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Home My WebLink About330962 10/09/18 J`% "�� CITY OF CARMEL, INDIANA VENDOR: 359584 w; ONE CIVIC SQUARE BRENNTAG MID SOUTH INC CHECK AMOUNT: $'"""`5,140.13' �� ;�� CARMEL, INDIANA 46032 3796 RELIABLE PARKWAY CHECK NUMBER: 330962 '$�roN.�• CHICAGO IL 60686 CHECK DATE: 10/09/18 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1206 4350900 BMS102147 5,140.13 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 $5,140.13 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 BMS102147 43-509.00 $5,140.13 1 hereby certify that the attached invoice(s),or 9/27/18 BMS102147 Reflecting Pond Supplies $5,140.13 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 Friday, October 05,2018 a ju/mIt-1 Lunn,Amy Admin Assistant 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 20Cost distribution ledger classification if claim paid motor vehicle highway fund. Clerk-Treasurer Brenntag Mid-South, Inc. BRENNTAG 1405 Highway 136 W•P.O. BOX 20 Henderson, Kentucky 42419-0020 INVOICE#: BMS102147 INV DATE: 9/27/18 *** PAGE 1 OF 1 *** DUE DATE: 10/27/18 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: 9/27/18 TERMS NET 30 DAYS _B_/_L-#. .- 2.2_705_7.2-0.0_ __ _ _ _ ___ __ __ _ __ _—SHIP_WHS : _ ___29 SLSPRSN_ : _29.3 CUSTOMER # . : 897255 SHIP VIA: OUR TRUCK - PKG CUSTOMER PO# : REFLECTING FOB . . : DELIVERED FREIGHT TERM: PREPAID TAX EX# : 0031201550-020 PRO NUMBER . : 778948765 UNITS SHIPPED PROD # WGT/GAL TOTAL QTY UNIT PRICE EXTENDED -------------------------------------------------------------------------------- 1319 . 9211 365998 10 . 14000 1319 . 9211G 3 . 8204 5, 042 . 63 1 . 0000 G BULK SODIUM HYPOCHLORITE 12 . 50 DRUM OFF DOT SP12412 >A BLK -------------------------------------------------------------------------------- QUESTIONS, CALL 317-898-8632 *************************************** * REMIT TO ADDRESS: * BRENNTAG MID-SOUTH, INC * 3796 RELIABLE PARKWAY * CHICAGO IL 60686-3007 * MERCHANDISE 5, 042 . 63 *************************************** FUEL SURCHARGE 97 . 50 ----------------- PAID ON OR PRIOR TO 10/27/18 INVOICE TOTAL USD 5,140.13 PAID AFTER 10/27/18 INVOICE TOTAL USD 5,242.93 Original Document ***ALL SALES SUBJECT TO AND GOVERNED BY THE TERMS AND CONDITIONS SET FORTH ON THE REVERSE SIDE xx Bill of Lading/Shipment.Receipt Page 1 0'. 3 BRENNTAG MID-SOUTH PHONE: 317w-898-8632 9/26/18 22:14:21 B R E N NT/ 3111 N POST RD FAX: i DEA REG NO. 00660IBNY INDIANAPOLIS, IN 46226 BOL# , : 22.70572-00 Delv Date: 9/27/18 Ship CARMEL STREET DEPARTMENT Sold CARMEL STREET DEPARTMENT Customer: 897255 Ship To: 2 Shap Date: 9/27/18 0 Whip To: REFLECTING POOL To: 3400 W. 131ST STREET At-0- Frt Terms: PREPAID Frt THIRD AVE. & 126111 STREET CARMEL, IN 46074 FOB. . . : DELIVERED Taken By : B1129SLD Sls CARMEL, IN 46032 Ship Via: OUR TRUCK - PKG Placed By: MIKE Recv Hrs: 8:00 AM-.1:00 PM Phonef. . : 317-4A.3-0841 Phone: 317•-443°_0841 Ext: Phone: 31.7--443-0841 Ext: Terms. . : NET 30 DAYS Cust PO# REFLECTING QUANTITY PACKAGING HM DESCRIPTION M QUANTITY PRODUCT CONT SHIPPED ORDERED BACK ORDERED CODE DEP IF LEAK OR SPILL OCCURS DURING TRANSPORTATION: CCN3170 EMERGENCY CONTACT: CALL CHEMTREC .TOLL FREE AT 1-300424-9300 24 HOURS -/ 7 DAYS E FREIGHT CARRIER: INVOICE TMS VIA EDT OR CARRIER PORTAL. TRIVER: C0N`FACT MIKE: ' 317-443-0841 CUSTOMER REQUESTING DELIVERY -Y I PM STF,',AIGH'I TRUCK ONLY CHEMICALS NEED TO BE DELIVERED AND.APPLIED DIRECTLY TO THE REFLECTING POOL. CITY EMPLOYEE 15.. TO BE PRESENT DURING ALL DELIVERIES AND APPLICATIONS- NO E.'SCERTIONS'_.! ..,. -----------.., „.... M...__, . ._„_w,_ ., #m w„www. w. ..,_„_.w.w ._. ... .W, _. _. �.. _. � „. �,w w ._._. .--------- Continued ...,.......,.-Con'ti.nued an NeX't Page .*>:M 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 regulations of the Department of Transportation. Signature of Shipper: Loaded By. ,,,,,,,,,,,,,, Checked 81�: .....,,.,,,,,,..,,,..,,,,...„..,.,...,,,,,,,,.. Pper: Vehicle: Driver: ,,,,,,, ' PURCHASER'S ACCEPTANCE OF THE GOODS COVERED BY THIS DOCUMENT SHALL CONSTITUTE ACCEPTANCE ,,,,,,,,,, Miles^ „ „ 11.11•„•••••• Tait? Ln/Tame €gut,,, , BY THE PURCHASER OF ALL TERMS AND CONDITIONS OF SALE STATED ON THE REVERSE SIDE HEREOF.. - „••° „ 1.11•••°••° MOREOVER,PURCHASER,HEREBY ACKNOWLEDGES RECEIPT OF ALL REQUIRED SDS(S). Woad Pallets Dlvd,,,,,,,1Wood Pa11,'ets Rtn:,,,,,,,,,,,,,, Received by: Date: CUSTd ER'&*le"S Dlvd,„„,,,,,„,.,.,,,,.,., Plastic Pallets Rtn:„ . „. 1 '4 S pl: QUANTITY PACKAGING HM DESCRIPTION M QUANTITY SHIPPED ORDERED PR IF LEAK OR SPILL OCCURS DURING TRANSPORTATION: BACKORDERED 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 regulations of the Department of Transportation. Signature of Shipper: PURCHASER'S ACCEPTANCE OF THE GOODS COVERED BY THIS DOCUMENT SHALL CONSTITUTE ACCEPTANCE BY THE PURCHASER OF ALL TERMS AND CONDITIONS OF SALE STATED ON THE REVERSE SIDE HEREOF. MOREOVER,PURCHASER,HEREBY ACKNOWLEDGES RECEIPT OF ALL REQUIRED SDS(S). Received by: Date: CUSTOME Bill o•F Lading/Shipment Receipt Page 3 of 3 BRENNTAG MID-SOUTH PHONE: 317-895-•3632 9/26%18 22:14:21. B R E N N T 3111 N POST RD FAX: DEA REG NO. 006601BNY INDIANAPOLIS, IN 46226 130L# . . : 2270572~00 S7aIv Date: 9/27/18 Ship CARMEL STREET DEPARTMENT Sold CARMEL STREET DEPARTMENT, Customer: P9."r255 Ship To: 2 Shap date: 9/27/13 0 Shir To: REFLECTING POOL To: 3400 WJ 131ST STREET Atte-•• Frt Terms: PREPAID Frt THIRD AVE. & 126TH STREET CARMEL, IN 46074. FOB. - : DELIVERED Taken By : BM29SLD SIS CARMEL, IN -16032 Shap ilia: OUR TRUCK - PKG Placed By: MIKE Recv Hrs: 8:00 AM- 1:00 PM Phone#. . : 317-443 --0841 Phone: 317-443-084.1 Ext: Phone: 317-443-0841 Ext: Terms. . ., ,NET 30 DAYS CUst FSO# : REFLECTING QUANTITY PACKAGING HM DESCRIPTION M QUANTITY PRODUCT CON' SHIPPED ORDERED BACK ORDERED CODE DEI IF LEAK OR SPILL OCCURS DURING TRANSPORTATION: P CCN3170 EMERGENCY CONTACT: CALL CHEMTREC TOLL FREE AT -800--424-9300 24 HOURS / 7 DAYS ;3,346.2 LD TOTE 330 GAL FULL ---------------------- ------------- H ..,....._...._,..........__,..._.__......._...._._,_._,a..,,.._..._.Tt�ta�. •NS`k 4'J@�.hilt:_._...,_,...._�.3,3�'5H�'+�-�a�.�(irUaSW��.