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Home My WebLink About334008 01/04/19 (9, CITY OF CARMEL, INDIANA VENDOR: 359584 CHECKAMOUNT: $*****1,501.20* ONE CIVIC SQUARE BRENNTAG MID SOUTH INCCARMEL, INDIANA 46032 3796 RELIABLE PARKWAYCHECK NUMBER: 334008 CHICAGO IL 60686 CHECK DATE: 01/04/19 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 601 5023990 167430 999.00 OTHER EXPENSES 601 5023990 167431 502.20 OTHER EXPENSES VOUCHER NO. 183685 WARRANT NO. Prescribed by State Board of Accounts City Form No.201(Rev 1995) ALLOWED 20 Vendor# 359584 IN SUM OF$ 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 $1,501.20 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 167430 01-6180703 $999,00 and received except 12/27/2018 167430 $999.00 167431 01-6180-03 $502.20 12/27/2018 167431 $502.20 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#: BMS167431 INV DATE: 12/20/18 * * PAGE 1 OF 1 * DUE_ DATE: 1/19/19 SOLD TO: SHIP TO: CITY OF CARMEL UTILITIES CARMEL WATER, PLANT 4 3450 WEST 131ST STREET 10675 N. GRAY ROAD CARMEL IN 46074 CARMEL IN 46032 FEDERAL ID #: 610504545 DATE SHIPPED: 12/20/18 TERMS NET 30 DAYS B/L #. . . : 2352988-00 SHIP WHS: 29 SLSPRSN: 293 CUSTOMER # . : 407542 SHIP VIA: OUR TRUCK - PKG CUSTOMER PO#: AC121718 FOB . . : DELIVERED FREIGHT TERM: PREPAID TAX EX# : 356000972-001-9 PRO NUMBER . : 781927490 UNITS SHIPPED PROD # WGT/GAL TOTAL QTY UNIT PRICE EXTENDED -------------------------------------------------------------------------------- 4.0000 873311 11 .87000 600 .0000# .6120 367 .20 150.0000 # CYL CHLORINE, LIQUID (BMS ONLY) >A RPK -------------------------------------------------------------------------------- QUESTIONS, CALL 317-898-8632 REMIT TO ADDRESS: BRENNTAG MID-SOUTH, INC * 3796 RELIABLE PARKWAY * MERCHANDISE 367 .20 * CHICAGO IL 60686-3007 * FUEL SURCHARGE 100 .00 ******************** ****************** INS & SEC SURCHARGE 35 .00 ----------------- PAID ON OR PRIOR TO 1/19/19 INVOICE TOTAL USD 502.20 PAID AFTER 1/19/19 INVOICE TOTAL USD 512.24 Original Document BRENNTAG BRENNTAG MID-SOUTH, INC. 1405 HIGHWAY 136 WEST PO BOX 20 HENDERSON KY- 42419-0020 INVOICE#: BMS167430 INV DATE: 12/20/18 * * PAGE 1 OF 1 *** DUE DATE: 1/19/19 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: 12/20/18 TERMS NET 30 DAYS B/L #. . . : 2352998-00 SHIP WHS : 29 SLSPRSN: 293 CUSTOMER # . : 407542 SHIP VIA: OUR TRUCK - PKG CUSTOMER PO#: AC121718 FOB . . : DELIVERED FREIGHT TERM: PREPAID TAX EX# : 356000972-001-9 PRO NUMBER . : 781927492 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 100 .00 **************************** ********** INS & SEC SURCHARGE 35 .00 ----------------- PAID ON OR PRIOR TO 1/19/19 INVOICE TOTAL USD 999.00 PAID AFTER 1/19/19 INVOICE TOTAL USD 1,018.98 Original Document Bill, 01" Lad 1ng/Sh1PIP ent RM�iAt �** Continued from PreoiOVs Page �� Page 2 of 3 BRENNTAG MID-SOUTH ' PHONE- 317-898-8632 ` �I/�9/�8 20:37:55 � - � -' ' ��U� 3111 # POST RD � FMX: � �� ~' DEA REG NO. 006601DNY ` ` INDIANAPOLIS, IN 46226 SOL# 2352988-00 DplY Date: I2/20/: Ship CARMEL. WATER" PLANT 4 Sold CITY OF CARMEL UTILITIES Customer:� 407542 Ship TO: 6 Ship Date: 12./20 � To: I0675 N. GRAY ROAD To: 34-50 WEST 131ST STREET AttD- Frt Terms: PREPAIl CARMEL" IN 46032 CARMEL, IN 46074 FOB. ' . : DELIVERED lakgD By : BM29SL] Ship Y+a: OUR TRUCK PKG Placed By. ANDY [[ R8cV Hrs: 8:00 AM- 4:80 PM PhoDe#' . : 217-57� phOO8: 017-718-3917 Ext: Phone: 317-571-2443 Ext: T8r0o' . : NET 30 DAYS CUst POff AC1217- r_QUANTIT� PACKAGING HM DESCRIPTION M QUANTITY PROD SHIPPED ORDERED BACK ORDERED COE IF %FQ\K OR SPILL OCCURS DURING TRWSgORrArzoN: � ' [CN3170 EMERGENCY CONTACT: CALL CHEMTRE[ TOLL PREE' MT 24 HOURS 7 DAYS RQ 1UN1017, ' IRQ,IIARINE POLLUTANT POISON-INHALATION HAZARD, ZONE B- !CHLORINE 4.0000 150.0000 LB CYL 1CHLORINE, LIQUID (BMS ONLY) >A RPK 4.0000 873,,'10ty. 30.0000 5.0000 35.0000'!Product picl�ed from:Lot: 2 Loc: A2R2A Qty: 4.0000 liFreight Class. . . '4100 Net Weight: 600.000 CYL!Weight Per Gallon: 11.87000___-__-_--_--- -----_--- __---___ -_-_ C' Total Net e1 t: 60C.0000 Total roGs This is to certify that the above named materi' ` ' ~ ~ ~ als are properly classified,described,packaged,marked,and labeled,mm ~~~~ ~~~~��n�~~v^^ ~~~a~ ~qm��c��u�� Loaded By: _ _~_~~~_____ Checked By: _______ Signature ozuugppVehicle: Driver: _�___-_--'- rn�c��amm'm�o�mp��mca Mil8a- __.~ Time In/lime OVt___ ~^ ^~~^~~~^~~~~~~~~~~~~~~~~^~'~~^`-----'-HEREBY ACKNOWLEDGE rLECE11PT OF ALL REQUMED SDS(S). Wood Pall�t$ Dlvd___________ Wood Pallets Rtn:__ MOREOVER � _> / c Pallets DlVd Plastic Pallets Rtn ,3:1,1.1. Of- Ladinq/Shipmen t, Receipt Page 1 of 2 BRENNTAG MID-"SOUTH PHONE.- 317-898-8632 12,119/18 20:38:15 B R E 3111 N POST RD Fk: „...;, ,. DEA REG NO. 006601,BNY INDIANAPOLIS, IN 46226 BOL# . : 2352998--00 Defy Date: 12/207, Ship Cr RMEL UTILITIES SFS PLTSold CITY OF CARMEL UTILITIES Ct1s'tomer: A07542 Ship To: 11 Ship Date: 12/20/ To: 4915 E 10.6 ST To. z145O WEST 131ST STREET Attn- Fr,.t, Terms PREPAI CARMEL, ' IN 4-6033 CARMEL., IN 46077 FOB. . . : DELIVERED Taken By BM298L y Ship Via: OUR TRUCE{ ;- PK,G Placed By: ANDY C Recv Hrs. '7:30 Ate- 4:00 Pini Phone#. : 317-57 Phone: 317-571.-:2 ,.43 Exp:: Phone: 317-571-2,443 Ext: Terms. _:` NET 30 DAYS Cus't PO# AC1217 QUANTITY QUANTITY PROF SHIPPED PACKAGING HM \ DESCRIPTION M ORDERED BACKORDERED COI IF LEAK OR SPILL OCCURS DURING TRANSPORTATION: CCN3170 EMERGENCY CONTACT: CALL CHEMTREC TOLL FREE AT 1-800•-424-9300 24 HOURS / 7 DAYS FREIGH`i" CARRIER: INVOICE TMa VIA. ED:I OR CARRIER P0ti`fAL. ; JEt"F 317-571--2639 ANDY :317-750-1.479 k jUig:1O1i, 'CHLORINE, v"RQ,MARINE POLLUTANT 1POISON-INHALATION HAZARD, LONE; B ;MERG #: 124. s. 1,0000 2000.0000 LB CYL �r �Cflt.ORLi�l�, LIQUIDaDMS ONLY ?A RF'Si � .00U0 253 ','Loc: OSE04 OSOELOT . ;lQty: 1.0000 11-0000 " Product picked -fr"rm: :.r 1 a, § Lot: 2 Lor. OSEO Q'f y: 1.0000 :oFr' caht Cass.. . . 200 r g ( ' ` Weac3ht Per Gallon: 1.1.37000 Net Weight: 2000,000 CYL i o'ta�.�Ne�tR�le:�.3h'tw.w ,_.._.,w.w.:2,O(JO.00Ot3._,�.+o'ta1Wa:,r®ss IJ e condition for transportation above named materials are properly classified,de ed caged arke an lab, d,a3,1#in proper• This is to certify that he ``�� on according`to the applicable regulations of t sp, o Loaded ' ': Checked BY: „•,.,,,,,,, Signature of Shipper: Vehicle• Driver: ,,,,. ,,,,,... PURCHASER'S ACCEPTANCE OF THE GOODS COVERED jh THIS DOCUMENT SHALL CONSTITUTE ACCEPTANCE miles: Time I n/Time O U t BY THE PURCHASER OF ALL TERMS AND CONDITIONS OF SALE STATED ON THE REVERSE SIDE HEREOF. """" """" "" MOREOVER,PURCHASER,HEREBY ACKNOWLEDGES RECEIPT;OFALL REQUIRED SDS(S). f� Wood Pallets Dlvd ..-*,.,. -",1,;,,• Wood Pallets 'Rtn ....-, Received by: r`�,- 1r��" tri' Plastic Pallets D3.v'a Plastic Pallets €�:t�'i //�`��t Date: " CUSTOMER COPY, "`°""""`""`"`"' I