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Home My WebLink About329768 09/10/18 �ur_s�ny �! CITY OF CARMEL, INDIANA VENDOR: 359584 ONE CIVIC SQUARE BRENNTAG MID SOUTH INC .: CHECKAMOUNT: $*****3,745.93* CARMEL, INDIANA 46032 3796 RELIABLE PARKWAY CHECK NUMBER: 329768 .; yiTON�a. CHICAGO IL 60686 CHECK DATE: 09/10/18 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1206 4350900 BMS073863 3,745.93 OTHER CONT SERVICES VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201 (Rev.1995) Vendor# 359584 ALLOWED 20 ACCOUNTS PAYABLE VOUCHER BRENNTAG MID SOUTH INC IN SUM OF$ 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 BMS073863 43-509.00 $3,745.93 1 hereby certify that the attached invoice(s),or 8/22/18 BMS073863 Reflecting Pool Supplies $3,745.93 1206 101 1206 101 bill(s)is(are)true and correct and that the materials or services itemized thereon for which charge is made were ordered and received except Tuesday, September 04, 2018 Huffman, Dave Director I hereby certify that the attached invoice(s),or bill(s), is(are)true and correct and I have audited same in accordance with IC 5-11-10-1.6 , 20 Cost distribution ledger classification if claim paid motor vehicle highway fund. Clerk-Treasurer Brenntag Mid-South, Inc. B R E N N TAG - 1405 Highway 136 W•P.O. BOX 20 Henderson,Kentucky 42419-0020 INVOICE#: BMS073863 INV DATE: 8/22/18 *** PAGE 1 OF 1 *** DUE DATE: 9/21/18 SOLD TO: SHIP TO: CARMEL STREET DEPARTMENT CARMEL STREET DEPARTMENT 3400 W. 131ST STREET REFLECTING POOL CARMEL IN 46074 THIRD AVE. & 126TH STREET CARMEL IN 46032 FEDERAL ID ## : �6f10/500454511�1 DATE SHIPPED: 8/22/18 TERM�LSTL :7 NET 30 DAYS ___ p �� _`_ 2--0, SLSPRS293 CUSTOMER # . : 897255 SHIP VIA: OUR TRUCK - PKG CUSTOMER PO# : REFLECTING FOB . . : DELIVERED FREIGHT TERM: PREPAID TAX EX# : 0031201550-020 PRO NUMBER . : 777700807 UNITS SHIPPED PROD # WGT/GAL TOTAL QTY UNIT PRICE EXTENDED -------------------------------------------------------------------------------- 989 . 9408 365998 10 . 14000 989 . 9408G 3 . 6855 3, 648 .43 1 . 0000 G BULK SODIUM HYPOCHLORITE 12 . 50 DRUM OFF-330 G POLY TOTE>A BLK -------------------------------------------------------------------------------- QUESTIONS, CALL 317-898-8632 * REMIT TO ADDRESS: * BRENNTAG MID-SOUTH, INC * 3796 RELIABLE PARKWAY * CHICAGO IL 60686-3007 * MERCHANDISE 3, 648 .43 *************************************** FUEL SURCHARGE 97 . 50 ----------------- PAID ON OR PRIOR TO 9/21/18 INVOICE TOTAL USD 3,745.93 PAID AFTER 9/21/18 INVOICE TOTAL USD 3, 820.85 Original Document * *ALL SALES SUBJECT TO AND GOVERNED BY THE TERMS AND CONDITIONS SET FORTH ON THE REVERSE SIDE *** Bill o•f Lading/Shipment Receipt Continued from Previous Page Page f 'of 3 ��NiaA�a�7 D��OUTH 't ��: ��.�-'�9�—$biz �/��/�.� ��.c��:��.o B R E N N T DEA REG NO. 00660IBNY �.