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Home My WebLink About327144 07/10/18 y o,_CAAb CITY OF CARMEL, INDIANA VENDOR: 359584 \. CHECK AMOUNT: $*****3,745.93* ONE CIVIC SQUARE BRENNTAG MID SOUTH INC CARMEL, INDIANA 46032 3796 RELIABLE PARKWAY CHECK NUMBER: 327144 yiTON�. CHICAGO IL 60686 CHECK DATE: 07/10/18 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1206 4350900 BMS019943 3,745.93 OTHER CONT SERVICES VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201 (Rev.1995) Vendor# 359584 ALLOWED 20 ACCOUNTS PAYABLE VOUCHER BRENNTAG MID SOUTH INC IN SUM OF$ CITY OF CARMEL 3796 RELIABLE PARKWAY An invoice or bill to be properly itemized must show:kind of service,where performed,dates service rendered,by whom,rates per day,number of hours,rate per hour,number of units,price per unit,etc. CHICAGO, IL 60686 Payee $3,745.93 Purchase Order# ON ACCOUNT OF APPROPRIATION FOR Street Department Terms Date Due PO# ACCT# DATE INVOICE# DESCRIPTION DEPT# INVOICE# Fund# AMOUNT Board Members DEPT# FUND# (or note attached invoice(s)or bill(s)) AMOUNT BMS019943 43-509.00 $3,745.93 1 hereby certify that the attached invoice(s),or 6/22/18 BMS019943 $3,745.93 1206 1 101 1206 101 bill(s)is(are)true and correct and that the materials or services itemized thereon for which charge is made were ordered and received except Monday,July 02,2018 Huffman, Dave Director 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 ,20 Cost distribution ledger classification if claim paid motor vehicle highway fund. Clerk-Treasurer Brenntag Mid-South, Inc. B R E N N T_AG 1405 Highway 136 W•P.O. BOX 20 Henderson,Kentucky 42419-0020 INVOICE#: BMS019943 INV DATE: 6/22/18 *** PAGE 1 OF 1 **-* DUE DATE: 7/22/18 SOLD TO: SHIP TO: CARMEL STREET DEPARTMENT CARMEL STREET DEPARTMENT 3400 W. 131ST STREET REFLECTING POOL CARMEL IN 46074 THIRD AVE. & 126TH STREET CARMEL IN 46032 FEDERAL ID # : 610504545 DATE SHIPPED: 6/22/18 TERMS : . NET 30 DAYS -2 6-72-5-i-00 - __. ___ - -- _SH�T_D_liTHS:-- 29_-.SLS_P3R-SIT:---793- -- - CUSTOMER # . : 897255 SHIP VIA: OUR TRUCK - PKG CUSTOMER PO# : REFLECTING FOB . . : DELIVERED FREIGHT TERM: PREPAID TAX EX# : 0031201550-020 PRO NUMBER . . UNITS SHIPPED PROD # WGT/GAL TOTAL QTY UNIT PRICE EXTENDED ----------------------------------------------------------------------------.---- 989 . 9408 365998 10 . 14000 989 . 9408G 3 . 6855 3, 648 .43 1 . 0000 G BULK SODIUM HYPOCHLORITE 12 . 50-o DRUM OFF-330 G POLY TOTE>A BLK -------------------------------------------------------------------------------- QUESTIONS, CALL 317-898-8632 * REMIT TO ADDRESS: * BRENNTAG MID-SOUTH, INC * 3796 RELIABLE PARKWAY * CHICAGO IL 60686-3007 * MERCHANDISE 3, 648 .43 *************************************** FUEL SURCHARGE 97 . 