159908 05/28/2008 \tif CITY OF CARMEL, INDIANA VENDOR: 359475 Page 1 of 1
0 ONE CIVIC SQUARE HELENA CHEMICAL CO CHECK AMOUNT: $679.39
CARMEL, INDIANA 46032 98324 COLLECTION CENTER DR
y�roa "Eo CHICAGO IL 60693 -0983 CHECK NUMBER: 159908
CHECK DATE: 5128/2008
DEPARTME A PO NUMBER I NVOICE NUMBER AMO DESCRIPTION
905 4238900 73647865 679.39 OTHER MAINT SUPPLIES
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0Delive Ticket 73637943
(Liberty Center (IN)) Helena Cheml Delivery
3073 S Main St Liberty Center, IN 46766 Loaded
Date 05/12/2008
Bill To: CITY OF CARMEL BROOKSHIPE GOLF COURSE Time 7:43:10 AM
12120 BROOKSHIRE PWY
CARMEL, IN 46033 Customer ID 3576723/-
Customer PO#
Salesperson 17090
Shipping Via.
Ship To: 12120 BROOKSHIRE PWY Description
CARMEL, IN 46033
Ticket Type Pickup
Comments:
Quantity Description EPA Registration Load Amount Unit Price
5.000 GAL Soaker Plus (2x2.5 Gal)(Gal) EXEMPT 1.000 CS
5.000 GAL KickStand RTU 4 -13 -3 (2x2.5 Gal)(Gal) 1.000 CS
2.000 QT Lontrel (T &O) (12x1 Qt)(Qt) 62719 -305 .167 CS
Recommendation Was Made By or Provided to the Seller. ❑Yes No
Received by: Date:
PURCHASER ACKNOWLEDGES AND AGREES TO THE TERMS AND CONDITIONS OF SALE NOTED ON THE REVERSE SIDE HEREOF.
CITY OF CARMEL BROOKSHIPE GOLF COURSE Delivery Ticket 73637943
Pesticide N35567 Exp. Date 12/31/2008
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(Liberty Center (IN)) Helena Chemical
3073 S Main St Invoice 73647865
Liberty Center IN 46766
260- 694 -6926
�Invoicg Date 05/15/2008
Bill To: CITY OF CARMEL BROOKSHIPE GOLF COURSE a Due Date, 06/1 5/2008
12120 BROOKSHIRE PWY
Customer ID 3576723
CARMEL, IN 46033
t
Salesperson 17090
Shipping Loc' g 1
.:Ship To: 12120 BROOKSHIRE PWY
CARMEL, IN 46033
Trcket(s) 73637943
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I Quantity Description rice s alp$
g Tot
aye, P te._
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ni
5.000 GAL Soaker Plus (2x2:5 Gal)(Gal) 40.05,18AL 200":25
5.000 GAL KickStand'RTU 4 -13 -3 (2x2.5 Gal)(Gal) 39.00.' /GAL lv 1195'.
2.000 QT Lontrel (T &O) (12x1 Qt)(Qt) 142.07 /QT 284:14
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Sub Total 679.39
NOTE: By acceptance of the products or services reflected on this invoice, the purchaser agrees to be bound by
all the terms and conditions of sale set forth in this invoice, including those on the reverse side of this invoice. P a AtTtolltlt Due 679.39
Re it To: Helena Chemical Company
98324 Collection Center Drive
Chicago IL 60693 -0983
Recommendation Was Made By or Provided to the Seller. Yes No In v01 73647865
CITY OF CARMEL BROOKSHIPE GOLF COURSE
Pesticide N35567 Exp. Date 12/31/2008
TERMS AND CONDITIONS OF SALE
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pwcx�eplicemea& Item is not na,um iii wmbinxouayt,onmthe due date. smn*<�rv�oul'llerc,,*a
CHARGE) equal mm maximum amo allowed uy/m° shall ueas�sa�o and uvyonme:npsuuao-ce/n*' Pic d.x~^,^".``/,
statement reflecting xmhpmnias Inmnaymo^/is re,el,e(immouvHeie" an�orcumedmvumxasen ouo,jni^`�,
purutkaswwill be applied ac, provided former Nance advicemm;slm ey mHe�ena In the even!,v,jrc'm� «/n'm�
emIttance advice, naymem^ will ueapril.au as, +e/enadeems xsomo m trip uant z"ppurc :nu"Is
vovmonts"urequ'mu.mvaunvmmmvuocvnom*muuvov/ona,at �s uprictn,m/"C' anal puc»""oo,soaoueesnnnu�/em'/w.