�b,,p, �• INDIANAPOLIS, IN 46.226, M BOL# . : 2236800-00 Vilely Date: 8/22/18 Ship CARMEL STREET DEPARTMENT Sold CARMEL STREET DEPARTMENT , Customer: 897255 ' Ship To: 2 Ship Date: 8/22/18 0 Shin To: REFLECTING POOL To: 3400 W. :131ST STREET A tn,,. Frt Terms: PREPAID Frt THIRD AVE. 8; 126TH STREET CARMEL,, IN 46074 FOB. . . : DELIVERED Taken By : BM299LD Sls CARMEL, IN 46032 Ship Via: OUR TRUCK'- PKG Placed By: MIKE Recv Firs: 8:00 AM� 1:00 PM Phone. .: 317-4430841 Phone: 317-443-•0841 Ext: Phdn.e: 317-443-0841 Ext: Terms. NET 30 DAYS Cust PO# : REFLECTING QUANTITY PACKAGING HM DESCRIPTION - M QUANTITY PRODUCT CON SHIPPED ORDERED BACK ORDERED CODE DEI IF' LEAK OR SPILL OCCURS DURING TRANSPORTATION: CCN3170 EMERGENCY CONTACT:. CALL CHEM'TREC -TOLL FREE AT ° 800-424-9300 24 HOURS / 7 DAYS " ;RQ UN1791, jHYPQCHLORITE SOLUTIONS, 18,PG III !MARINE POLLUTANT (SODIUM HYPOCHLORITE) RQ DOT-SP 1241.2 ! 'ERG #- 154 SODIUM HYPOCHLORITE 12.5% NSF DRUM OFF-330 G POLY TOTE X0088„t30Op 1 .0000 T/T ” SODIUM HYPOCHLORITE 12.596 DRUM OFF--330 G POLY TOTE>A BLK 10038.6000 .600365998 ;Loc: E811 E815 E707 E813 E710 E816 :Qty: .8000 764.0000 . 46.0000 1066.5000 10038.0000 2.0000 Product pickedfrom: Lot: 365998298228 Loc: E71.o Qty: 10, 738.0000 Freight Class. 55 height Per Gallon.. 1.0.14000 ' Net Weight: 10038.000 BULK 'To o be completed o unloading: .�___......_...�.��.----- :. ____...w_�.__M t`s�. aHose connected Compartmen Driver: r ------------------------------------ :Hose ....,—............,.,...,..— m .....«...._,.........— Hose connect- d t p� r storage tank .end quantity shipped will Fit into cus'to per container. ;Customer: .... »f". _ ..,..,.,... ***,Continued on Next. Page *1* This is to certify that the'above named materials Qproperly classified,described,packaged,marked,and labeled,and are in proper condition for transportation according to the ap ltcable regulations of the D�'artm n� Transportation: Signature of Shipper: r . �i�� %lel A/ Loaded By. " .. ",,...,.,..,.......,.., Checked By-, .....................� . Vehicle: Driver: PURCHASER'S ACCEPTANCE OF THE GOODS COVERED BY THIS DOCUMENT SHALL CONSTITUTE ACCEPTANCE 7Iim Out. '""""`" BY THE PURCHASER OF ALL TERMS AND CONDITIONS OF SALE STATED ON THE REVERSE E HEREOF. M��eS' Time fin/T 1me I�U't MOREOVER,PU HASER, E ACKNOWLEDGES RECEIPT OF ALL REQUIRED SDSI ). Woad Pala 'tM"DT vd», "µ» Wood Pallets Rtn:,," ", Plastic Pallets Dlvd Plastic Pallets Rtn Received by: C �J�.'4 fi��cl" 7! Date: ", ...,...».. ....,. » ».,.,....... CUSTOMER COPY mil of Lad:i.ng Shipment Receipt Page . 3 :rpf 3 p pR'��, Tt7t�» � � -SflUTN PHONE: 317-898--86 32 8/2'2/ W 10:31:40 �R E N NT� DEA [•�3�11.1N PEG OST RD11 n-i�n9,�V FAX: . INDIANAPOLIS, IN 45226 O!,_#k 2236800---00 De1v date: 8/22/18 Ship CARMEL STREET DEPARTMENT Said CARMEL STREET DEPARTMENT CUS; tinea: 897255 Ship Tc: 2 Ship Dc�e- 8/22!`1.8 0 Ship TO, REFLECTING POOL To: 3400 W. 131ST STREET Attr1-- Frt Terms: PREPAID Frt C THIRD AVE. r& 126TH 'S'TREET CARMEL, IN 1,607.4. FOB. . : DELIVERED Tamen By : BM29SLD Sls P CARMEL., 1N 46032 Ship Via: OUR TRUCK - PKG Ple.ced, By: MIKE Rec'v) Firs: 8:00 AM-- 1.:00 FSM Prone#. . : 317-443-0841. Phone: 31:7—.443w0841 Ext: ?'hone: Ext: Terms. . : NET 30 DAYS Cust AO# : REFLECTING QUANTITY QUANTITY PRODUCT CONTE SHIPPED PACKAGING HM DESCRIPTION M ORDERED BACKORDERED CODE DEPC IF LEAK OR SPILL OCCURS DURING TRANSPORTATION: CCNal70 EMERGENCY CONTACT: CALL CHEMTREC TOLL FREE AT l 8t3O-42'��`J300 24 HOURS / 7 JAYS � � 3,346.2 LB TOTE 330 GAL FUU _ -____.__.._-______o _._ �__. __ _. __.w�__.a_.___.__ .. ____ , __.________ _. _ ._�___.