50 ----------------- PAID ON OR PRIOR TO 7/22/18 INVOICE TOTAL USD 3, 745.93 PAID AFTER 7/22/18 INVOICE TOTAL USD 3,820.85 Original Document ** ALL SALES SUBJECT TO AND GOVERNED BY THE TERMS AND CONDITIONS SET FORTH ON THE REVERSE SIDE*** nt Receipt *** Continued from Previous Page *** Page 2 of 3 PHONE: 317-898-8632 6/21/18 21:16:43 g R E IV N �4G x FAX: BOL# . : 2167253--00 Dely Date: 6/22/18 PARTMENT Sold CARMEL STREET DEPARTMENT Customer: 897255 Ship To: 2 Ship Date: 6/22./18 0 Ship From: 29 To: 3400 W. 131ST STREET Attna- Frt Terms: PREPAID Frt Code : TH STREET CARMEL, IN 46014 FOB. . . : DELIVERED Taken By : BM29SLD Sls Per . : 293 Ship Via: OUR TRUCK - PKG Placed By: MIKE Recv Hrs: 8:00 AM- 1:00 PM Phone#. . : 317-•443•`0841 8.41 Ext: Phone: 317-443-0841 Ext: Terms. . : NET 30 DAYS Cust PO## : REFLECTING PACKAGING HM DESCRIPTION M QUANTITY PRODUCT CONTAINER GROSS ORDERED BACK ORDERED CODE DEPOSIT WEIGHT CURS DURING TRANSPORTATION: CCN3170 EMERGENCY CONTACT: CALL CHEMTREC TOLL FREE AT 1-800-424-930C WEIGHT 24 HOURS / 7 DAYS IN LBS RQ UN1791, HYPOCHLORITE SOLUTIONS, ;B,PG IIT MARINE POLLUTANT (SODIUM HYPOCHLORITE) RQ :DOT-SP 12412 ERG #: 154 SODIUM HYPOCHLORITE 12.5% .NSF DRUM OFF-330 G POLY TOTE 000 T/T SODIUM HYPOCHLORITE 12.5% DRUM OFF-3301, G POLY TOTE>A BLK 10038.0000 365998 :10038 Loc: E811 E816 E711 Qty: .8000 3144.0000 6692.0000 y J .'Product packed from: Lot: Lac: ZZZ Qty: 10,038.0000 Freight Class. . . : 55 - i Weight Per Gallon: 10.14000 Net Weight: 10038.000 BULK i ..r f To he completeSde Fo-e unloading: -------------------------- - t ._.__.__._...�.W._...____ _._w-- - w_w_. ___ Hose connects `i�rect compartment(s). ; 1; 2; .�c 4; 5� Driver-connect. ....,.a.::_...,.........�..., �4 , a i i i i } 'Hose connec,,,N,dto,M",r er storage tank and quantity shipped will fat into customer container 'Customer• Continued on Next Page materials are properly classified,described,packaged,marked,and labeled,and are in proper . ? , tot a applicable regulations of the Department of Transportation. rx Loaded B ....................... t'. By-, Checked By: Vehicle: . - Driver. THE GOODS COVERED BY THIS DOCUMENT SHALL CONSTITUTE ACCEPTANCE """" " """ ""' ......�............• ......`•.. " S AND CONDITIONS OF SALE STATED ON THE REVERSE SIDE HEREOF. Miles: %' Time In/Time Out E ACKNOWLEDGES RECE T OF ALL REQUIRED SDS(S). "� ,{Y�i Wood Pallets Dlvd " Woad Pallets Rtn:...� " U-fWA-41 Date: Plastic Pallets Dlvd._.............._ Plastic Pallets Rtn:,,,,,,,„......�.......,_.�... ....... CUS`�OMER COPY it Receipt Page 1 of 3 PHONE: 317-898-8632 6/21/18 2i:16:43 R E IV T/-�1►G FAQ(: --- BOLA# 2167253-00 Dely Date: 6/22/18 , PARTMENT Sold CARMEL STREET DEPARTMENT -Customer: 897255 Ship To: 2 Ship Date: 6/22/1.8 0 Ship From: 29 To: 3400 W. 131ST" STREET -Attn-• Frt Terms: PREPAID Frt Code TH STREET CARMEL, IN 46074 FOD. . . : DELIVERED Taken By : BM29SLD Sls Per . : 293 Ship Via: OUR TRUCK -• PKG Placed By: MIKE Recv Hrs: 8:00 AM- 1.:00 PM Phone. . : 31.7-443-0841. 