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334064 01/04/19 (9) CITY OF CARMEL, INDIANA VENDOR: 368571 ONE CIVIC SQUARE HERITAGE CRYSTAL CLEAN, LLC CHECKAMOUNT: $********88.00* CARMEL, INDIANA 46032 13621 COLLECTIONS CENTER DRIVE CHECK NUMBER: 334064 CHICAGO IL 60693-0136 CHECK DATE: 01/04/19 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 651 5023990 15464777 88.00 OTHER EXPENSES VOUCHER NO. 187117 WARRANT NO. ALLOWED 20 Prescribed by State Board of Accounts City Form No.201(Rev 1995) Vendor #,368571 IN SUM OF$ ACCOUNTS PAYABLE VOUCHER HERITAGE-CRYSTAL CLEAN, LLC CITY OF CARMEL 13621 COLLECTIONS CENTER DRIVE An invoice or bill to be properly itemized must show: kind of service,where performed, CHICAGO, IL 60693-0136 dates service rendered, by whom, rates per day, number of hours, rate per hour, numbers of units, price per unit, etc. Payee 88.00 368571 Purchase Order No. ON ACCOUNT OF APPROPRATION FOR HERITAGE-CRYSTAL CLEAN, LLC Terms Carmel Wasterwater Utility 13621 COLLECTIONS CENTER DRIVE Due Date BOARD MEMBERS I hereby certify that that attached invoice(s), CHICAGO, IL 60693-0136 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 15464777 01-736H-08 $88,00 and received except 12/28/2018 15464777 $88.00 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 Heritage-Crystal Clean, LLC Invoice Billing Inquiries:(877)938-7948 HERITAGE-CRYSTAL CLEAN,LLC custsery@crystal-clean.com 2175 Point Boulevard,Suite 375 C rsta I Elgin,IL 60123 Remit to:13621 COLLECTIONS C I can CHICAGO,EL 60 93NTER DRIVE --0136 1 of 1 • 15464777 12/20/2018 • 153913 • $88.00 $0.00 2421 MB 0.424 E0233X 10309 04354823084 S2 P5995730 0001:0001 .• $ss.00 'I-1111-11111'11111ti111111111I1I111111111tt11111'IIIIIII...IIIII CARMEL UTILITIES HOUSEHOLD • $ss.00 ATTN:ACCOUNTS PAYABLE Subject to finance charges if payment not received by 01/19/19 30 W MAIN ST CARMEL IN 46032-1938 • •' • • • http://www.hccquickconnect.com • • SDM GBV FLT Service Location 'O No: Agreement: - INDIANAPOLIS 756406 Svc Date Work Order Product Description/Comment Equip QTY Unit Price Tax Amt Total Cost 12/20/2018 00-OOC4SOW USED OIL PICKUP-CHARGE 400 $0.10 , $0.00 $40.00 12/20/2018 00-OOC4SOW USED OIL PICKUP-CHARGE 480 $0.10 $0.00 $48.00 Item Total: $88.00 Thank you for your Business. Save time and money with online billing.Choose email,paper,or fax delivery. View your invoice history and balances. Pay online by ACH or credit card. Import invoices into your accounting system. Go to http://hccquickconnect.com to enroll today! Thic form flnvnir)is Aco d nnn of fhn nhr.vn.ofo.-nn-,a Ce..,o.e e,..ee..,e.,•..,.....,..,u..a•_,.,,r-_•_:n.___::r__..�_:.__.:.:_._.._.____ .... -