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HomeMy WebLinkAbout325730 05/30/18 0�/ ,"? CITY OF CARMEL, INDIANA VENDOR: 037000 ® ONE CIVIC SQUARE CARGILL INC-SALT DIVISION CHECK AMOUNT- $****15,198.62* x. %, CARMEL, INDIANA 46032 PO BOX 415927 CHECK NUMBER: 325730 y,�.`roN"`O� BOSTON MA 02241-5927 CHECK DATE: 05/30/18 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 601 5023990 2904110290 2,546.64 OTHER EXPENSES 601 5023990 2904112822 2,549.68 OTHER EXPENSES 601 5023990 2904115968 2,519.23 OTHER EXPENSES 601 5023990 2904118073 2,513.14 OTHER EXPENSES 601 5023990 2904120097 2,515.17 OTHER EXPENSES 601 5023990 2904120473 2,554.76 OTHER EXPENSES VOUCHER NO. 181632 WARRANT NO. Prescribed by State Board of Accounts City Form No.201(Rev 1995) ALLOWED 20 Vendor # 37000 IN SUM of$ ACCOUNTS PAYABLE VOUCHER CARGILL INC-SALT DIVISION CITY OF CARMEL P O BOX 415927 An invoice or bill to be properly itemized must show: kind of service,where performed, BOSTON, MA 02241-5927 dates service rendered, by whom, rates per day, number of hours, rate per hour, numbers of units, price per unit,etc. Payee $15,198.62 37000 Purchase Order No. ON ACCOUNT OF APPROPRATION FOR CARGILL INC-SALT DIVISION Terms Carmel Water Utility P O BOX 415927 Due Date BOARD MEMBERS I hereby certify that that attached invoice(s), BOSTON, MA 02241-5927 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 .2904110290 01-6180-03 $2,546.64 and received except 5/21/2018 2904110290 $2,546.64 2904112822 01-6180-03 $2,549.68 5/21/2018 2904112822 $2,549.68 2904115968 01-6180-03 $2,519.23 5/21/2018 2904115968 $2,519.23 2904118073 01-6180-03 $2,513.14 5/21/2018 2904118073 $2,513.14 2904120097 01-6180-03 $2,515.17 5/21/2018 2904120097 $2,515.17 2904120473 01-6180-03 $2,554.76 5/21/2018 2904120473 $2,554.76 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 cA/A% @ INVOICE rfill2904112822 Cargill Salt Remit To: Cargill,Incorporated A business of CARGILL,INCORPORATED PO Box 415927 15407 MCGINTY ROAD WEST Boston MA 02241-5927 WAYZATA MN 55391 USA USA Bill-To: CARMEL WATER UTILITIES Ship-To: CARMEL WATER UTILITIES CARMEL CITY OF CARMEL WATER OPERATIONS 10675 3450 W 131ST ST 10675 N GRAY RD CARMEL IN 46074-8267 CARMEL IN 46033-9703 USA USA Sold-To: CARMEL WATER UTILITIES CARMEL CITY OF Billing Date: 05/11/2018 Sales Order: 3764850 Inco Terms: DLD DESTINATION Reference Date: 05/11/2018 Shipment Date: 05/11/2018 Your Purchase Order: W180fX I Gross Weight: 50,240.000 LB Currency: USD Payment Terms: NET 30 DAYS FROM DATE OF INVOICE Cargill Delivery No.: 806337133 Due Amt: 2,549.68 Due Date: 06110/2018 (All date format in MM/DD/YYYY) Line Product Sales Product Priced Quantity UoM Price Extended No: Code Contract Description Shipped Quantity Amount 1 100011920 100035057 ROCK INDUST BULK NSF@60 25.120 ST 101.50000 USD/ST 2,549.68 Net Weight:50,240.000 LB 50,240.000 LB Bill of Lading:2006306269 Place of Loading 5204 RIVER RD Subtotal 2,549.68 CINCINNATI OH 45233-1643 USA Sales Tax 0.00 INVOICE TOTA USD__--2,549.64- This ,549.6 -This sale may be subject to applicable discounts,allowances or rebates which are not reflected in the price