941 Ext: Phone: 31.7-•443.0841. Ext: Terms. . : NET 30 DAYS Cust PO # : REFLECTING PACKAGING HM ; DESCRIPTION M QUANTITY PRODUCT CONTAINER GROSS ORDERED BACK ORDERED CODE DEPOSIT WEIGHT .CURS DURING TRANSPORTATION: CCN3170 EMERGENCY CONTACT: CALL CHEMTREC TOLL FREE AT 1800-424-9300 WEIGHT 24 HOURS / 7 DAYS IN LBS FREIGHT CARRIER: INVOICE TMS VIA EDI OR CARRIER PORTAL. ;DRIVER: CONTACT MIKE: 31.7.443-0841. CUSTOMER REQUESTING DELIVERY BY 1 PM STRAIGHT TRUCK ONLY ;CHEMICALS NEED TO BE DELIVERED AND APPLIED DIRECTLY TO THE REFLECTING POOL. CITY EMPLOYEE IS TO BE PRESENT DURING ALL DELIVERIES AND APPLICATIONS- NO EXCEPTIONS! ! -------------------------------------- -------------------------------------- __ w__..._w___._.------------------ --_____ K._-_____ __materials are properly classified,'described,packaged,marked,and labeled,and are in proper . Continued On Next Page *x to the applicable regulations of the Department of Transportation. Loaded By: �............. .�.... Checked By. ...... ...•..................... ............. F THE GOODS COVERED BY THIS DOCUMENT SHALL CONSTITUTE ACCEPTANCE Vehicle Driver: „� w ERMS AND CONDITIONS OF SALE STATED ON THE REVERSE SIDE-HEREOR Miles: „_,•„•• Tame In/T]m@ Ou't EBY ACKNOWLEDGES RE,CEIPT OF ALL REQUIRED SDS(S). Wood Pallets Dlvd ........ Wood Pallets stn: �.., .,. ,•,.,,,,,,.N, Date: 6 Plastic Pallets DlVd....................... Plastic Pallets R•tn:... _...............•.�..•.........�..., CU8 T®!SER COPY n t. Rccae.?iP,, Page 3,of 3 PHONE: ',q17-898-8632 6/21/:1.8 21:16:43 B R E 1 Vp�N i T AGE-_ FAX: ��a � � � I^ ,.,4 . 6 BOL# .': 2167253-00 Dely Date: 6/22/18 PARTMENT Sold , CARMEL STREET D:'FARTMENT 'Customer: 897.255 Ship To: 2 Ship .Date: 6/22/18 0 Ship From: 29 To: 3400 W. 131ST STREET ' `.;Attn- Frt Terms: PREPAID Frt Code : TH STREET CARMEL, N 4'6074 FOD. DELIVERED Taken By : BM29SLD Sls Per . : 243 Ship Via: OUR TRUCK - PKG Placed By: MIKE ' Recy Hrs: 8:00 AM- 1:00 PM Phone#. , : 317-4430841 841 Ext: Phone: 317-443-084 . Ext„ Terms. . : NET 30 DAYS r Cust PO# : REFLECTING PACKAGING HM DESCRIPTION M QUANTITY PRODUCT CONTAINER GROSS ORDERED BACK ORDERED CODE DEPOSIT WEIGHT :CURS DURING TRANSPORTATION: . ; CCN3170 EMERGENCY CONTACT: CALL CHEMTREC TOLL FREE AT 300 WEIGHT 24 HOURS / 7 DAYS IN LDS 3,34'6.2 LD TOTE 330 GAL FULL Total. Net Weight: 10,038 Total gross Weight: 10,038 �sr l I materials are properly classified,described,packaged,marked,and labeled,and are in proper to the applicable regulations of the Department of Transportation. LoadedBy: .............»..,...,„.»,,,,,,..,.,.,....,..,....,. Checked By: ,,,,,...,».......»..,,.,.,,.,,.,..,,...,, ». F THE GOODS COVERED BY THIS DOCUMENT SHALL CONSTITUTE ACCEPTANCE Vehicle-. Driver” ERMS AND CONDITIONS OF SALE STATED ON THE REVERSE SIDE HEREOF. Miles:». »•••••••»•-•„•••••••;»•••. X;,,, Time In/Tame Out ,, » „ EBY ACKNOWLEDGES RECEIPT OF ALL REQUIRED SDS(S). Wood Pallets Dlyd » Wood Pallets Rtn: PlasticPallets Rtn~ Date: Plastic Pallets DlVd».,,,»„„,.,».,».» ' _CUST®1MER COPY