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Home My WebLink About324608 04/25/18 4+�s.CggMf CITY OF CARMEL, INDIANA VENDOR: 359584 3. ONE CIVIC SQUARE BRENNTAG MID SOUTH INC CHECK AMOUNT: $*****2,075.75* '. CARMEL, INDIANA 46032 3796 RELIABLE PARKWAY CHECK NUMBER: 324608 M_roN.L-0 CHICAGO IL 60686 CHECK DATE: 04/25/18 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 601 5023990 960659 917.50 OTHER EXPENSES 601 5023990 960660 1,158.25 OTHER EXPENSES t.tl� VOUCHER NO. 181326 WARRANT NO. Prescribed by State Board of Accounts City Form No.201(Rev 1995) ALLOWED 20 Vendor# 359584 IN SUM OF$ ACCOUNTS PAYABLE VOUCHER BRENNTAG MID-SOUTH INC CITY OF CARMEL 3796 RELIABLE PARKWAY An invoice or bill to be properly itemized must show: kind of service,where performed, CHICAGO, IL 60686-0037 dates service rendered, by whom, rates per day, number of hours, rate per hour, numbers of units, price per unit,etc. Payee $2,075.75 359584 Purchase Order No. ON ACCOUNT OF APPROPRATION FOR BRENNTAG MID-SOUTH INC Terms Carmel Water Utilitv 3796 RELIABLE PARKWAY Due Date BOARD MEMBERS I hereby certify that that attached invoice(s), CHICAGO, IL 60686-0037 PO# ACCT# or bill(s)is(are)true and correct and that 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 960659 01-6180-03 $917.50 and received except 4/18/2018 960659 $917.50 960660 01-6180-03 $1,158.25 4/18/2018 960660 $1,158.25 1 / 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 BRENNTAG AM BRENNTAG MID-SOUTH, INC. 1405 HIGHWAY 136 WEST PO BOX 20 HENDERSON KY 42419-0020 INVOICE#: BMS960659 INV DATE: 4/13/18 * PAGE 1 OF 1 *** DUE DATE: 5/13/18 SOLD TO: SHIP TO: CITY OF CARMEL UTILITIES CARMEL UTILITIES PLT 1 3450 WEST 131ST STREET 4915 E 106 ST CARMEL IN 46074 CARMEL IN 46033 FEDERAL ID #: 610504545 DATE SHIPPED: 4/13/18 TERMS NET 30 DAYS B/L #. . . : 2094418-00 SHIP WHS: 29 SLSPRSN: 293 CUSTOMER # . : 407542 SHIP VIA: OUR TRUCK - PKG CUSTOMER PO#: AC041018 FOB . . : DELIVERED FREIGHT TERM: PREPAID TAX EX# : 356000972-001-9 PRO NUMBER . : 773072343 UNITS SHIPPED PROD # WGT/GAL TOTAL QTY UNIT PRICE EXTENDED -------------------------------------------------------------------------------- 1 .0000 253418 11 .87000 2000.0000# .4050 810.00 2000 .0000 # CYL CHLORINE, LIQUID (BMS ONLY) >A RPK -------------------------------------------------------------------------------- QUESTIONS, CALL 317-898-8632 REMIT TO ADDRESS: BRENNTAG MID-SOUTH, INC 3796 RELIABLE PARKWAY * MERCHANDISE 810.00 * CHICAGO IL 60686-3007 * FUEL SURCHARGE 72.50 *************************************** INS & SEC SURCHARGE 35.00 ----------------- PAID ON OR PRIOR TO 5/13/18 INVOICE TOTAL USD 917.50 PAID AFTER 5/13/18 INVOICE TOTAL USD 935.85 Original Document BRENNTAG BRENNTAG MID-SOUTH, INC. 1405 HIGHWAY 136 WEST PO BOX 20 HENDERSON KY 42419-0020 INVOICE#: BMS960660 INV DATE: 4/13/18 * * PAGE 1 OF 1 ** DUE DATE: 5/13/18 SOLD TO: SHIP TO: CITY OF CARMEL UTILITIES CARMEL WATER, PLANT 5 3450 WEST 131ST STREET 5484 E. 126TH STREET CARMEL IN 46074 CARMEL IN 46032 FEDERAL ID #: 610504545 DATE SHIPPED: 4/13/18 TERMS NET 30 DAYS B/L #. . . : 2094421-00 SHIP WHS: 29 SLSPRSN: 293 CUSTOMER # . : 407542 SHIP VIA: OUR TRUCK - PKG CUSTOMER PO#: AC041018 FOB . . : DELIVERED FREIGHT TERM: PREPAID TAX EX# : 356000972-001-9 PRO NUMBER . : 773072346 UNITS SHIPPED PROD # WGT/GAL TOTAL QTY UNIT PRICE EXTENDED -------------------------------------------------------------------------------- 1 .0000 253418 11 .87000 2000.0000# .4050 810.00 2000.0000 # CYL CHLORINE, LIQUID (BMS ONLY) >A RPK -------------------------------------------------------------------------------- 3 .0000 873311 11 .87000 450.0000# .5350 240 . 