HomeMy WebLinkAbout311249 05/09/17 Q
CITY OF CARMEL, INDIANA VENDOR: 367211
ONE CIVIC SQUARE WATER SOLUTIONS UNLIMITED INC CHECK AMOUNT: $kk■k■2,411.00`
CARMEL, INDIANA 46032 PO BOX 347 CHECK NUMBER: 311249
FRANKLIN IN 46131 CHECK DATE: 05/09/17
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
601 5023990 41234 2,411.00 OTHER EXPENSES
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4MWATER
SOLUTIONS INVOICE
UNLIMITED
P. O. Box 347 Invoice Number: 41234
295 Industrial Drive Invoice Date: Apr 21, 2017
Franklin, IN 46131 Page: 1
Voice: (317)736-6868
Fax: (317)736-4322
CARMEL UTILITIES CARMEL UTILITIES
3450W. 131ST STREET 4915 E. 106TH ST.
CARMEL, IN 46074 PLANT 1
USA CARMEL, IN 46033
USA
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CARMEL S016101654 Net 30 Days
OR,
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DH DAVID HARVEY WSU-FR 4/19/17 5/21/17
2,200.00 FLUORIDE LBS, SODIUM FLUORIDE 50#BAG 1.08 2,376.00
1.00 DELIVERY CHG 35.00 35.00
Subtotal 2,411.00
Sales Tax
Subtotal Invoice Amount 2,411.00
Check/Credit Memo No: Freight Amount
TOTAL 2411:tt0
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
UNLIMITED
FROM: WATER SOLUTIONS UNLIMITED SOLD TO: CARMEL
FRANKLIN,IN USA CARMEL UTILITIES
317-736.868
www.getwsU.eom
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 16101654 DH [FRANKLIN BO 5935- 4/19/2017 4/19/2017
CITY SHIPPED PACKAGING HM DESCRIPTION NET WT(LB) GROSS WT(LB) CLASS
44 50 LB BAG X UN1690,SODIUM FLUORIDE SOLID,6.1,III 2200 2200
(Received : S ✓✓✓
Date :
Pb ge
ACCT # : C �-
e.: Plant lour,dr- b S
For Chemical Emergency Spill,Leak,Fire,Exposure,or Accident,Call CHEMTREC Day or Night-Within USA
and Canada: 1.800-424-9300
subtotal(weight subject to oomeotion): 2200 2200
This Is to certify that Me above named materials are properly dassified,packaged,marked,and labeled,and are in proper condition Tor transportation according to Me applicable regulations of the DOT.
NOTE:Where the rate is dependent on value,shippers are required to state specifically in witting 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
Prepaid Collect q Prepaid q
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CUSTOMERS AGENT SHIPPER'S AGENT
PRINTED NAME: PRINTED NAME:
SIGNATURE: SIGNATURE: