HomeMy WebLinkAbout315978 9/12/2017 �,,yf. CITY OF CARMEL, INDIANA VENDOR: 367949
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ONE CIVIC SQUARE MILLER INDUSTRIAL FLUIDS LLC CHECK AMOUNT: S*******214.20*
?4 CARMEL, INDIANA 46032 1751 N RAYMOND ST CHECK NUMBER: 315978
' INDIANAPOLIS IN 46221 CHECK DATE: 09/12/17
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DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
601 5023990 46472 214.20 OTHER EXPENSES
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Invoice Number Invoice Date
M MILLER 46472 8/25/2017
MILLER INDUSTRIAL FLUIDS,LLC Order Number Due Date
49909 9/24/2017
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
Ship Date Shipped Via Freight Terms Payment Terms
8/8/2017 Sales will Deliver-Herb Net 30
Purchase Order Number Sales Agent Order Date Customer Number
3M080217 Herb Simpson 8/2/2017 CITYCARMEL
Qty Shipped Packaging Total Product Unit Price Amount
Quantity
2. 1 ECH CTN 2. ECH Mobilith SHC 100 107.100/ ECH 214.20
14044MO1014
Mobilith SHC 100 (13.7 oz)
Merchandise SubTotal 214.20
Total Invoice 214.20
Please Remit Payment To: Miller Industrial Fluids, LLC * 1751W. Raymond St. • Indianapolis, IN • 46221 USA
STRAIGHT BILL OF LADING
From:Miller Industrial Fluids,Inc. MILLER 8/2/2617
MILLER INDUSTRIAL FLUIDS,LLC
At: 1751 W.Raymond St. ,-
Indianapolis,IN 46221 49909
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
I 3450 W 131st St I 4915 E 106th St EMERGENCY
L Carmel, IN 46074 Carmel IN 46033 SPILL,LEAK,
P
L USA USA AOR CICENT
T 317-716-6624 T 317-716-6624 CALL:CHEMTREC
0 Q DAY OR NIGHT
[I0 OPERATOR VIA : 800-424-9300
SHIPMENTS VIA D.O.T.HAZARDOUS MATERIALS PLACARDS FURNISHED BY:
CITYCARMEL ryodneI Sa es will Deliver-Herb MOTOR CARRIER
❑ SHIPPER ❑ CARRIER
OUST.NO SKIP DATE FREIGHT TAX Ftp REMARK CRY SATE A BY
IM080217 8/18/2017 Yes
QUANTITY QUANTITY PACKAGING HM DESCRIPTION NET WEIGHT GROSS FRT
ORDERED SHIPPED WEIGHT CLS
2 2 1 ECHCTN Mobilith SHC 100 18 18
14044MO1014 Mobilith SHC 100 (13.7 oz)2 CTN
Total Weights: 18 18
Receiwed : �
Dat
2-17
AC T # : `4
. Use :
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
regulations of DOT. SHIPPER'S CHECKLIST D Amt: $ 0.00
(Signaturef'ritle)
If the shipment moves between two ports by a carrier by water,the law requires that the bill of DELIVERED BY:
ladingshall state whether it is"carrier's or shipper's weight"NOTE-where the rate is dependent DOT LABELS DOT
PP 9 P 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
PROPERDOT CHECKED FOR RECEIVED BY:
FREIGHT CHARGES NAME ON ALL PROPER
Subject to Section 7 of the conditions,if this shipment is If charges are to be PACKAGES SEALING
to be delivered to the consignee without recourse on the prepaid,write or
consignor,the consignor shall sign the following stamp here,'TO BE
Statement: PREPAID" AIR CARGO PELIGRO DATE:
ONLY LABEL
The carrier shall not make delivery of this shipment APPLIED
without payment of freight and all other lawful charges.
SIGNATURE HEREBY CONFIRMS
PLANT SHIPPING THAT QUANTITY SPECIFIED IS
(Signature of Consignor) / CORRECT AND RECEIVED IN
GOOD CONDITION