HomeMy WebLinkAbout310041 04/10/17 @CITY OF CARMEL, INDIANA VENDOR: 367949
ONE CIVIC SQUARE MILLER INDUSTRIAL FLUIDS LLC CHECK AMOUNT: $ 119.48-
CARMEL, INDIANA 46032 1751 N RAYMOND ST CHECK NUMBER: 310041
INDIANAPOLIS IN 46221 CHECK DATE: 04/10/17
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
601 5023990 43283 119.48 OTHER EXPENSES
Y
W
4
V
O
rn
O ?
. 'o
2 �c
ID
ms
O L •a
N oG N � •� c
U.
<- N O N Z Z a
p
06-
C)
C)
Paqe 1 of 1
51 MILLER Invoice Number Invoice Date
43283 3/22/17
MILLER INDUSTRIAL FLUIDS,LLC Order Number Due Date
46609 4/21/17
1751 W. Raymond St. Phone: (317) 634-7300 Fax: (317) 636-6761
Indianapolis, IN 46221 USA
INVOICE
Sold To: Ship To:
City of Carmel Utilities City of Carmel/Water Treatment
3450 W 131st St Plant
Carmel, IN 46074 4915 E 106th St
USA Carmel, IN 46033
USA
Shit) Date Shi ed Via Freight Terms Payment Terms
3/7/17 Sales will Deliver-Herb Net 30
Purchase Order Number Sales Agent Order Date Customer Number
)M 3117 Herb Simpson 3/2/17 CITYCARMEL
Qty Shipped Packaging Total Product Unit Price Amount
Quantity
1. 1 CTN CTN 1. CTN Mobil Polvrex EM 61.980/ CTN 61.98
14102EX1014
Mobil Polyrex EM
5. 5 GAL PL-R 5. GAL Supro R&O 32 11.500 / GAL 57.50
15057MI0005
Supro R&O 32
Merchandise SubTotal 119.48
Total Invoice 119.48
---------- - ---- - - --- -- - - - - - - -- - -- --
Please Remit Payment To: Miller Industrial Fluids, LLC - 1751 W. Raymond St. • Indianapolis,IN • 46221 USA
STRAIGHT BILL N LADING
M
MILLER
From: Miller Industrial Fluids,Inc. 3 2017
MILLER INDUSTRIAL FLUIDS,LLC
At: 1751 W. Raymond St. OIL NO.
Indianapolis,IN 46221 46609
PHONE: (317)634-7300 FAX: (317)636-6761 Page 1 of 1
B City of Carmel Utilities H City of Carmel/Water Treatment Plant FOR CHEMICAL
13450 W 131st St I 4915 E 106th St EMERGENCY
L Carmel, IN 46074 Carmel IN 46033 SPILL,LEAK,
P
L USA USA , FIOR ACCIDENT SE
T 317-716-6624 T 317-716-6624 CALL:CHEMTREC
0 0 DAY OR NIGHT
CJ$T NO. OPERATOR SHIP VIA SHIPMENTS VIA D.O.T.HAZARDOUS MATERIALS PLACARDS FURNISHED BY: 800-424-9300
CMCARMEL one To Be Determined MOTOR CARRIER ❑ SHIPPER ❑ CARRIER
CUs)°.ORM NO. r14102EX1014
w OATS FREIGHT TAX FOB REMARK DELIVERY DATE CHECKED BY
JM 3117 /2017 Yes
QUANTITY QUANTITYPACKAGING HM DESCRIPTION NET WEIGHT GROSS FRT
ORDERED SHIPPED WEIGHT CLS
1 1 CTN Mobil Polyrex EM 0 0
Mobil Polyrex EM 1 CTN
1 1 5GALPL-R Supro R&O 32 37 40
15057MI0005 Supro R&O 32 1 PL-R
Total Weights: 37 40
ate : —l7-��
CCT #: � Zor
se : O i f VL&rucse
SHIPPER'S CERTIFICATION This is to certify that the above named materials are properly classified,described,
packaged,marked and labeled and are in proper condition for transportation according to the applicable COD
regulations of DOT.
SHIPPER'S CHECKLIST Amt: $ 0.00
(Signaturefritle)
I the s ipment moves between two ports by a carrier by water,the law requires that the i o DELIVERED BY:
lading shall state whether it is"carrier's or shipper's weight"NOTE-where the rate is dependent DOT LABELS DOT
APPLIED AND AUTHORIZED
on value,shippers are required to state specifically in writing the agreed or declared value of SECURE CONTAINERS
the property. The agreed or declared value of the property is hereby specifically stated by the
shipper to be not exceeding per
PROPER DOT CHECKED FOR RECEIVED BY:
FREIGHT CHARGES NAME ON ALL PROPER
Subject to Section 7 of the conditions,if this shipment is PACKAGES SEALING
to be delivered to the consignee without recourse on the If charges are to be
consignor,the consignor shall sign the followingprepaid,write or
g g g stamp here,'TO BE
statement: PREPAID" AIR CARGO PELIGRO DATE:
ONLY LABEL APPLIED
The carrier shall not make delivery of this shipment
without payment of freight and all other lawful charges.
SIGNATURE HEREBY CONFIRMS
THAT QUANTITY SPECIFIED IS
(Signature of Consignor) PLANT/SHIPPING CORRECT AND RECEIVED IN
GOOD CONDITION