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Home My WebLink About331480 10/25/18 i pl.C�q� ® �. CITY OF CARMEL, INDIANA VENDOR: 359584 ONE CIVIC SQUARE BRENNTAG MID SOUTH INC CHECK AMOUNT: $*******996.50* 9 �a�; CARMEL, INDIANA 46032 3796 RELIABLE PARKWAY CHECK NUMBER: 331480 y��TON�°. CHICAGO IL 60686 CHECK DATE: 10/25/18 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 651 5023990 BMS115542 996.50 OTHER EXPENSES VOUCHER NO. 186704 WARRANT NO, ALLOWED 20 Prescribed by State Board of Accounts City Form No.201(Rev 1995) Vendor # 359584 IN SUM OF$ ACCOUNTS PAYABLE VOUCHER BRENNTAG (ULRICH) CITY OF CARMEL 3796 Reliable Parkway An invoice or bill to be properly itemized must show: kind of service,where performed, CHICAGO, IL 60686 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(ULRICH) Terms Carmel WasterWater UtllltV 3796 Reliable Parkway Due Date BOARD MEMBERS I hereby certify that that attached invoice CHICAGO, IL 60686 (s), or bill(s)is(are)true and correct and that PO# ACCT# the materials or services itemized thereon DATE INVOICE# Description DEPT# INVOICE# Fund# AMOUNT for which charge is made were ordered and DEPT# FUND# (or note attached invoice(s)or bill(s)) AMOUNT BMS115542 01-7182-05 $996.50 and received except 10/18/2018 BMS115542 $996.50 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. 20_ Clerk-Treasurer BRENNTAG BRENNTAG MID-SOUTH, INC. 1405 HIGHWAY 136 WEST PO BOX 20 HENDERSON KY 42419-0020 INVOICE#: BMS115542 INV DATE: 10/15/18 * PAGE 1 OF 1 * * DUE DATE: 11/14/18 SOLD TO: SHIP TO: CARMEL WASTE WATER HAZEL DELL 9609 HAZEL DELL PARKWAY 9609 HAZEL DELL INDIANAPOLIS IN 46280 CARMEL IN 46280 FEDERAL ID #: 610504545 DATE SHIPPED: 10/15/18 TERMS NET 30 DAYS B/L #. . . . : 2292720-00 SHIP WHS : 29 SLSPRSN: 293 CUSTOMER # . : 407542 SHIP VIA: OUR TRUCK - PKG CUSTOMER PO#: VERBAL FOB . . : DELIVERED FREIGHT TERM: PREPAID TAX EX# : 356000972-001-9 PRO NUMBER . : 779609597 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 11/14/18 INVOICE TOTAL USD 996.50 PAID AFTER 11/14/18 INVOICE TOTAL USD 1,016.43 Original Document fill of Lading/ShipmAnt Receipt Page 1 of 3 3RENNTAG MID-SOUTH 1 PHONE: 317-898-8632 10/15/18 13:55:12 gRENNTAG �I`• 3111 N POST RD, 1J FAX: DEA REG NO- 00660IB Y CNDIANAPOLIS, IN 46226- tt- BOL# _: 2292720-OG Dely Date: 10/15/18 Ship HAZEL 'DELL Sold CARMEL WASTE WATER Customer: 407542 Ship To: 10 Ship Date: 10/15/18 0 Ship From: 29 To: 9609 HAZEL DELL To: 9609 HAZEL DELL PARKWAY Attn- Frt Terms: PREPAID Frt Code : CARMEL, IPI 46280 INDIANAPOLIS, IN 46280 FOB. .: DELIVERED Taken By : BM29SLD $is Per k: 293 Ship Via: OUR TRUCK - PKG Placed By: JEFF COOPER Recv Hrs: 8;00 AM- 4:00 PM Phone#. .: 317-571-2443 Phone: 317-571-2634 Ext: Phone: 317-571-2443 Ext: Terms. _: NET 30 DAYS Cust PO# VERBAL QUANTITY PACKAGING HM DESCRIPTION M QUANTITY, PRODUCT CONTAINER GROSS SHIPPED ORDERED BACKORDERED CODE DEPOSIT WEIGHT IF LEAK OR SPILL OCCURS DURING TRAM&ORTATION: 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_ :"DIRECTIONS: '`. KEYSTONE N TO-96TH STREET_ EAST TO GRAY. TURN LEFT TO . 106TH STREET. ON CORNER_ ,IJVEHICLE: LIFTGAT- Accessorial Requirements LIFTGATE ----------------------------------�- '_' ';:, ------__----_.----_------------------------------------_--- -------_----- -------- -_-- ------ ------ _ ;:13 * Continued an 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 e Department of Transportation. Signature ofShletnaccordin to the licablereulationsofth' Loaded B Checked P g PP g B PP _ _...._. I-� Driver: r b'7 PURCHASER'S ACCEPTANCE OF THE GOODS COVEREb BY THIS DOCUMENT SHALL CONSTITUTE ACCEPTANCE Mi l es:e_ � /�• „•,„„,„,,,,,„,,,,_„,_ •„,,,,,,,,,,„„,_ � ............... r' BY THE PURCHASER OF ALL TERMS AND CONDITIONS OF SALE STATED ON THE REVERSE SIDE HEREOF.' Miles:e s „ _„_,•„„,_, _„• Time I n/T lm e Out_,,,,,•, MOREOVER,PUR SER-"—RE ACKNOWLEDGESRECEIPTOFALLREQUIREDSDS(S). Wood Pallets Dlvd,„ Wood Pallets Rtn:,__ 'Ilkf lets Dlvd_,„,,,, Plastic Pallets Rtn I .;�<'C^'^ Date: �b ' CUSaIiE .,._ .,, ,__ Received by: r' 1 - ill of Ladih9/Shipment Receipt Continued from Previous Page .x* Page 2 of 3 m z RENNTAG MID-SOUTH PHONE.::PHONE:: 317-898-8632 10/15/18 13.55.12 y FAX BRENNTAG -ID 111 N POST RD A �� EA REG NO. 00660IBNY hlDIANAP0115, IN 46226' BOL# .: 2292720-00 Pely .Date: 10/15/18 age il- hf! hip 14AZEL DELL StAd CARMEL WASTE WATER Customer: 407542 Ship To: 10 Ship Date: 10/15/18 0 Ship From: 29 !to �'� 0: 9609 HAZEL. DELL T6. 9609 HAZEL DELL PARKWAY Attn- .,4 rt Terms: PREPAID Frt Code f gl ~ CARMEL, IN 462.80 INDIANAPOLIS, IN 46280 FOB. . .: DELIVERED TaKen By : BM29SLD Sls Per .: 293 Ship Via: OUR TRUCK - PKG :Placed By: JEFF COOPER Recv Hrs: 8:00 AM- 4:00 PM iPhone#• .: 317-571-2443 Phone: 317-571-2634 Ext: ' Phone: 317-571-2443 Ext: Terms. .: NET 30 DAYS "Gust PO# VERBAL. QUANTITY QUANTITY PRODUCT CONTAINER GROSS PACKAGING HM DESCRIPTION M ^' SHIPPED ORDERED BACKORDERED CODE DEPOSIT WEIGHT IF LEAK OR SPILL OCCURS DURING TRANSPORTATION: CCN3170 EMERGENCY CONTACT: CALL .CHEMTREC TOLL FREE AT -800-424-93W, WEIGHT 24,HOURS / 7 DAYS IN LBS DRQ�UN1017, ' �, ,�HLOR•INE, RO,MAKNE_POLLU NT I, I OT&ON IWA A HAZARD.- ZOnIE a p TION H Ltd "#: 1,4_z;, E; 1.0000 ,2006.0000 LB CYL '�GIJLORINE,._LIQUIll' (BMS ONLY) L >A RPK LOO JO 253418 3360 1 OSE05 O000t 6.0000 6.0000 �� 1 Product picKed from: Lot: 2 Loc: OSl+04 Qty: 1.0000 J l Leight Class...: 200 (.. ._;Weight Per Gallon: 11.87000 Net Weight: 2000.000 CYL t` ------------�-------------------•--- -----------a _;_-------- -= ----- --_- _- - ----- ------------------ Total _ n�:.. Total Net Weight: 1,000 Total ross Weight: 3,1'360 This is to certify that the above named materials a�e properly classified,described,packaged,marked,and labeled,and are in proper condi[ionfor[ransportadonaccord(ttgtotteappltcableregola[ionsof[heDepartmen[ofTranspoAation. Loaded By: ,,,,,,,,,,•,,., - Checked B�(: ,,,,,,,M,,,,,, }. Signature of shipper: Vehicle: Driver __.. PURCHASER'S ACCEPTANCE OF THE GOODS COVERED BY THS DOCUMENT SHALL CONSTITUTE ACCEPTANCE i Miles:,,,,,, Time In/ Outs B''THE PURCHASER OF ALL TERMS AND CONDITIONS OF SALE STATED ON THE REVERSE SIDE HEREOF. MOREOVER,P CHASER HEREBX�CKNOWLEDGESRECEWTOFALLREQUIREDSDS(S). e lv - is Pallets Rtn -- �,(\ od Pallets Rtn ,,,_• i ast P Vii'- `• •......_......_ ._..._..� _.... Received by: CU Wood D1Y o r i Date: _ _ 1 is D d........._............. Plastic i.il.o'E',,Ladinp/Shipment Receipt Page 3 of 3 4ZEL BELL PHON377-571-2634 " 10/15/18 73:55:12 509-HAZEL' DELL r FAX 1. �",c BRENNTAG I ARMEL,'�IN 46280 > 5 BOL## .: 2292720-00 Aeiv Date: 10/1518 hip'73RENNTAG MID-SOUTH PfelT°Up HAZEL DELL t Customer: 407542 Ship To: 10 Ship Date: 10/15/7:8 0 Ship From 29 o: 3111' N POST RData ' 9609 HAZEL DELL k; Attn- r,i-t Terms: PREPAID Frt Code . DEA. REG NO. 00660_IBN'Y l.s CARMEL, IN 46280 FOB. . .: DELIVERED taken By : 'BM29SLD Sls Per 293 INDIANAPOLIS; IN 46226 Ship Via: OUR TRUCK - PKG Placed By: JEFF COOPER . . •s Recv Hrs: 8:00 AM- 4':00 PM Phone#:. .: 317-571-2443 t: Phone.: 317-898-8632 Ext: ; Phone: 317-571-2634 Ext: Terms. .: NET 30 DAYS rust PO# : VERBAL QUANTITY DESCRIPTION!. M QUANT6Y PRODUCT CONTAINER GROSS PACKAGING HIN. ORDERED BACK ORDERED CODE DEPOSIT WEIGHT - SHIPPED IF LEAK OR SPILL OCCURS. DURING TRANS RTATION: CCN3170, EMERGENCY CONTACT:`CR !_ CHEMTREC TOLL FREE AT 1-800-424-9300 WEIGHT E, 24 HOURS / 7 DAYS a IN LES k p* rix r� z ax*x uxcmz*z z*zz vz*a »x *xcz z<zczs�uz< z�z x xmz z � z xc RESIDUE RE t UN PRODUCTSI&R. mxz z: z ;. x :&xz *x xmx wz z m � z< zTz z �zz aez x 'az *x ';tt� z zcmzcz DO NOT HIP DRIVERS PLEASE LIST SERIAL NQqPERS ON ALL RETURN SERIA COVTAINERS err DRQ^ ��y E -D.. ( LAS? DCOPI7AINE yE' r sr��'• gA t rLORINE fir' 'tt i° RQ;MARINE POLLUTANT is ON-INHALATION HAZARD, ZONE B d' - '° LORINE - " 0000 ? 0000 LB CYL tHLORINE;: LIQUID (BMS ONLY) >A RPK NONE 1.000 ' 253418 ---------------- --------------- s .fI`f This is to certify that the above named materials are properly classified+described packaged,marked,and labeled,and are in proper rtify condition for transportation,according to the applicable regulations of theAepartment of Transportation. Loaded By: C112 C k e d By, ' Signature of Shipper: " Vehicle. DI"iVer PURCHASER'S ACCEPTANCE OF THE GOODS COVERED BY?'!HIS DOCUMENT SHALL CONSTITUTE ACCEPTANCE "" ""'"'"'_"'"`"""""" """'"'"`" '"'""""'""""^""`"` `"" " " gYTHE PURCHASER OFALL TERMS AND CONDITIONS OF)4ESTATED ONTHE REVERSE SIDE HEREOF. ?; Mi125:•"•••,•••••••,•• T fl2 IR/Time OUt,,,,__,,,,•„„,,,,,,,,, _,,;,;.„,,, MOREOVER,PURCHASE R,�iERE] —ACKNOWLEDGESREC'gh�1'OFALLREQUIREDSDS(S). Ub00d,Pallets Div dWood Pallets Rtn: ..... lets D]Vd._......,...".,,-,... . Plastic Pallets Rtn Received by: Date: CUSP7FErGC _, a