shown. All invoices must be paid within the terms quoted. We reserve the right to charge interest on overdue accounts. For ACH(non CTX)and wire transfers,remittance advice should be emailed to remitdetail@cargill.com or faxed to 952-367-1672 in order to ensure accurate&timely allocation of funds. Billing Enquiries Commercial: Email: Food: 800-553-7879 Internet: Page 1 of 1 Cd/1 ® INVOICE rfill 2904110290 Cargill Salt Remit To: Cargill,Incorporated A business of CARGILL,INCORPORATED PO Box 415927 15407 MCGINTY ROAD WEST Boston MA 02241-5927 WAYZATA MN 55391 USA USA Bill-To: CARMEL WATER UTILITIES Ship-To: CARMEL WATER OPERATONS CARMEL CITY OF CARMEL WATER OPERATIONS 4915 3450 W 131 ST ST 4915 E 106TH ST CARMEL IN 46074-8267 CARMEL IN 46033-9703 USA USA Sold-To: CARMEL WATER UTILITIES CARMEL CITY OF Billing Date: 05/10/2018 Sales Order: 3764829 Inco Terms: DLD DESTINATION Reference Date: 05/10/2018 Shipment Date: 05/10/2018 Your Purchase Order: W18ge<5 Gross Weight: 50,180.000 LB Currency: USD Payment Terms: NET 30 DAYS FROM DATE OF INVOICE Cargill Delivery No.: 806334239 Due Amt: 2,546.64 Due Date: 06/0912018 (All date format in MM/DD/YYYY) Line Product Sales Product Priced Quantity UoM Price Extended No: Code Contract Description Shipped Quantity Amount 1 100011920 100035055 ROCK INDUST BULK NSFOR60 25.090 ST 101.50000 USD/ST 2,546.64 Net Weight:50,180.000 LB 50,180.000 LB Bill of Lading:2006306302 Place of Loading 5204 RIVER RD Subtotal 2,546.64 CINCINNATI OH 45233-1643 USA Sales Tax 0.00 INVOICE TOTA ---- --- - -- -- - -- - - - - - - - - --- - ---- -USD 2,546.64- This sale may be subject to applicable discounts,allowances or rebates which are not reflected in the price shown. All invoices must be paid within the terms quoted. We reserve the right to charge interest on overdue accounts. For ACH(non CTX)and wire transfers,remittance advice should be emailed to remitdetail@cargill.com or faxed to 952-367-1672 in order to ensure accurate&timely allocation of funds. Billing Enquiries Commercial: Email: Food: 800-553-7879 Internet: Page 1 of 1 Cd/1 INVOICE r#111 2904120473 Cargill Salt Remit To: Cargill,Incorporated A business of CARGILL,INCORPORATED PO Box 415927 15407 MCGINTY ROAD WEST Boston MA 02241-5927 WAYZATA MN 55391 USA USA Bill-To: CARMEL WATER UTILITIES Ship-To: CITY OF CARMEL CARMEL CITY OF CARMEL WATER OPERATIONS 5484 3450 W 131 ST ST 5484 E 126TH ST CARMEL IN 46074-8267 CARMEL IN 46033-9289 USA USA Sold-To: CARMEL WATER UTILITIES CARMEL CITY OF Billing Date: 05/16/2018 Sales Order: 3764856 Inco Terms: DLD DESTINATION Reference Date: 05/ Shipment Date: 05/16/2018 Your Purchase Order: 8005 Gross Weight: 50,340.000 LB Currency: USD Payment Terms: N DAYS FROM DATE OF INVOICE Cargill Delivery No.: 806345497 Due Amt: 2,554.76 Due Date: 06/15/2018 (All date format in MM/DD/YYYY) Line Product Sales Product Priced Quantity UoM Price Extended No: Code Contract Description Shipped Quantity Amount 1 100011920 100035053 ROCK INDUST BULK NSF@60 25.170 ST 101.50000 USD/ST 2,554.76 Net Weight:50,340.000 LB 50,340.000 LB Bill of Lading:2006306273 Place of Loading 5204 RIVER RD Subtotal 2,554.76 