HomeMy WebLinkAbout322899 03/12/18 VOUCHER NO. 174279 WARRANT NO. Prescribed by State Board of Accounts City Form No.201(Rev 1995)
ALLOWED 20
Vendor# 367211 IN SUM OF$ ACCOUNTS PAYABLE VOUCHER
WATER SOLUTIONS UNLIMITED INC CITY OF CARMEL
8824 UNION MILLS DR An invoice or bill to be properly itemized must show: kind of service,where performed,
PO BOX 157 dates service rendered, by whom, rates per day,number of hours, rate per hour,
CAMBY, IN 46113 numbers of units, price per unit,etc.
Payee
$4,787.00 367211 Purchase Order No.
ON ACCOUNT OF APPROPRATION FOR WATER SOLUTIONS UNLIMITED INC Terms
Carmel Water Utility 8824 UNION MILLS DR Due Date
BOARD MEMBERS PO BOX 157
- -- - ------- --
I hereby certify that that attached invoice(s), CAMBY, IN 46113
or bill(s)is(are)true and correct and that
PO# ACCT# the materials or services itemized thereon for DATE INVOICE# Description
DEPT# INVOICE# Fund# AMOUNT which charge is made were ordered and DEPT# FUND# (or note attached invoice(s)or bill(s)) AMOUNT
43739 01-6180-03 $4,787.00 and received except 2/28/2018 43739 $4,787.00
I hereby certify that the attached invoice(s),or bill(s),is(are)true and correct and I have audited
same in accordance with IC 5-11-10-1.6
Cost distribution ledger classification if claim paid motor vehicle highway fund. , 20_
Clerk-Treasurer
WATER -
SOLUTIONS
- UNLIMITED I NVO 1C.E.:.
.
Invoice Number: . 43739
::P. O:Box 157
8824 Union Mills Dr.:CA .: :..:
Invoice Date:: .:: Feb 23 2018
M BY;:I:N:46113 Page:. 1.
Voice: (317):736-6868
Fax: (317)736-4022
=113111T0 Ship°toy
CARMEL UTILITIES CARMEL 6TILITIES
3450W.-:131ST STREET :: 491.5 E. 106TH
.CARMEL, IN 46074 PLANTA. a.
.:.USA CARMEL, N 46033
. .. ..... USA
,_, � CustomerlD � '��� WSUDelivery-Receipt No � ' PaymentTe�ms � f.
- :---------CARMEL----- --50161-03835^ ``-- —
Net 30.Days
_.,;: SlippmgMethod ,-v�� „� ',.,��v ShipDate
DH DAVID:HARVEY WSU-CAM.:; 2/22%18 3/25/18
_. .
..:
Quantity � Item �`�r� #M, , Deser�ptwn ;- v�ntJmt Price �`�'� Amount` _
4,400:00 FLUORIDE. LBS;.SODIUM FLUORIDE 50#BAG 1.08 4,7152.00
1.00: DELIVERY CHG 35.00 35.00
wso
qw
.....
Subtotal 4,787.0. ..:.
Sales Tax
Subtotal Invoice Amount 4,787:00
Freight Amount : .: :..:.
Check/Credit Memo:Not :: : .....
w.
I Lw
.., x,787 00
Please remit payment to: Please include your invoice number on your check.
Water Solutions-Unlimited, Inc].:--
P.O. Box 157:..:.
:Camby, IN 46113
. ..
WATER
SOLUTIONS STRAIGHT BILL OF LADING-ORIGINAL-NOT NEGOTIABLE
UNLIMITED
FROM: WATER SOLUTIONS UNLIMITED SOLD TO: CARMEL
8824 UNION MILLS DR. CARMEL UTILITIES
CAMBY,IN USA
317-738-3666
v .gehvsu.tom SHIP TO: CARMEL UTILITIES
US DOT HAZMAT REG NO.:0610816 551 020Y ATTN: JERRY CLOUD
4915 E.108TH ST.
CARMEL,IN 46033
317-716-3909
CUSTID DELR/ERYRECEIPTNO SALESID SHIPWA PO NUMBE SHIPDATE DELWERY DATE
CARMEL 16103835 DH SU-CAMBY AS 5934 2/2212018 2122/2018
CITY SHIPPED PACKAGING HM DESCRIPTION NETWT(LB) GROSS WT(LB) CLASS
88 50 LB BAG X UN1690,SODIUM FLUORIDE SOLID,6.1,III 4400 4400
Reveired . 6 i
Date :
PO # :
ACCT
use.: ►►=r�,� ,a moi+ 5
DELI Y�INS,�TRUCTION DE IVER KI ' T 1 AND:,
SKID To
IAN-1 F
For Chemical Emergency Spill,Leak,Fire,Exposure,or Accident,Call CHEMTREC Day or Night-Within USA
and Canada:1-800-424-9300
Saldamt eigmeubjedbmrredlan): 4400 4400
This Is to mdifyM the abava named mutable are prapWy daa fled padeged,marled,end lebded,and are In proper oeaean for barepormrbn a=rdbV to fire Wkable regelati.ama DDE.
NOTE:Where the rola m daperrdam on value,ohtppers are required to state specifically In writing the agreed m dedared value of the property.The agreed or dedered value o} lie property Is hereby epedfi®lly stated by the ahlpper to he not exceeding $
per
COD REMIT TO ADDRESS: COD Amt$ TOTAL CHARGES:$ FREIGHT CHARGES:
COD FEE: Collect q Collect q Prepaid q
Prepaid
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CUSTDMERSAGENT SHIPPERSAGENT
PRINTED NAME PRINTED NAME:
SIGNATURE SIGNATURE: LZ
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