tommectiun). 4400 4400
This is to certify that the above named materials are property dassired,packaged,marked,and labeled,and are in proper condition for transportation according to the applicable regulations of the DOT. -
NOTE:Where the rate is dependent on value,shippers are required to state specifically in writing the agreed or declared value of the property.The agreed or declared value of the property is hereby specifically stated by the shipper to be not
exceeding $ - per -
COD REMIT TO ADDRESS: COD Amt:$ TOTAL CHARGES:$ FREIGHT CHARGES:
COD FEE: Collect q-
Pre aid Collect q Prepaid q
RECENED.sub(ed b u dhadualty determined rates or mres,o Nat have been agreed upon In writing between the comer and shipper,It applirab%,,therms,to the retes.d—Acations,and rules that have been established by the canter and are available to the shipper,on request.and to all applicable state and
fed
eM regulatlans:Ne Proph,described abevelnapparentgoM d,r,exmptasnoted(,,MentaMmMitionofmntenbolpackegesunknown),mark,d.mnstgned,anddatripedaslmdkatodbelawwhkhuWmmpany(thew,Mmmpanyb,inguM,,t dlhrpughoutthismntredasmeaninganyp,m,nor
ragas to c c possession of erre pmpery under Ne mnsee)agrees to carry to delivery al said demin enn,g on its route,or oth—Asa to deliver to another miner on the rents to said destination.II is muwany agre,d as m w h carder el all er any el saw Pmmrty over all er any poN,n olsaid mute m destination
end as b aeric party at any rima interested in eg m erry of said Pmpertythat every servim to be mdarrred hereunder shag be subied b eU Na mrdifnns ml proNbited bylaw,wheNerpmrled orwntren herein mMa'neQ wnidr ere hereby agree b M the snippet aM acmpted fm Nrrrsell end his asslgrrs.
CUSTOMER'S AGENT SHIPPER'S AGENT
PRINTED NAME: PRINTED NAME:
SIGNATURE: - SIGNATURE: