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Home My WebLink About330443 09/26/18 %'�,q�'� CITY OF CARMEL, INDIANA VENDOR: 359584 l; ONE CIVIC SQUARE BRENNTAG MID SOUTH INC CHECK AMOUNT: $*******996.50* ,� a� CARMEL, INDIANA 46032 3796 RELIABLE PARKWAY CHECK NUMBER: 330443 9MIi6d"ba CHICAGO IL 60686 CHECK DATE: 09/26/18 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 601 5023990 091231 996.50 OTHER EXPENSES VOUCHER NO. 182793 WARRANT NO. Prescribed by State Board of Accounts City Form No.201(Rev 1995) ALLOWED 20 Vendor # 359584 IN SUM OF$ ACCOUNTS PAYABLE VOUCHER BRENNTAG MID-SOUTH INC CITY OF CARMEL 3796 RELIABLE PARKWAY An invoice or bill to be properly itemized must show: kind of service,where performed, CHICAGO, IL 60686-0037 dates service rendered, by whom, rates per day,number of hours, rate per hour, numbers of units, price per unit,etc. Payee 996.50 359584 Purchase Order No. ON ACCOUNT OF APPROPRATION FOR BRENNTAG MID-SOUTH INC Terms Carmel Water Utility 3796 RELIABLE PARKWAY Due Date BOARD MEMBERS I hereby certify that that attached invoice(s), CHICAGO,IL 60686-0037 or bill(s)is(are)true and correct and that PO# ACCT# the materials or services itemized thereon for DATE INVOICE# Description DEPT# INVOICE# Fund# AMOUNT which charge is made were ordered and DEPT# FUND# (or note attached invoice(s)or bill(s)) AMOUNT 091231 01-6180-03 $996.50 and received except 9/18/2018 091231 $996.50 I 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. 20L— Clerk-Treasurer BRENNTAGAMI BRENNTAG MID-SOUTH, INC. 1405 HIGHWAY 136 WEST PO BOX 20 HENDERSON KY 42419-0020 INVOICE#: BMS091231 INV DATE: 9/13/18 * * PAGE 1 OF 1 ** DUE DATE: 10/13/18 SOLD TO: SHIP TO: CITY OF CARMEL UTILITIES CARMEL UTILITIES PLT 1 3450 WEST 131ST STREET 4915 E 106 ST CARMEL IN 46074 CARMEL IN 46033 FEDERAL ID #: 610504545 DATE SHIPPED: 9/13/18 TERMS NET 30 DAYS B/L #. . 2256617-00 SHIP WHS: 29 SLSPRSN: 293 CUSTOMER # . : 407542 SHIP VIA: OUR TRUCK - PKG CUSTOMER PO#: AC091018 FOB . . : DELIVERED FREIGHT TERM: PREPAID TAX EX# : 356000972-001-9 PRO NUMBER . : 778442631 UNITS SHIPPED PROD # WGT/GAL TOTAL QTY UNIT PRICE EXTENDED -------------------------------------------------------------------------------- 1 .0000 253418 11 .87000 2000.0000# .4320 864.00 2000.0000 # CYL CHLORINE, LIQUID (BMS ONLY) >A RPK -------------------------------------------------------------------------------- QUESTIONS, CALL 317-898-8632 * REMIT TO ADDRESS: BRENNTAG MID-SOUTH, INC * 3796 RELIABLE PARKWAY * MERCHANDISE 864.00 * CHICAGO IL 60686-3007 * FUEL SURCHARGE 97 .50 *************************************** INS & SEC SURCHARGE 35.00 ----------------- PAID ON OR PRIOR TO 10/13/18 INVOICE TOTAL USD 996.50 PAID AFTER 10/13/18 INVOICE TOTAL USD 1,016.43 Original Document Bill. of Lading/Shipment Receipt Page I of 2 p BRENNTAG MID-SOUTH PHONE: 817-898--8632 9/j2/18 28:88:4�' p�.E N N1 3111 N DOST RD FAX: ' DEA REG NO. 00660IBNY INDIANAPOLIS, IN 46226 BOLA# 2256617-00 Delv Date: 9/13/18 Ship, CARMEL UTILITIES PLT I Sold CITY' OF CARMEL UTILITIES Customer: 407542 Ship To: 11 Shap Date: 9/18/18 0 Shag To: 4915 E .106 ST To: 3450 !TEST 131ST �STREET' Attn- Frt 'Terms: PREPAID Frt CARMEL, IN 46033 ,CARMEL, IN 4607 FOB. . . : DELIVERED Taken By : BM29SLD SIS Shap Via: OUR TRUCK - PKG Placed By: ANDY CREASY Recv .Hrs. 7:30 AM- 4.00 PM Phone#. . : 317-571-2443 Phone: 317-571-2448 Ext: Ph,bne:' 317--571.-2448 " Ext: Terms. .; NET 30 DAYS Cunt POS- : AC091018 QUANTITY PACKAGING, HM � DESCRIPTION M QUANTITY PRODUCT COI SHIPPED ORDERED BACK ORDERED CODE DI IF LEAK OR SPILL OCCURS DURINGTRANSPORTATION-— CCN3170 EMERGENCY CONTACT: CALM; CHEMTREC TOLL FREE T -300-424-9300 ,_. 24 HOURS / 7 DAYS FREIGHT ,;CARRIER: INVOICE TMS VIA EDI OR CARRIER PORTAL. 'EFF 31,7---,571-2639 . ANDY 31.7-750-1479 RQ UN1017, CHLORINE, RQ,MARINE POLLUTANT POISON-INHALATION HAZARD, ZONE B ERG #: 124 i CHLORINE 1.0000 2000.0000 LB CYL CHLORINE, LIQUID (BMS ONLY) >A RPK 1.0000 258418 hoc: OSE05 OSE04 Qty: 6.0000 7.0000. Product packed from: Lot: 2 Loc: OSE04 Qty: 1.0000 ' Freigh-t Class._. 200 Weight Per Gallon: 11.87000 Net Weight: 2000.000 CYL Total aet Weight: 2,000 Total Gross Weight: This is to certify that the above named materials are properly classified,described, e marked,and labeled,and are in proper 9 condition for transportation according to the applicable regulations of the D me Tran ortation. f Loaded By". Checked By: Signature of Shipper: PURCHASER'S ACCEPTANCE OF THE GOODS COVERED B H DOCUMENTS CONSTITUTE ACCEPTANCE Vehicle: Driver: ,, „„„...................� BY THE PURCHASER OF ALL TERMS AND CONDITIONS SALE:STATED ON THE REVERSE SIDE HEREOF Miles:-_-,..... Time In./Time Out,,,,„,,,„ ,,,• , ........ S MOREOVER,PURCHA ,HEREBY OWLEDGES RECEIPT OF ALL REQUIRED SDS(S). jv Wood Pallets Dlvd Wood Pallets Rtn:,5-Z ,,„,, ",,,,,,,,,,,, 1 , Received by: ti Plastic Pallets Dlvd Plastic Pallets Rtn- a_:� Date: