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HomeMy WebLinkAbout326784 06/29/18 5y p�C�gyf a! 4� CITY OF CARMEL, INDIANA VENDOR: 372296 ® �• ONE CIVIC SQUARE JACKSON OIL&SOLVENTS, INC. CHECK AMOUNT: $*****1,200.00* s ;a CARMEL, INDIANA 46032 75 REMITTANCE DRIVE,DEPT 6988 CHECK NUMBER: 326784 9%ir`ori"�°`. CHICAGO IL 60675-6988 CHECK DATE: 06/29/18 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 651 5023990 001104034 1,200.00 OTHER EXPENSES VOUCHER NO. 185838 WARRANT NO. ALLOWED 20 Prescribed by State Board of Accounts City Form No. 201 (Rev 1995) Vendor # 372296 IN SUM OF$ ACCOUNTS PAYABLE VOUCHER JACKSON OIL&SOLVENTS INC CITY OF CARMEL 75 REMITTANCE DRIVE An invoice or bill to be properly itemized must show: kind of service,where performed, DEPT 6988 dates service rendered, by whom, rates per day, number of hours, rate per hour, CHICAGO, IL 60675-6988 numbers of units, price per unit, etc. Payee $1,200.00 372296 Purchase Order No. ON ACCOUNT OF APPROPRATION FOR JACKSON OIL&SOLVENTS INC Terms Carmel Wasterwater Utility 75 REMITTANCE DRIVE Due Date BOARD MEMBERS DEPT 6988 I hereby certify that that attached invoice CHICAGO, IL 60675-6988 (s), or bill(s)is(are)true and correct and that PO# ACCT# the materials or services itemized thereon DATE INVOICE# Description DEPT# INVOICE# Fund# AMOUNT for which charge is made were ordered and DEPT# FUND# (or note attached invoice(s)or bill(s)) AMOUNT 001104034 01-7363-06 $1,200.00 and received except 6/21/2018 001104034 $1,200.00 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 JACKSON OIL & SOLVENTS, INC. Original Invoice 75 REMITTANCE DRIVE DEPT 6988 Page 1 CHICAGO,IL 60675-6988 (317)636-4421 * (800)221-4603 Invoice No: 001104034 1 Invoice Date: 06/15/2018 Order No: 128582800 Load Date: 06/11/2018 Purchase Order No: 0 Reference No: 0 Bill of Lading No: 0 Shipped Via: JACKSON OIL GEN DEL. 1 Bill To: 742600 Ship To: 742600 CARMEL WASTEWATER-SEWER CARMEL WWTP 9609 HAZEL DELL PARKWAY 10601 HAZEL DELL PKWY INDIANAPOLIS,IN 46280 INDIANAPOLIS,IN 462800000 Product Description Price Order Qty Ship Qty Extended Price 98FFS EA FUEL FILTER&TRANSFER 1,200.000 1.00 1.00 $1,200.00 INSX IN SALES TAX EXEMPT 0.000% 1,200.00 $0.00 Date Due: 07/15/2018 Invoice Total: $1,200.00 Please pay from invoice and remit to address above.