___ ------------------------------ Total, Net Weight: ''.t1,C133 :a L 1 -t. ross Weil lit: r r •. . .a This is to certify that the above named mat�a�s are properly classified,described,packaged,marked,and labeled,and are in proper condition for transportation according to,the/applicable regulations of the,Department of Transportation. / Loaded 43y: ,,,,,,, Checked 13y: ,,,,,,..,..,,,,,,,,.,, ,..,,,,,,,.. Signature of Shipper: ,tom!/1p'/" �T f �"` � Vehicle Driver: PURCHASER'S ACCEPTANCE OF THE GOODS COVERED BVj HIS DOCUMENT SHALL CONSTITUTE ACCEPTANCE hlCi f .""""""'""""" " BY THE PURCHASER OF ALL TERMS AND CONDITIONS OF SALE STATED ON THE REVERSE SIDE HEREOF. i'�1.1 QS „ Ta,rne a Cl j''�;dile OU t.... „ ,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, o t MOREOVER,PURCHASER,HEREBY ACKNOWLEDGES RECEIPT OF ALL REQUIRED SDS(S). Wood Pallets DI vdc ., Wood Palle't,s Rtn ,,,,,, �+Iasl�� Peld,e�JC V1V4d PI�J'�3C }r Received by: Date: Pale,o R'i n Cu STOEMER COPY t 8 ll, of Lading/Shipment pmen't, receipt s I Page :4.0 1 BRE_ a�� ® ori-- qu7� PHONE. 317.1 8632 8/22/18 10 3� B R E N N T, F`Yv Ti 3111 N P03T RD FAX: � u,' DEA REG NO. 00660IBNY INDIANAPOLIS, IN 46226 .a v " L� }, . 223680q-UO Del.v Date: - 3/'22/18 Ship CARMEL STREET DEPARTMENT Sold CARMEL STREET DEPARTMENT 6`d.tomer: 597255 Ship To: 2 Ship DD te': 8/22/:1.5 0 Ship ,To: REFLECTING POOL, To: :�� W. 131ST STREET ;Attn- FA"t Teres.: PREPAID Frt THIRD AVE., & 1261.61 STREET EL, IN 46074, 'FbB . : DELIVERED Taken B'y- : BM29SLD Sls CARMEL, IN-.46032 ;Ship Via:, OUR TRUCK -- PKG' Placed {By: MIKE t?ercv Hrs: 8:00 AM- 1:00 PMPhone#.`; . . 31.7-443--0841 Phone: 317-443-0841 Ext.- Pone: 317-443-084 . . Ext: 7 ems. . : NE7 O DAYS Cult PQI : REFLECTING QUANTITY `-0 DESCRIPTION M QUANTITY PRODUCT CON' SHIPPED PACKAGING HM r' :,',k;,. ORDERED BACKORDERED CODE DEE IF LEAK OR SPILL OCCURS DURING TRANSPORTATION: CCN3.170 EMERGENCY CONTACT: CALL CHEMTREC TOLL FREE AT -80.0-•424-9300 24 HOURS / 7 DAYS FREIGHT CARRIER: INVOICE TMS VILA EDI OR CARRIER PORTAL. f; DRhVER= CONTACT MIKE: 317-443-0841 H .,CUSTOl'3;ER REQUESTING DELIVERY IN THE AM STRAIGHT TRUCK ONLY :,NE#�TCALS NEED l_O BE DELIVERED AND APPLIED DIRECTLY TO THE -REFLECTING POOH:. CITY EMPLOYEE IS TO BE PRESENT DURING ALL ` DELIVERIES AND APPLICATIONS-- NO EXCEPTIONS! ! COntinued?l-on Next .Page: * This is to certify that the above named materials are properly classified,described,packaged,marked,and labeled,and are in proper condition for transportation according to,the applicable regulation of the-D ae rtt t of Transportation. Signature of Shipper: _ r1''t '> �, r%�'� Loaded y= , ,,,,,,,,,,,,,,,,,,,,„,,,,,,,,,,,,,,,,,,,,,,,,,,,,, Checked 3y"- ,,...,, ,.,,,,.,, ,,,,....,,,..... ...,,,,, !� �° " Vehj,eie� Driver: PURCHASER'S ACCEPTANCE,OF THE GOODS COVERED BY TRIS DOCUMENT SHALL CONSTITUTE ACCEPTANCE 4 Miles '” ,T i " BYMOREOVER,THECHASER OF ALL TERMS AND CONDITIONS OF SALE STATED ON THE REVERSE SIDE HEREOF. „•••••°•••°°•• ••°•• Time In/,Time Out;,, „,••• •� BY T 'PURCHASER,HEREBY ACKNOWLEDGES RECEIPT OF ALL REQUIREDSDS(S). Wood Pallets Dlvd _ Wood Pallets Rin:,,,,,,„„„, Received by: Date: Plastic Pallets Dlvd„,_ „,_,�,., . Plastic Pallets Rtn:• „, CUSTOMER COPY