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Home My WebLink About329075 08/22/18 CITY OF CARMEL, INDIANA VENDOR: 359584 ONE CIVIC SQUARE BRENNTAG MID SOUTH INC CHECK AMOUNT: $*****3,746.15* CARMEL, INDIANA 46032 3796 RELIABLE PARKWAY CHECK NUMBER: 329075 2y�TON CHICAGO IL 60686 CHECK DATE: 08/22/18 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1206 4350900 BMS053954 3,746.15 OTHER CONT SERVICES VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201 (Rev.1995) Vendor# 359584 ALLOWED 20 ACCOUNTS PAYABLE VOUCHER BRENNTAG MID SOUTH INC IN SUM OF$ 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 $3,746.15 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 BMS053954 43-509.00 $3,746.15 1 hereby certify that the attached invoice(s),or 8/1/18 BMS053954 $3,746.15 1206 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 Tuesday,August 14,2018 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 B renntag Mid-South, Inc. B R E N N TAG 1405 Highway 136 W•P.O.BOX 20 Henderson,Kentucky 42419-0020 INVOICE#: BMS053954 INV DATE: 8/01/18 *** PAGE 1 OF 1 *** DUE DATE: 8/31/18 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: 8/01/18 TERMS NET 30 DAYS 2-93 CUSTOMER # . : 897255 SHIP VIA: OUR TRUCK - PKG ' CUSTOMER PO# :. REFLECTING POND FOB DELIVERED FREIGHT TERM: PREPAID TAX EX# : 0031201550-020 PRO NUMBER . : 776912930 UNITS SHIPPED PROD # WGT/GAL TOTAL QTY UNIT PRICE EXTENDED -------------------------------------------------------------------------------- 990 . 0000 365998 10 . 14000 990 . 000OG 3 . 6855 3, 648 . 65 1 . 0000 G BULK SODIUM HYPOCHLORITE 12 . 5% 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 . 65 *************************************** FUEL SURCHARGE 97 . 50 ----------------- PAID ON OR PRIOR TO 8/31/18 INVOICE TOTAL USD 3, 746.15 PAID AFTER 8/31/18 INVOICE TOTAL USD 3,821.07 Original Document *x*ALL SALES SUBJECT TO AND GOVERNED BY THE TERMS AND CONDITIONS SET FORTH ON THE REVERSE SIDE M** *:K;: Conti'A'ed from Previous Page Page 2 of :3 PHONE- 37.'7-898 -8632 7/31/7.5 2'1,:42:13 B RE N NTAG FAQ: �• 3NY 5226 DOLE: :: 2213958•-00 De1v Date: 8/01./18 DEPARTMENT Sold CAR11EL STREET DEPARTMENT Customer: 897255 Ship To: 2 Ship Date: 8/01/18 0 Ship From,, 29 1L To: X400 W. 131ST STREET Attn- F"rt Terms: PREPAID rrt Code : G.26T'.H STREET CARMEL, IN 46074 FOE. . : DELIVERED Taken By : FM29aLD Sls Per . : 29:3 182 Ship Via: OUR TRUCK - PKG Placed By: MIKE Recv F,rs: 8:00 AM-- 1:00 PM Phtone#. ,. . -0;341 Ext: Phone: 317-443-•0841 Ext: g Terms. . --'NET' 30 DAYS Cust PO# : REFLECTING POND PACKAGING HM DESCRIPTION M QUANTITY PRODUCT CONTAINER GROSS 11 ORDERED BACK ORDERED CODE DEPOSIT WEIGHT a OCCURS DURING TRANSPORTATION: CCN3170 EMERGENCY CONTACT: CALL C14EMTREC TOLL FREE AT -f3a0-424--9300 WEIGHT _ 24 HOURS / 7 DAYS IN LBS ,RQ :UN1791, HYPOCHLORITE SOLUTIONS, !8,PG III MARINE POLLUTANT (SODIUM HYPOCHLORITE) RQ DOT-SP 1241.2 ERG #t: 1.54 SODIUM HYPOCHLORITE 12.5% NSE~' DRUM OFF-330 G POLY TOTE 30100 T/T SODIUM HYPOCHLORITE 12.5% DRUM OFF-330 G POLY TOTE>A BLK 10038.6000 365998 10039 Loc: E711 E811 E816 Qty: 6692.0000 .5000 506.8000 Product picked from. Lot: UNKNDWN 3s _:�_ � '- A':., Loc: ZZZ Qty: 10, 38.6000 ., Freight Class. . . . 55 Weight Pei" Gallon: 1.0.14000 Net Weight: 10038.600 BULK To he completeO'�before unloading: -lase connecte�4�tp mi _e compartment(s). ; 1; 2; 3; 4; 5 Driver. r�.. {` �....... ......... o ------------ . Hose .-__Hose tonne ed to pr per storage tank and quantity shipped will Fit into customer container. Customer. *** Continued an Next Page aterials are properly classified,described,packaged,marked,and labeled,and are in proper .,the applicable regulations of the Department of Transportation. — •--- Loaded By.- ................v,................................... Checked y: Vehicle: Driver. _.............._....,,r<' CONSTITUTE ACCEPTANCE ...... ..�, .: .' THE GOODS COVERED BY THIS DOCUMENT SHALL CO TUTE A Hiles MS AND CONDITIONS OF SALE STATED ON THE REVERSE SIDE HEREOF. -•••••• Time In/Time CJUt BY ACKNOWLEDGES RECEIPT OF ALL REQUIREDSDS(S). "t Wood Pallets Dlvd,•....... Wood Pallets Rtn: �t `7 � "0 i'M��tePv- Pallets D.Ivd..............•...•.•... Plastic Pallets R'tn:, ...,,........,..•.. A (� Date: nt Recoipt Page 1'yof 3 PHONE: 31.7-898-8632 _ 7/31/18 21:42:13 FAX: R E N N TAG BOL# . : 2213958-00 Delv Date: 8/01/18 PARTMENT Sold CARMEL STREET DEPARTMENT Customer: 897255 Shap To: 2 Ship Date: 8/01/18 0 Shap From: 29 TO" 3400 W. 131ST STREET ; ,Attn- Frt Terms: PREPAID Frt Code TH STREET CARMEL, IN 45074- `'_FOB- - - : DELIVERED Taken By : BM29SLD Sls Per . : 24'3 Ship Via:` •OUR TRUCK - PKG Placed By: MIKE Recv Hrsy � �00 AM- 1.:00 PM Phone#. 841 Ext Phone: 317--443-0841. Ext: Terms. . : N�JO DAYS Cust PO# : REFLECTING POND PACKAGING HM \'- DESCRIPTION QUANTITY PRODUCT CONTAINER GROSS ORDERED BACKORDERED, CODE DEPOSIT. WEIGHT ;CURSDURING TRANSPORTATION: ;� p CCN3170 EMERGENCY CONTACT: CALL CHEMTREC TOLL FREE AT 1--800-424-9300 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! ! ---------- --------------------------------------------------------- —_____.____ ____. ________ __._ . t I materials are properly classified,described,packaged,marked,and labeled,and are in proper Conta nlJed an Next Page 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:,,,.,.. „ •.. .... Time .In,/Time SDS( ,Out ,,,,,,,, '.E BY ACKNOWLEDGES RECEIPT OF ALL REQ (S )• Waad Pallets D]vd .-..-...._�,. ... Wood �tn: � ................. ��ST as•tic Pallets Divd..,_._...�,..,....� Plastic Date: Pallets Rtn:....................... ,,...,,... „. Plastic COPY Page 3"Of .3 .z PEiONE: 31 °-8s 8-8632 � 7/31/18 21:42:13 B R E N N TAGFAX: DOL# . : 2213958-00 Delv Date: 8/01/18 PA`"IJNENT Sold Ci-iRI[E-L STRECI.T .DErPART'HENT Customer: 897255 Ship To: 2 Ship Date: 8/01./18 0 Ship From: 29 To:, W. 131ST �,,iF'ELT Attn- Frt Terms: PREPAID Frt Cade : TH STREET i:t^NMEL, IN - 0.74 FOD. . : DELIVERED Taken By : BM29SLD Sls Per » : 293 Ship Via: OUR TRUCK - PKG Placed By: MIKE ; Recv WrS: 8 00 AM- 1.:00 PM Phone#. 8 Ext: Phone: 317-443-0841 Ext: Terms» . : EE1 30 DAYS Cush P0# : REFLECTING POND ';fQUANTITY PRODUCT CONTAINER GROSS PACKAGING HM " DESCRIPTION M ORDERED BACKORDERED CODE DEPOSIT WEIGHT'. .CURS DURING TRANSPORTATION: \ J CCN3170 EMERGENCY CONTACT: CALL CHEMTREC TOLL FREE AT 1-800-424•-9300 WEIGHT 24 HOURS / 7 DAYS IN LDS -"3',-3346»2 LTi TOTE 330- GAL FULL q ------------------------ €' Total Net Weight: 10,039 Total (crass Weight". 10,039 a lY 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. ..........^., ...^... ..........^......^...,...................... Vehicle: Driver: F THE GOODS COVERED BY THIS DOCUMENT SHALL CONSTITUTE ACCEPTANCE """ '^^•....^ ERMS AND CONDITIONS OF SALE STATED ON THE REVERSE SIDE HEREOF. ' Miles: Time In/Time Out :EBY ACKNOWLEDGES RECEIPT OF ALL REQUIRED SDS(S). pWlasta.ad Pallets Dlvd ...._^........_^.^.... Wood Pallets Rtn: ,•^,....^,^.^.^•....,.^..^•...^ .. .... ^.^.,•... j3 ,.^. ic Pallets Dlvd.^.�....,..,•.�, .. Plastic Pallets Date: CU Rtn:_._. �..^..^............. COPY