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308979 03/07/17
CITY OF CARMEL, INDIANA VENDOR: 358385 ONE(9, ) CIVIC SQUARE GENERAL SHALE& BRICK CHECKAMOUNT: S"""""855.60" CARMEL, INDIANA 46032 PO BOX 5825 CHECK NUMBER: 308979 CAROL STREAM IL 60197-5825 CHECK DATE: 03/07/17 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 2201 4236200 182629313 855.60 CEMENT / \ C k 3 $ § § O§ = f C qqfn > r X \ q \ $ / m X O f % I $ 2 / § \ (1) Z 7 / \ O \ � . ) 7 (D Q e a # -n ® 0) 2 } (D cn co 6 m o / \ § OD ƒ 0 / 0 - o « o m / / # � J D 2 CL ® a 2 z -n 2 4 O 2 ; $ . / O | 0CD § m \ E $ 3 i 2 LT - 2 r, ® � &$ ƒ / Cl) k PL CD k$ ƒ CD © , & m k q o § (a 7 a _ _ �CL _ - m # « = 2 ` 3 { \ 2 ƒ ® - E CD $ \ 2 a E 0 m k 0 < 2 E . ƒ k ƒ \ / 4 g / R E E § k ƒ § » 2 a § [ . - , y K i § \ q } e E o = -0 - CL 7 - w ) \ \ CD m M \ D \ � - P \ & ; E G -nz � $ 0 03// § \ / ƒ \ 2 / # D % z ; 0 tCL I \ } ( | 0< 0T \f 0- { - f_m ( ) 7 -n � C?/ c g [ 2 0 CD CD \ M n / j E / \ CD r r- O £ + ( Z CD ) 0 / C m 0 CD � � �` � a CD CD / CD n E - _CD MCL T3 L / Cl) a a 2 § CD \ z \ f § / _ > Q Q » 00 g . \ § ) � \ 11 General Shale ......................11....... ........... ...... ............... ........................... ........................... ':i:::i:''`''::::'::::i:::`::i:;:li::::':'::::>is:`::`::`::::::::::: ` .........:....:......:.. .................................................................................................................................. .................................................................................................................................. .................................................................................................................................. .... ........ ........ .................................................................................................................................. .................................................................................................................................. Invoice: 182629313 Invoice Date: 03/01/2017 Bill To: 279670 Customer P0: CARMEL STREET CITY OF CARMEL 3400 W 131ST STREET Bill of Lading: 172886639 WESTFIELD IN 46074-8267 Goods Issue Date: 03/01/2017 Order: 321745007 Sales Rep: 399 Ship-To: CITY OF CARMEL Order Loc.: Carmel 3400 W 131ST STREET CARMEL IN WESTFIELD IN 46074-8267 Phone: 317-846-2566 Mode of Shipment: Customer Pickup / 057 Material Material Description Quantity Price Value USD Batch Number and Description 6099001047 ESSROC BRIXMENT GRAY TYPE S 75 LB BAG 92 BAG 9.30 855.60 Subtotal 855.60 TAX TOTAL 855.60 LATE PAYMENT CHARGE of 1.5% PER MONTH. PLEASE RETURN THIS PORTION WITH YOUR PAYMENT Accnt#: Customer Name Invoice-Date Invoice Amount Due 279670 CITY OF CARMEL 03/01/2017 182629313 855.60 Remit To: GENERAL SHALE BRICK, INC PO Box 5825 CAROL STREAM IL 60197-5825 Terms: Up to 03/31/2017 without deduction i 0010 General Shale REFERENCE CONDITIONS ON BACK :::::ii:'7::i::: :::. , :::. ::......... Bill To: 279670 Bill of Lading: 172886639 CITY OF CARMEL Date: 03/01/2017 3400 W 131ST STREET WESTFIELD IN 46074-8267 Order Loc: Carmel CARMEL IN Sales Order: 321745007 Customer P0: CARMEL STREET Ship-To: Telephone: (317) 733-2001 CITY OF CARMEL 3400 W 131ST STREET Shipper: GESH Carmel WESTFIELD IN 46074-8267 CARMEL IN 057 Mode of Shipment: Customer Pickup BRICK STCC 32 511 Directions: Material Description Order Quantity Weight Batch 6099001047 ESSROC BRIXMENT GRAY TYPE S 75 LB BAG 92 BAG 6,900.00 LB 3,136.36 KG TOTAL WEIGHT 6,900.00 LB 3,136.36 KG Drivers Name Driver License No. and State Trucking Company Dispatcher Name Phone No. DOT # Verified By