75 150 .0000 # CYL CHLORINE, LIQUID (BMS ONLY) >A RPK -------------------------------------------------------------------------------- QUESTIONS, CALL 317-898-8632 REMIT TO ADDRESS: * BRENNTAG MID-SOUTH, INC 3796 RELIABLE PARKWAY * MERCHANDISE 1,050.75 CHICAGO IL 60686-3007 * FUEL SURCHARGE 72.50 *************************************** INS & SEC SURCHARGE 35.00 ----------------- PAID ON OR PRIOR TO 5/13/18 INVOICE TOTAL USD 1,158.25 PAID AFTER 5/13/18 INVOICE TOTAL USD 1,181 .42 Original Document Bill of Ladling'/Shipment—Receipt Page 1 of 2 3�1lN�Ap05TDR�0UTx ,. PHONE: 317-898-8632 - „ ., . .. , �"x/12/18 .17:15:34 B R E N N T DEA' REG NO. ,.0066OlBNY INDIANAPOLIS;. IN -45226. BOL# 2094418-'00 Dely Date: 4/13/18 Ship CARM L: 'UT LIITES". LT 1 Sold CITY, Oi= CARMEL UTILITIES Customer: 4075.42' Sh'ip' To. .11 Ship Date: 4/13/18 0 Shi To: . 49,15 E. 106 ST , To.. 3.450 WEST 131ST STREET. Attn- Frt Terms: PREPAID' Frt CARMEL, IN, 460'83 CARMEL., .IN 46074 FOB. . . : •DELIVERED Taken By : BM29SLD . Sls Ship Via: OUR TRUCK - PKG Placed By: ANDY Recv Hrs: 7:30 AM-- 4:.00 PM Phone#. . :, 317-571-2443 Phone; 317--571-2443 Ext., Phone: 317-571-24 -3 Ext-. Terms.. . : NET 30 DAYS ' Cust PO# : AC041018 QUANTITY ., SHIPPED PACKAGING HM DESCRIPTION M QUANTITY PRODUCT CON ORDERED BACKORDERED .,CODE DEI IF 'LEAK OR. SPILL OCCURS DURING' TRANSPORTATION: CCN3170 EMERGENCY CONTACT: CALL CHEM,TREC TOLL FREE AT 1-800 -424-930 '24. HOURS,/ 7• DAYS FREIGHT CARRIER:, INVOICE TMS VIA EDT OR CARRIER PORTAL, Received : f Date : RQ uN1017; P O # CHLORINE, ACCT # 2.3',(5.1),(8), o- RQ,MARINE POLLUTANT ` POISON--INHALATION HAZARD, ZONE BU s e ERG #., 124 . t fCHLORINE' ' 1 0001 20OG Q000 LB CYL CHLORINE, LIQUID (BMS ONLY). >A RPK 1.0000' 253418 f Loc: 05E05 , g 1 E.Qty: 15.297.5 ' Product picked from: Lot: 2 'Lac: OSE05 Qty: 1.0000 ' Freight Class. . . . 200 .! Weight Per Gallon: 11.87.000 . Net Weight. 2000.000 ' CYL ------------. ___ _____________________-____ _,------ __ ,_____-7--__ a..______, __-_ Total. Net Weight: 2,000 Total Gross Weight: This is to certify that the above named materials are properly classified,described,packaged,marked,'and labeled,and are in propel condition for transportation p ation accordiggto fhe applicable regulations of the Department of Transportation. Signature':of Shipper:., �f'�_ — Loaded By: ..:......... .», »,.,. Checked ;Syr -" Vehicle: Driver: PURCHASER'S,ACCE 'NCE' THE GOODS COVERED BY THIS DOCUMENT SHALL CONSTITUTE ACCEPTANCE BY THE PURCHASER OF ALL TERMS AND CONDITIONS OF SALE STATED ON THE REVERSE SIDE HEREOF. Mil eS"•••••••••••••••»•"•"•»•» »»•••,»». •••»•.»•"•••».••• Time In/Time Out,,•" MOREOVER,PURCHASER,I EB• ACKNOWLEDGES RECEIPT OF ALL REQUIRED SDS(S). Wood Pallets Dlvd » Wood Pallets Rtn: i Plastic Pallets Dlvd Plastic Pallets Rtn . Received by: �. ' �� Date: ,». ( ._ CUSTOMER COPY Bi.1.1 of Ladin"6/Shipment.Receipt ��' Continued from'Previous Page Page 3 at 5 11 N P0MID-SOU�fH �xry 317-8398--3632 DEA' REQ NO:'."gQfabAIY INDIANAPOLIS, 1N .4622b' BOL# . : 2094421-00 De1v Date: 4/13/18 Ship CARk'EL. WATER2,, .PLANT' 5 Sold .. CITY OF. CARMEL. UTILITIES- .,. CustoMer:, 407542" 'Ship To: .. 