�i1t: 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 regulations of the Department of Transportation. Signature of Shipper: Loaded By: ..................... Checked By:. ...,,.......... : river: PURCHASER'S ACCEPTANCE OF THE GOODS COVERED BY THIS DOCUMENT SHALL CONSTITUTE ACCEPTANCE Vehicle: """"""""""""""""""""""'"`°""" "" ""» ""»' BY THE PURCHASER OF ALL TERMS AND CONDITIONS OF SALE STATED ON THE REVERSE SIDE HEREOF. Miles:, Time I n/Tame OU'-,.. „•»,,,,.,,_,_....,,,. MOREOVER,PURCHASER,HEREBY ACKNOWLEDGES RECEERT OF ALL REQUIRED SDS(S). Mood Pallets DL+/d Wood Pallets Rtn: „ • Date: ' �L r 1 lets Dlvd,.•.•,,.,,.„.,••M,. Plastic Paillets Rtn: ,,•••,,. ,,.• Received by: CUS�TO�M1=F'COP » •"••'•' Dill. of Lading/Shipment Receipt Continued from Previous Page Pale of 3 BRENNTAG MID-SOUTH PHONE: $17-898-8632 9/26/18 22:14:21 B R E� N 1 3111 N POST RD FAX: DEA REG NO. 00660IBNY � :. . .INDIANAPOLIS, IN 46226 DOLS . : 270572-00 Deli Date.: 9/27/18 Ship CARMEL STREET" DEPARTMENT Sold CARMEL STREET DEPARTMENT Customer: 897255 Ship To: 2 Ship Dat6 9/27/1.8 0 Shii To: REFLECTING POOL. ' To: 3400 W. 131ST STREET Attn- F rt Terms: PREPAID Frt `THIRD AVE, & 126TH STREET CARMEL, IN 46074 FOP). DELIVERED Taken Dy',': BI.295LD SIS CARMEL., IN 46032 Snip Via: OUR TRUCK - PKG Placed :By' , MIKE Rec.v Hrs: 8:00 AM- 1:00 PM Phone#. ! « 317 -4:•3•-°08.41 Phone: $17-443-08,41 Ext: Phone: 317'443-08.41. Ext: Terms. . : NET 30 DAYS Coat POS . REFLECTING QUANTITY QUANTITY PRODUCT ,COP SHIPPED PACKAGING HM DESCRIPTION M ORDERED BACK ORDERED CODE DE -IF LEAK OR SPILL OCCURS DURING TRANSPORTATION: CCN3170 - EMERGENCY CONTACT: CALL CHEMTRFC TOLL FREE AT -800-424 .9300 24 HOURS /, 7 DAYS r iHYPOCHLORITE SOWTION5, B,PG .IIIA " 'MARINE POLLUTANT (SODIUM HYPOCHLORITE) RQ I DOT-SP 124.12 f SODIUM HYPOCHLORITE 12.5% NSF DRUM OFF-330.4a POLY TOTE . '�f 1.0000 T/T "ODIUM HYPOCHLORITE 12.5% DRUM OFF DOT jSP1.241.2 - >A ELK 1.3384.$000. 165998. E811 E813 .4710 E713 Qty: 3000 .5000 ut)00 239 .0000 } Lot #". Class.o......, „>_..,. .,. f.w.....,,,. ., ", ",... .....,,.. 'Mej:Oh t Per Gallon: 1.0.14000 Net MAx,ght: 13 334. 300 SULK >"o be completed ' "ole} �aloading: floseconnected "1. "' mpartm,ent(s). j .J..j 21, a j Driver.. "............... .,,(./..,.. ,.....,,.,.. .,,. 1 4 I I 1 9 I ;Hose connected to proper storage tank and quantity shipped will fit into custo ner container. Customer: Continued on Next Page This is to certify that the above named materials are properly classified described marked,and labeled,and are in proper condition for transportation according to the applicable regulations of the D artm of Tran, ortatio Loaded BY. Checked By "..,.., 2£�. Signature of Shipper: ! .��'� i r i ueha,cl.e: ..............................�,.,,.........,....... Driver: PURCHASER'S ACCEPTANCE OF THE GOODS"COVERED BY HIS DOCUMENT S CONSTITUTE ACCEPTANCE Time T17/Tune Out Miles BY THE PURCHASER OF ALL TERMS AND CONDITIONS O SALE STATED ON THE REVERSE SIDE HEREHiles OF, "'" " °........ " MOREOVER,PURCHASER,HEREBY ACKNOWLEDGES RECEIPT OF ALL REQUIREDSDS(S). wood Pallets Dlvd,,, ","......,... Mood Pallets Rtn. > Received by: lam°// ; == "�= "--� Date: U'(` � j CUS�'T1d► EarCOP�' l> is Dl vd..>. ... ...........>. Plastic Pa.,'-.lets et5 Rin