CINCINNATI OH 45233-1643 USA Sales Tax 0.00 INVOICE TOTA USD_ 2,554.7 This sale may be subject to applicable discounts,allowances or rebates which are not reflected in the price shown. All invoices must be paid within the terms quoted. We reserve the right to charge interest on overdue accounts. For ACH(non CTX)and wire transfers,remittance advice should be emailed to remitdetail@cargill.com or faxed to 952-367-1672 in order to ensure accurate&timely allocation of funds. Billing Enquiries Commercial: Email: Food: 800-553-7879 Internet: Page 1 of 1 c4/1 INVOICE rdill 2904120097 Cargill Salt Remit To: Cargill,Incorporated A business of CARGILL,INCORPORATED PO Box 415927 15407 MCGINTY ROAD WEST Boston MA 02241-5927 WAYZATA MN 55391 USA USA Bill-To: CARMEL WATER UTILITIES Ship-To: CARMEL WATER OPERATONS CARMEL CITY OF CARMEL WATER OPERATIONS 4915 3450 W 131 ST ST 4915 E 106TH ST CARMEL IN 46074-8267 CARMEL IN 46033-9703 USA USA Sold-To: CARMEL WATER UTILITIES CARMEL CITY OF Billing Date: 05/16/2018 Sales Order: 3777232 Inco Terms: DLD DESTINATION Reference Date: 05/16/2018 Shipment Date: 05/16/2018 Your Purchase Order: W1800 /1-) Gross Weight: 49,560.000 LB Currency: USD Payment Terms: NET 40 DAYS FROM DATE OF INVOICE Cargill Delivery No.: 806346852 Due Amt: 2,515.17 Due Date: 06/15/2018 (All date format in MM/DD/YYYY) Line Product Sales Product Priced Quantity UoM Price Extended No: Code Contract Description Shipped Quantity Amount 1 100011920 100035055 ROCK INDUST BULK NSF®60 24.780 ST 101.50000 USD/ST 2,515.17 Net Weight:49,560.000 LB 49,560.000 LB Bill of Lading:2006325500 Place of Loading 5204 RIVER RD Subtotal 2,515.17 CINCINNATI OH 45233-1643 USA Sales Tax 0.00 INVOICE TOTA USD 2,515.1 This sale may be subject to applicable discounts,allowances or rebates which are not reflected in the price shown. All invoices must be paid within the terms quoted. We reserve the right to charge interest on overdue accounts. For ACH(non CTX)and wire transfers,remittance advice should be emailed to remitdetail@cargill.com or faxed to 952-367-1672 in order to ensure accurate&timely allocation of funds. Billing Enquiries Commercial: Email: Food: 800-553-7879 Internet: Page 1 of 1 cA/1 INVOICE rfill2904115968 Cargill Salt Remit To: Cargill,Incorporated A business of CARGILL,INCORPORATED PO Box 415927 15407 MCGINTY ROAD WEST Boston MA 02241-5927 WAYZATA MN 55391 USA USA Bill-To: CARMEL WATER UTILITIES Ship-To: CARMEL WATER UTILITIES CARMEL CITY OF CARMEL WATER OPERATIONS 4425 3450 W 131 ST ST 4425 E 126TH ST CARMEL IN 46074-8267 CARMEL IN 46033-2401 USA USA Sold-To: CARMEL WATER UTILITIES CARMEL CITY OF Billing Date: 05/14/2018 Sales Order: 3764843 Inco Terms: DLD DESTINATION Reference Date: 05/14/2018 Shipment Date: 05/14/2018 Your Purchase Order: W18MAYS �� 5 Gross Weight: 49,640.000 LB Currency: USD Payment Terms: NET FROM DATE OF INVOICE Cargill Delivery No.: 806340465 Due Amt: 2,519.23 Due Date: 06/1312018 (All date format in MM/DD/YYYY) Line Product Sales Product Priced Quantity UoM Price Extended No: Code Contract Description Shipped Quantity Amount 1 100011920 100035056 ROCK INDUST BULK NSF@60 