HomeMy WebLinkAbout326928 06/29/18 / CITY OF CARMEL, INDIANA VENDOR: 368571
ONE CIVIC SQUARE HERITAGE CRYSTAL CLEAN, LLC CHECK AMOUNT: $********65.00*
ja? CARMEL, INDIANA 46032 13621 COLLECTIONS CENTER DRIVE CHECK NUMBER: 326928
M,iTON.�. CHICAGO IL 60693-0136 CHECK DATE: 06/29/18
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 15149535 65.00 OTHER EXPENSES
VOUCHER NO. 185756 WARRANT NO. ALLOWED 20 Prescribed by State Board of Accounts City Form No. 201(Rev 1995)
Vendor # 368571 IN SUM OF$ ACCOUNTS PAYABLE VOUCHER
HERITAGE-CRYSTAL CLEAN, LLC CITY OF CARMEL
13621 COLLECTIONS CENTER DRIVE An invoice or bill to be properly itemized must show: kind of service,where performed,
CHICAGO, IL 60693-0136 dates service rendered, by whom, rates per day, number of hours, rate per hour,
numbers of units, price per unit,etc.
Payee
65.00 368571 Purchase Order No.
ON ACCOUNT OF APPROPRATION FOR HERITAGE-CRYSTAL CLEAN, LLC Terms
Carmel Wasterwater Utilitv 13621 COLLECTIONS CENTER DRIVE Due Date
BOARD MEMBERS
I hereby certify that that attached invoice CHICAGO, IL 60693-0136
(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
15149535 01-7362-06 $65.00 and received except 6/13/2018 15149535 $65.00
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
Heritage-Crystal Clean, LLC Invoice
Billing Inquiries:(877)938-7948
c� HERITAGE-CRYSTAL CLEAN,LLC custsery@crystal-clean.com
�+/- 2175 Point Boulevard,Suite 375
C rS l a I Elgin,IL 60123 Remit to: 13621 COLLECTIONS
CENTER DRIVE
C
my ean® CHICAGO,IL 60693-0136
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• 15149535
• 06/04/2018
• 222055
• $65.00
• $0.00
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ATTN:ACCOUNTS PAYABLE Subject to finance charges if payment not received by 07/04/18
9609 HAZEL DELL PKWY
INDIANAPOLIS IN 46280-2935 • •- • • • http://wvvw.hccquickconnectcom
"INST1111111 • DKL FKK PKM
Service Location PO No: Service Agreement: Release Info:
INDIANAPOLIS I P102474 CCOS SA 98548
Svc Date Work Order Product Description/Comment Equip QTY Unit Price Tax Amt Total Cost
06/04/2018 00-OOB72EL 64G TOTER USED OIL FILTER PICK-UP 1 $65.00 $0.00 $65.00
Item Total: $65.00
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This form(invoice)is deemed part of the above referenced service Agreement between Heritage-Crystal Clean,LLC and the identified customer and all terms and conditions and certifications contained therein are deemed apart hereof.
_________________________________________________________________________________________________________________________________________________________________________________________________.
TO ENSURE PROPER CREDIT PLEASE INCLUDE THIS PORTION WITH YOUR PAYMENT
Heritage-Crystal Clean LLC Remittance CITY OF CARMEL
Current Charges: Invoice Number: 9609 HAZEL DELL PKWY
$65.001 15149535 INDIANAPOLIS IN 46280
Total Amt Due: Amount Enclosed:
$65.001 1 Change of Address? FPayment Due Upon Receipt
Check box and complete other side.
Account Number: Remit To:
222055
PO Number:
HERITAGE-CRYSTAL CLEAN, LLC
13621 COLLECTIONS CENTER DRIVE
CHICAGO, IL 60693-0136
0001:0001