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>'� �• CITY OF CARMEL, INDIANA VENDOR: 368571
ONE CIVIC SQUARE HERITAGE CRYSTAL CLEAN, LLC CHECK AMOUNT: S'""'""""75.00"
� ,g°: CARMEL, INDIANA 46032 13621 COLLECTIONS CENTER DRIVE CHECK NUMBER: 31 1 1 19
�"4oN�° CHICAGO IL 60693-0136 CHECK DATE: 05/09/17
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 14553406 75.00 OTHER EXPENSES
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Heritage-Crystal Clean, LLC Invoice
Billing Inquiries:(877)938-7948
HERITAGE-CRYSTAL CLEAN,LLC custserv@crystal-clean.com
`•.� 2175 Point Boulevard,Suite 375
C C'/'/ a I Elgin,IL 60123
Remit to: 13621 COLLECTIONS
C I ea n e CENTER DRIVE
CHICAGO,IL 60693-0136
_ 1 of t
• 14553406
04/27/2017
153913
$75.00
.. . $0.00
220 1 MB 0.423 E0217X 10237 D2422376121 S2 P4196325 0001:0001 $75.00
���tlt�IltJ��lll�tl��ll�"I��"'I��I�I�I�tI�I��ttJI��I�IJ�lll�l ' $195.00
$270.00
CARMEL UTILITIES HOUSEHOLD
ATTN:ACCOUNTS PAYABLE Subject to finance charges if payment not received by 05/27/17
30 W MAIN ST
CARMEL IN 46032-1938 • •• • • • httD://www.hccquickconnect.com
•• • LSZ QMV FXK
Service Location '• No: `• •
INDIANAPOLIS 756406
Svc Date Work Order Product Description/Comment Equip QTY Unit Price Tax Amt Total Cost
04/27/2017 00-009R6NR TRIP FEE-USED OIL SERVICE 1 $75.00 $0.00 $75.00
Item Total: $75.00
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This form(invoice)is deemed part of the above referenced Service Agreement between Heritage-Crystal Clean,LLC and the identified customer and all terms and conditions and certifications contained therein are deemed a part hereof.
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