24.820 ST 101.50000 USD/ST 2,519.23 Net Weight:49,640.000 LB 49,640.000 LB Bill of Lading:2006306228 Place of Loading 5204 RIVER RD Subtotal 2,519.23 CINCINNATI OH 45233-1643 USA Sales Tax 0.00 INVOICE TOTA USD 2,519.2 This sale may be subject to applicable discounts,allowances or rebates which are not reflected in the price shown. All invoices must be paid within the terms quoted. We reserve the right to charge interest on overdue accounts. For ACH(non CTX)and wire transfers,remittance advice should be emailed to remitdetail@cargill.com or faxed to 952-367-1672 in order to ensure accurate&timely allocation of funds. Billing Enquiries Commercial: Email: Food: 800-553-7879 Internet: Page 1 of 1 Cd104% INVOICE rflil2904118073 Cargill Salt Remit To: Cargill,Incorporated A business of CARGILL,INCORPORATED PO Box 415927 15407 MCGINTY ROAD WEST Boston MA 02241-5927 WAYZATA MN 55391 USA USA Bill-To: CARMEL WATER UTILITIES Ship-To: CARMEL WATER UTILITIES CARMEL CITY OF CARMEL WATER OPERATIONS 10675 3450 W 131ST ST 10675 N GRAY RD CARMEL IN 46074-8267 CARMEL IN 46033-9703 USA USA Sold-To: CARMEL WATER UTILITIES CARMEL CITY OF Billing Date: 05/15/2018 Sales Order: 3764853 Inco Terms: DLD DESTINATION Reference Date: 05/15/20 Shipment Date: 05/15/2018 Your Purchase Order: 004 Gross Weight: 49,520.000 LB Currency: USD Payment Terms: N S FROM DATE OF INVOICE Cargill Delivery No.: 806343644 Due Amt: .2,513.14 Due Date: 06/14/2018 (All date format in MM/DD/YYYY) Line Product Sales Product Priced Quantity UoM Price Extended No: Code Contract Description Shipped Quantity Amount 1 100011920 100035057 ROCK INDUST BULK NSF@60 24.760 ST 101.50000 USD/ST 2,513.14 Net Weight:49,520.000 LB 49,520.000 LB Bill of Lading:2006306309 Place of Loading 5204 RIVER RD Subtotal 2,513.14 CINCINNATI OH 45233-1643 USA Sales Tax 0.00 INVOICE TOTA USD 2,513.1 This—slid may be subject to applicable discounts,allowances or rebates which are not reflected in thprice--shown. All invoices must be paid within the terms quoted. We reserve the right to charge interest on overdue accounts. For ACH(non CTX)and wire transfers,remittance advice should be emailed to remitdetail@cargill.com or faxed to 952-367-1672 in order to ensure accurate&timely.allocation of funds. Billing Enquiries Commercial: Email: Food: 800-553-7879 Internet: Page 1 of 1 PACKING LIST Cdr fill Ship From: 1ADF b 7,3 Ship To: 2500017294 CINCINNATI US CS Pla�7#/ � CARMEL WATER OPERATIONS 10675 5204 RIVER RD 10675 N GRAY RD CINCINNATI OH 45233-1643 CARMEL,IN,US,46033-9703 Delivery Number 806337133 Master BOL Number: 2006306269 Shipment Date: MAY.11,2018 Stop BOL Number: 20063062690020 Delivery Date: MAY.11,2018 Load Sequence: 0020 Carrier SCAC: RVBD Shipping Conditions: Full Truck Load Carrier Name: RIVER BEND Container frailer Id: 178 Incoterms: DLD,DESTINATION Seal Numbers: Item Material Material Description Customer- Batch Qty Net Gross Volume Sales Order Customer PO Number Material UPC Weight/ Weight/ coo Item Level notes UOM UOM UOM UOM 10 100011920 ROCK INDUST BULK 50,240.000 50,240.000 50,240.000 653.120 0003764850 NSF®60 LB LB LB FT3 -- - W18004 ^-- -- Packaging