4, Ship Date: 4/x:3/18,.O Shi To: 5484 E: i26TN ;STREET To: 3450 WEST 131ST'STREET Atte- Frt Terms: PREPAID ' Fri CARMEL IN 460 CARMEL, 'Iii 46074 EOBw w: ` I1E'LIVE ^D Taken By -. BM29SLD ' SIS Ship`'Vi,a: OUR TRUCK -. PKG- Plated By: ANDY r P " RecV H s w 7 w 30 APS-- 4tl q0' M.- Phone# `° 3�7-��1-2w.43 Phone tl,,S.L7- 71�2684 E�ctw PP1Anew ,317'-571-2443 Ex�w, ' Terms. w -.' 'NET' 3q DAYS . Cust PO# w AC041018 QUANTITY:.. SHIPPED PACKAGING HM DESCRIPTION M QUANTITY PRODUCT CON ORDERED. BACK ORDERED CODE DE IF LEAK,,OR .SPILL` OCCURS .'DURING TRANSPORTATION: k - CCN3170 EMERGENCY CONTACT:' CALL CHExTREC. TOLL FRE AT, 1msgO-424-9�W 24..HOURS / 7 DAYS, e C e I v e d 1 Q UN�.017., ate 1 L1 { ( ", CHLORINE, 0 2.5;(5;1�,.f8j; ' ' CCT #: Lo►o3 Rte',MARINE POLLUTANT . .E.RG ION ARI, ,ZONE S *� SON-INHALAT HAZARD se : 1 #. 124 &, }.CHLORIDE 30 g00 6600 LB CYL p ; CHLORINE 7' LIQUID (BMS .ONLY) >A RIP9 3.0000 8373311 .{ Loc A2R1A A2RZ2A gSE06 : Qty 2'».0000 7Y':0000 2: B 11 of-.L ading/Shipment Receipt continued from Previous Pa' e Page 2 .of 5 BRENNTA M D:-5tlU7H PHONE 317-898-8632 4/12/iS 17:16:15 B R E N IV T 311.1 N POST- RD FAX: DEA REG`.Nq OO66O ,BNY• INDIANAPOLIS TN.�4622'6 BaL# 2094421-00 - Del.v Date. 4/1318 , Ship CARMEL°'"oTik,,. PLANT '5 :Sold CITY OF c RMEL UTTL ITIES- Cu 'ismer 407 4 Ship. Ta` 4 Shap late: 4113/18 0 Sh1 To: :5484E 1126TH' STREET To : 1450 34.50 WEST 1318T STT 'ET . Attn- Frt Terms: PREPAID Fri CARMEL;: SN 6a3 '. ' CARMEL.. IN 46074 FOB. . : DELIVERED, Taken By DM299LD' SlE Ship Via: .OUR ,TRUCK PKG Placed By: ANDY Recv Hrs: 7:30 AM- 4:00 ,PM Phone#. 317"571:2443 Phi nea;"317 7i--26'94 Ext�; Phone:. 317. 571-2443. Ext;,, Terns. :: N T.: a DAYS Cult pA ': AC041018 QUANTITY PACKAGING„ HM DESCRIPTION M QUANTITY, PRODUCT CON SHIPPED ORDERED BACKORDERED CODE DE IV,. LEAK, OR SPZLL 'OCCURS DURING TRANSPORTATION: . . CC 1 , C CHE EC TO FRE1-800-424-930 , N3-70 EMLRGkN Y CONTACT. CALL MTR LL AT % e , 24 HOURS / 7 ,DAYS R c ceived: 33-10 RQ.UN10.17., . : D i t e �1 13 8 CHLORINE> 2;:3 `(5:1.),(8 ; p # ; RQ,MARINE POLLUTANT 2. POISON-TNHAL ATIaN 'HAZARD. SONE . . , A C T # IERG . 124 • 1 CHLORINE U ; -_9,000, L'aQQO LB.•, C4'L ` ;; CHLCJRx�I LwxuTD (SMS pNt„Yj. >A RP .OaOa 2534 .8. N 0SE0 „ Qty: 15.2825 Product picked from N i . s• Lot: 2 Loc:. aSE05 Qty: 1<0000 Freight Class. _: X00.. WeightPer' Gallon: . 11,.87000 Net Weight: 2aga;.aQ� CVL w �mContinuad •on Next Pa eg • �� . This is to certify that the above named materials are properly classified,described;packaged,marked,and labeled,and are in proper condition.fbr transporeation accordin g the applicable regitilations:of the Department of Transportation. w Loaded`'By= , . " Checked By: Signat6re'of Shippe :I1_1;:m - Vehicle: " Driver. PURCHASER'S;ACCEPTANCE'OF THE GOODS COVERED BY THIS DOCUMENT SHALL CONSTITUTE ACCEPTANCE - Miles: Ta�rne In/Time, out BY THE PURCHASER Off'ALL TERMS AND CONDITIONS OF SALE STATED ON THE REVERSE SIDE HEREOF. "`"" """' '" " " '" MOREOVER,PU ASER, REB• ACKNOWI EDGES RECEIPT'OF ALL REQUIRED SDS(S). f ",. rv'r 1 Wood all e s' l.vd, Wodd a e s n . Plastic. Pallets Dlvd , Plasta.c- Pal�.ets Rt ..Received bye � .�' ::i�---°''� Date: ,,., "�► - I CUS'rOMER COPY