192004 11/23/2010 CITY OF CARMEL, INDIANA VENDOR: 359584 Page 1 of 1
j
E =1 ONE CIVIC SQUARE BRENNTAG MID SOUTH INC CHECK AMOUNT: $4,129.00
CARMEL, INDIANA 46032 3796 RELIABLE PARKWAY
`].d� �o• CHICAGO IL 60686 CHECK NUMBER: 192004
CHECK DATE: 11/23/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
601 5023990 931024 211.00 OTHER EXPENSES
601 5023990 931025 3,918.00 OTHER EXPENSES
BRENNTAG
INVOICE BMS931024 INV DATE: 11/15/10 PAGE 1 OF 1
DUE DATE: 12/15/10
30LD TO: SHIP TO:
CARMEL WASTE WATER CARMEL WATER, PLANT 3
3450 WEST 131ST STREET 4425 E. 126TH STREET
CARMEL IN 46074 CARMEL IN 46032
FEDERAL ID 610504545 DATE SHIPPED: 11/15/10 TERMS NET 30 DAYS
3/L 620927 -00 SHIP WHS: 29 SALESPRSN: 294
:USTOMER 407542 SHIP VIA: OUR TRUCK PKG
.'USTOMER PO JERRY FOB DELIVERED
TAX EX# 35600972 -001 -9
JNITS SHIPPED PROD WGT /GAL TOTAL QTY UNIT PRICE EXTENDED
4.0000 873311 11.870 600.0000# .3100 186.00
150.0000 CYL CHLORINE, LIQUID (BMS ONLY)
>A RPK
JESTIONS, CALL 317 -898 -8632
REMIT TO ADDRESS:
BRENNTAG MID SOUTH, INC
3796 RELIABLE PARKWAY
CHICAGO IL 60686 -0037 MERCHANDISE 186.00
F****** INS SEC SURCHARGE 25.00
PAID ON OR PRIOR TO 12/15/10 INVOICE TOTAL 211.00
PAID AFTER 12/15/10 INVOICE TOTAL 215.22
Original Document
a
INVOICE BMS931025 INV DATE: 11/15/10 PAGE 1 OF 1
DUE DATE: 12/15/10
30LD TO: SHIP TO:
CARMEL WASTE WATER CARMEL WATER, PLANT 5
3450 WEST 131ST STREET 5484 E. 126TH STREET
CARMEL IN 46074 CARMEL IN 46032
{EDERAL ID 610504545 DATE SHIPPED: 11/15/10 TERMS NET 30 DAYS
3/L 620925 -00 SHIP WHS: 29 SALESPRSN: 294
3USTOMER 407542 SHIP VIA: OUR TRUCK PKG
:USTOMER PO JERRY FOB DELIVERED
TAX EX# 356000972 -001 -9
JNITS SHIPPED PROD WGT /GAL TOTAL QTY UNIT PRICE EXTENDED
80.0000 805002 1.000 4000.0000# .9500 3,800.00
50.0000 BAG SOD FLUORIDE GRAN
>A F/S
2.0000 873311 11.870 300.0000# -3100 93.00
150.0000 CYL CHLORINE, LIQUID (BMS ONLY)
>A RPK
JESTIONS, CALL 317 -898 -8632
REMIT TO ADDRESS:
BRENNTAG MID SOUTH, INC
3796 RELIABLE PARKWAY
CHICAGO IL 60686 -0037 MERCHANDISE 3,893.00
INS SEC SURCHARGE 25.00
PAID ON OR PRIOR TO 12/15/10 INVOICE TOTAL 3,918.00
PAID AFTER 12/15/10 INVOICE TOTAL 3,996.36
Original Document
VOUCHER 103339 WARRANT ALLOWED
35.9584 IN SUM OF
BRENNTAG MID -SOUTH INC
3796 RELIABLE PARKWAY
CHICAGO, IL 60686 -0037 WA7M
OPERATIONS
Carmel Water Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
931025 01- 6180 -03 $3,918.00
�t 31ca`� ��,�1 sDt o3 ate.
C()
Voucher Total
Cost distribution ledger classification if
claim paid under vehicle highway fund
Prescribed by State Board of Accounts City Form No. 201 (Rev 1995)
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice or bill to be properly itemized must show, kind of service, where
performed, dates of service rendered, by whom, rates per day, number of units,
price per unit, etc.
Payee
359584
BRENNTAG MID -SOUTH INC Purchase Order No.
3796 RELIABLE PARKWAY Terms
CHICAGO, IL 60686 -0037 Due Date 11/17/2010
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
11/17/201( 931025 $3,918.00
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
Date Officer