Materials: GRAND TOTAL: 50,240.000 LB 50,240.000 50,240.000 653.120 LB LB FT3 Shipping Instructions: JERRY CLOUD 317-571-2669 JCLOUD@CARMEL.IN.GOV 2ND CONTACT KEN RHODES 317-571-2669 CUSTOMER REQUESTS REED WALKER AT RIVERBEND TO MAKE DELIVERIES NEEDS TO BE A SEMI DUMP AND NOT A FULL DUMP Customer Unloading Instructions: 3 , Page: 1/1 MAY.11,2018 14:19 EST PACKING LIST Cor ill Ship From: 1ADF Ship To: 2000003085 CINCINNATI US CS CARMEL WATER OPERATIONS 4915 5204 RIVER RD 4915'E 106TH ST CINCINNATI OH 45233-1643 CARMEL, IN,US,46033-9703 Delivery Number 806334239 Master BOL Number: 2006306302 Shipment Date: MAY.10,2018 Stop BOL Number: 20063063020020 Delivery Date: MAY.10,2018 Load Sequence: 0020 Carrier SCAC: RVBD Shipping Conditions: FTL No Consolidation Carrier Name: RIVER BEND Container/Trailer Id: 178 Inco terms: DLD,DESTINATION Seal Numbers: Item Material Material Description Customer- Batch Qty Net Gross Volume Sales Order Customer PO Number Material UPC Weight/ Weight/ coo Item Level notes UOM UOM UOM UoM 10 100011920 ROCK INDUST BULK 50,180.000 50,180.000 50,180.000 652.340 0003764829 NSF060 LB LB LB FT3 W18001 - - Packaging Materials: GRAND TOTAL: 50,180.000 LB 50,180.000 50,180.000 652.340 LB LB FT3 Shipping Instructions: COA&BOL requirements:Email tojcloud@carmel.in.gov Delivery contact:Jerry Cloud 317-571-2669. Customer Unloading Instructions: cBrv�D BY LS�l C DATE 1-1 POS._ AC r# �8. lUSB ah sty sc, Page:1/1 MAY.10,2018 13:58 EST PACKING LIST Ship From: 1ADF Ship To: 2500017293 CINCINNATI US CS CARMEL WATER OPERATIONS 5484 5204 RIVER RD 5484 E 126TH ST CINCINNATI OH 45233-1643 CARMEL,IN,US,46033-9289 Delivery Number 806345497 Master BOL Number: 2006306273 Shipment Date: MAY.16,2018 Stop BOL Number: 20063062730020 Delivery Date: MAY.15,2018 Load Sequence: 0020 CarrierSCAC: RVBD Shipping Conditions: Full Truck Load Carrier Name: RIVER BEND Container/Trailer Id: 178 Incoterms: DLD,DESTINATION Seal Numbers: Item Material Material Description Customer- Batch Qty Net Gross Volume Sales Order Customer PO Number Material UPC Weight/ Weight/ COO Item Level notes UoM UoM UoM UoM 10 100011920 ROCK INDUST BULK 50,340.000 50,340.000 50,340.000 654.420 0003764856 NSF®60 LB LB LB FT3 W18005 - Packaging Materials: GRAND TOTAL: 50,340.000 LB 50,340.000 50,340.000 654.420 LB LB FT3 Shipping Instructions: JERRY CLOUD 317-571-2669 JCLOUD@CARMEL.IN.GOV 2ND CONTACT KEN RHODES 317-571-2669 CUSTOMER REQUESTS REED WALKER AT RIVERBEND TO MAKE DELIVERIES NEEDS TO BE A SEM/I_DUMP AND NOT A FULL DUMP L Customer Unloading Instructions: McEryw DATE 5 . %-I A��cr#�'"�"..._"' 145 6. USs-1/6.4- 5 -�•► l�- Page: 1/1 MAY.16,2018 08:41 EST PACKING LIST Ship From: 1ADF Ship To: 2000003085 CINCINNATI US CS CARMEL WATER OPERATIONS 4915 5204 RIVER RD 4915 E 106TH ST CINCINNATI OH 45233-1643 CARMEL,IN,US,46033-9703 Delivery Number 806346852 Master BOL Number: - 2006325500 Shipment'Date: __ MAY.16,2018 - -Stop BOL Number: 20063255000020 Delivery Date: MAY.17,2018 Load Sequence: 0020 Carrier SCAC: RVBD Shipping Conditions: FTL No Consolidation Carrier Name: RIVER BEND Container/frailer Id: 178 Incoterms: DLD,DESTINATION Seal Numbers: Item Material Material Description Customer- Batch Qty Net Gross Volume Sales Order Customer PO Number Material UPC Weight/ Weight/ COO Item Level notes UoM UoM UOM UoM 10 100011920 ROCK INDUST BULK 49,560.000 49,560.000 49,560.000 644.280 . 