HomeMy WebLinkAbout333884 12/27/18 CITY OF CARMEL, INDIANA VENDOR: 359684
ONE CIVIC SQUARE BRENNTAG MID SOUTH INC CHECK AMOUNT: $*******999.00*
'•i' �; CARMEL, INDIANA 46032 3796 RELIABLE PARKWAY CHECK NUMBER: 333884
9 CHICAGO IL 60686 CHECK DATE: 12/27/18
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION,
651 5023990 BMS160742 999.00 OTHER EXPENSES
VOUCHER NO. 187082 WARRANT NO. ALLOWED 20 Prescribed by State Board of Accounts City Form No.201(Rev 1995)
Vendor# 359584 IN SUM OF$ 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
999.00 359584 Purchase Order No.
ON ACCOUNT OF APPROPRATION FOR BRENNTAG(ULRICH) Terms
Carmel Wasterwater Utility 3796 Reliable Parkway Due Date
BOARD MEMBERS
I hereby certify that that attached invoice CHICAGO, IL 60686
(s),
PO# ACCT# or bill(s)is(are)true and correct and that DATE INVOICE# Description
the materials or services itemized thereon
DEPT# INVOICE# Fund# AMOUNT for which charge is made were ordered and DEPT# FUND# (or note attached invoice(s)or bill(s)) AMOUNT
BMS160742 01-7182-05 $999,00 and received except 12/18/2018 BMS160742 $999.00
I hereby certify that the attached invoice(s),or bill(s),is(are)true and correct and I have
audited same in accordance with IC 5-11-10-1.6
Cost distribution ledger classification if claim paid motor vehicle highway fund. , 20_
Clerk-Treasurer
BRENNTAG
hSRx:
BRENNTAG MID-SOUTH, INC.
1405 HIGHWAY 136 WEST
PO BOX 20
HENDERSON KY 42419-0020
INVOICE#: BMS160742 INV DATE: 12/12/18 * PAGE 1 OF 1 **
DUE DATE: 1/11/19
SOLD TO: SHIP TO:
CITY OF CARMEL UTILITIES HAZEL DELL
3450 WEST 131ST STREET 9609 HAZEL DELL
CARMEL IN 46074 CARMEL IN 46280
FEDERAL ID #: 610504545 DATE SHIPPED: 12/12/18 TERMSW NET 3029AYS
SLSPRSN: 293
B/L #. . . : 2347450-00 SHIP
CUSTOMER # . : 407542 SHIP VIA: OUR TRUCK - PKG
CUSTOMER PO#: S19188 FOB . . : DELIVERED
FREIGHT TERM: PREPAID TAX EX# : 356000972-001-9
PRO NUMBER . : 781627657
UNITS SHIPPED PROD # WGT/GAL TOTAL QTY UNIT PRICE---------EXTENDED
--
-------------------------------------------------------------
1 .0000 253418 11 .87000 2000 .0000#
.4320 864.0
2000.0000 # CYL CHLORINE, LIQUID (BMS ONLY)
-------------------------------------
Received by :�. - --
Date: _ PO #: ��►��
cct #v.
Use:
QUESTIONS, CALL 317-898-8632
* REMIT TO ADDRESS:
* BRENNTAG MID-SOUTH, INC
* 3796 RELIABLE PARKWAY * MERCHANDISE 864.00
IL 60686-3 100.00
007 * FUEL SURCHARGE
CHICAGO 35.00
*************************************** INS & SEC SURCHARGE
PAID ON OR PRIOR TO 1/11/19 INVOICE TOTAL USD 999.00
PAID AFTER 1/11/19 INVOICE TOTAL USD 1,018.98
Original Document
Brenntag Mid-South, Inc.
RETURNED CONTAINER RECENT ,
Customer Named B/L# `? '+�; %' Date
QTY CODE DESCRIPTION CREDIT$ QTY CODE DESCRIPTION CREDIT$
827848 55 GAL STEEL DRUM 305564 100#ANHY AMMONIA CYL
929593 55 GAL STEEL DRUM RECON 797329 150#ANHY AMMONIA CYL
120431 5GAL CARBOY
179417 100#CHLORINE CYL
VENDOR STEEL DRUM 249173 150#CHLORINE CYL
617606 15 GAL DELDRUM 550384 TON CHLORINE CYL
505920 30 GAL DELDRUM
430722 55 GAL DELDRUM 875152 150#SULFUR DIOXIDE CYL
VENDOR POLY DRUM 6317 1 TON SULFUR DIOXIDE CYL
181031 250#HYDROGEN PEROXIDE DR
411951 55'GAL DI WATER DRUM COMMENTS ABOUT CONTAINERS
248103 15,GAL STAINLESS STEEL DRUM
928859 55 GAL STAINLESS STEEL DRUM v
638978 PLASTIC PALLETS
PORTABLE TANKS
Product Name Tank# SSICS1 PL Product Name. - Tank# SS CS PL
Misc. Comments `
ALL CONTAINERS'MUST.BE-CJ 13LETELY EMPTY AND BUNGS INTACT AND SECURE.
CONTAINERS-RETURNEDJ�N'POOR.CONDITION ARE SUBJECT TO LOSS OF DEPOSIT.
Customer Signature; _ r� Driver Signature:
Form#1039 Rev 01/17y