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315331 08/29/2017 (9) CITY OF CARMEL, INDIANA VENDOR: 358385 ONE CIVIC SQUARE GENERAL SHALE& BRICKCHECK AMOUNT: S********93.00* CARMEL, INDIANA 46032 PO BOX 5825 CHECK NUMBER: 315331 CAROL STREAM IL 60197-5825 CHECK DATE: 08/29/17 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 2201 4236200 182727880 93.00 CEMENT n 0 G \ « \ § § 2 z 0 o k 0 ^ q > ? J 0 q a r q / q = / 2 % m a I 2 2 CL CO / 7 / \ O — ¥ e )� m Q e a to E _ R e $ ca c 0 / / k t � > OD / \ k E 2 ® » /- � J CL ° >_ z 2 0 z > -n 9 O CD \ } | 7 0 ¥ 3 ) \ } / / \ / / i n G /OF / » / 7 / - ƒ \ \ 2 m f $ # « c 3 { r \ 9 / > / } — k 7 � f $ \ S \ 7 E a / CL m / CD / ƒ — m k co \ 0) � / \ & § — f ƒ § « 3 a ) \ OD § , 7 CL #CD § § < _ f — w m \ \ CY D) 0 A CD / / > \ ) \ # § \ § -nz a4 0 _ a 9 » w z g ® O k ƒf R ) 2 m J \ k C o CD 0 ^ C 3 \ %« CL / ƒ £ ( 00CD \/ \ D f_7 ( 90 - D� / q D co 7 ® / r _ ± 2 \ CD � M 0 / 0 j E / SD r O a ¥ 2 2 / ] ::rCD rCD f ( / D a § $ } & n § k 2 _ n a m ] CD 0 D \ / \ '69 % / 2 \ \ k E ® \ 0010 General Shale ..... ....... ...... ......................... ........ .......XX. * "'M: XX .. .. .. ........ ............ ....... .. ........ .. ... . ................... Invoice: 182727880 Invoice Date: 08/10/2017 Bill To: 279670 Customer P0: shop CITY OF CARMEL 3400 W 131ST STREET Bill of Lading: 172990467 WESTFIELD IN 46074-8267 Goods Issue Date: 08/10/2017 Order: 322734136 Sales Rep: 399 Ship-To: Job: j aures rundle p/u Order Loc.: Carmel CITY OF CARMEL CARMEL IN 3400 W 131ST STREET Phone: 317-846-2566 WESTFIELD IN 46074-8267 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 10 BAG 9.30 93.00 Subtotal 93.00 TAX TOTAL 93.00 LATE PAYMENT CHARGE of 1.5% PER MONTH. 0010 General Shale REFERENCE CONDITIONS ON BACK a rbc, a ... ......... Bill To: 279670 CITY OF CARMEL Bill of Lading: 172990467 3400 W 131ST STREET Date: 08/10/2017 WESTFIELD IN 46074-8267 Order Loc: Carmel CARMEL IN Sales Order: 322734136 Ship-To: Customer P0: shop Telephone: (317) 733-2001 Job: j aures rundle p/u CITY OF CARMEL Shipper: 3400 W 131ST STREET G IN Carmel WESTFIELD IN 46074-8267 CARMEL N 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 10 BAG 750.00 LB 340.91 KG TOTAL WEIGHT 750.00 LB 340.91 KG Drivers Name Driver License No. and State Trucking Company Dispatcher Name Phone No. DOT # Verified By