0003777232 NSF060 LB LB LB FT3 W18001 Packaging Materials: GRAND TOTAL: 49,560.000 LB 49,560.000 49,560.000 644.280 LB LB FT3 Shipping Instructions:. COA&BOL requirements:Email to jcloud@carmel.in.gov [� _ Delivery contact:Jerry Cloud 317-571-2669. Customer Unloading Instructions: 33ci0 Received : Date :. PO #� ACCT s� ,VSE • Page:1/1 MAY.16,2018 14:27 EST P, PACKING LIST,;::';`' c4rfill - y Ship From: 1ADF Ship To: 2500017292 CINCINNATI US CS CARMEL WATER OPERATIONS 4425 5204 RIVER RD 4425 E 126TH ST CINCINNATI OH 45233-1643 CARMEL,IN,US,46033-2401 Delivery Number 806340465 Master BOL Number: 2006306228 Shipment Date: MAY.14,2018 Stop BOL Number: 20063062280020 Delivery Date: MAY.11,2018 Load Sequence: 0020 Carrier SCAC: RVBD Shipping Conditions: Full Truck Load Carrier Name: RIVER BEND Container/Trailer Id: 178 Incoterms: DLD,DESTINATION Seal Numbers: Item Material Material Description Customer- Batch Qty Net Gross Volume, Sales Order Customer PO Number Material UPC Weight/ Weight/ COO Item Level notes UOM UOM UOM UOM 10 100011920 ROCK INDUST BULK 49,640.000 49,640.000 49,640.000 645.320 . 0003764843 NSF®60 LB LB LB FT3 W18003 CUSTOMER REQUESTS REED WALKER AT RIVERBEND TO MAKE DELIVERIES NEEDS TO BE A SEMI DUMP AND NOT A FULL DUMP Packaging Materials: GRAND TOTAL: 49,640.000 LB 49,640.000 49,640.000 645.320 LB LB FT3 Shipping Instructions: JERRY CLOUD 317-571-2669 JCLOUD@CARMEL.IN.GOV 2ND CONTACT KEN RHODES 317-571-2669 Customer Unloading Instructions: CUSTOMER REQUESTS REED WALKER AT RIVERBEND TO MAKE DELIVERIES NEEDS TO BE A SEMI DUMP AND NOT A FULL DUMP RBGBIYBD SY a .`. SS5 DATB - Sts-1Q _ - USE �lah+ S Sa1+-1A P%fit Page: 1/1 MAY.14,2018 13:49 EST I PACKING LIST Cdr ill Ship From: 1ADF Ship To: 2500017294 CINCINNATI US CS CARMEL WATER OPERATIONS 10675 5204 RIVER RD 10675 N GRAY RD CINCINNATI OH 45233-1643 CARMEL,IN,US,46033-9703 Delivery Number 806343644 Master BOL Number: 2006306309 Shipment Date: MAY.15,2018 Stop BOL Number: 20063063090020 Delivery Date: MAY.14,2018 Load Sequence: 0020 Carrier SCAC: RVBD Shipping Conditions: Full Truck Load Carrier Name: RIVER BEND Container/Trailer Id: Incoterms: DLD,DESTINATION Seal Numbers: Item Material Material Description Customer- Batch Qty Net Gross Volume Sales Order Customer PO Number Material UPC Weight/ WeighU c00 Item Level notes UOM UOM UOM UOM 10 100011920 ROCK INDUST BULK 49,520.000 49,520.000 49,520.000 643.760 0003764853 NSF®60 LB LB LB FT3 Packaging Materials: GRAND TOTAL: 49,520.000 A LB 49,520.000 49,520.000 643.760 LB LB FT3 Shipping Instructions: JERRY CLOUD 317-571-2669 JCLOUD@CARMEL.IN.GOV 2ND CONTACT KEN RHODES 317-571-2669 CUSTOMER REQUESTS REED WALKER AT RIVERBEND TO MAKE DELIVERIES NEEDS TO BE A SEMI DUMP AND NOTA FULL DUMP �C�' 6ysss,. - Customer Unloading Instructions: Received: Date : I6-1 g PO # : ' ACCT # : Use • Pldh sa 11' Page:1/1 MAY.15,2018 14:02 EST