payment u/ all costs o/uuneu/vn. including ,yasonomeammeym fees, neu/�wevu
Title m product and ,/oxu//oouo,uuwaoo�pmuyma»a//pum,mpum�aup/ "nvv�a/,na�vv/acmnmepum,ct°m Ills
poau.s.u.
oommvn earner. wm, respect to any nmuuu/ returned m*e/eno.ns,lrrloss shall mmamw.m»urcxo"o,um./moemmeo uu
received by Helena at file original snipping point or at such mhei lot'afion -is He,cna !nay ceu/onaw.oFsaF1 ow FOR Aoomnw4L
TERMS AND CONDITIONS op SALE INCLUDING HELENA suw/rpnmmnnAmTV^woumxA r ION oF LIABILITY Awonsm7D
LIMITED WARRANTY AND LIMITATION QFL|AB|L|TY AND REMEDIES
Sic, v,*a,rao,ow/v and that all onw,s Sold xetei /oo^wnnwo`eu,w/oouun�mn,n/em/ze,/ssvmh*�vroo,.,""^^^/..
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WARRANT voFwsnCvAmr ABILITY oRn1wsaauFr*p FOR Axv PARTICULAR puxpmes,xuomoyuo�I
WARRANTIES SHALL os IMPLIED avI-AkN1
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of such claim.
THE EXCLUSIVE REMEDY AGAINST
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EVEN r SHALL DAMAGES uo ANY OTHER RECOVERY op ANY KIND AGAINST o-_uen EXCEED r:s PRICE orr�cap�c/�'c
GOODS WHICH CAUSE r*exusaso/oaa, DAMAGE, INJURY oRcnHexo; AIM. SELLER SHALL NOT asuAeLF, �twu4x/
AND au CLAIMS AGAINST Ssusn ARE mmwso FOR spEc/AL, DIRECT onoumeEouewn*/o^mxosnonsx=rwp�sn�
ANY mAruns.IwcLuo/ws,aurworuMnso/ouoaaoppnop/rsonwcowecnopunpnopu�,,�osyory'.�
LABOR CHARGES Awo FREIGHT cvAnaea,w*srncnon NOT BASED ow`Hl-ucusnsmswuo�uc� ans»���,
WARRANTY. STRICT u^o/u [YIN ronron ANY OTHER oAuoEopAo/ION
SEED WARRANTY
Heler Chemical Cowpa %varrat its that seeds have been lab&od as iocuire.d urw '�itahe ailo Feder, tti,;cd ial,, :I
flbpn� conform to me label descro*,ion. Helena C GooIp, makes no otn(� o! lkvlho,�warranty, ixpn:lssed o Imp �Ki, of
e to the purchase pncc ")f tok
IN CASE DF ERRORS OR INQUIRIES ABOUT YOUR B/LL
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SHIPPING ORDER
FROM: (Liberty Center (IN)) Helena Chemical Co. Ticket 73637943
3073 S Main St Date: 05/12/2008
Liberty Center, IN 46766 Phone: 260- 694 -6926
Field:
TO: CITY OF CARMEL BROOKSHIPE GOLF COURSE
12120 BROOKSHIRE PWY
CARMEL, IN 46033
Package Unit HM Quantity Unit Product EPA Registration Weight(Ibs)
1.000 CS 5.000 GAL NOT REGULATED BY D.O.T.
Compound, Fertilizer (Manufactured Fertilizer), Liquid, NOIBN (NMFC
68140, Sub 6, Class 70) "Non -DOT Regulated"
KickStand RTU 4 -13 -3 (2x2.5 Gal)(Gal) 44.870
1.000 CS 5.000 GAL NOT REGULATED BY D.O.T.
Adhesive, Adjuvants, Spreaders or Stickers, Liquid, N.O.I. (NMFC
4610, Class 60) "Non -DOT Regulated"
Soaker Plus (2x2.5 Gal)( al) EXEMPT 42.600
.167 CS 2.000 QT NOT REGULATED BY D.O.T.
Compound, Weed Killing, Liquid (Herbicide), N.O.I. (NMFC Item
50320, Class 60) "Non -DOT Regulated"
Lontrel (T &O) (12x1 Qt)(Qt) 62719 -305 5.000
This is to certify that the above -named materials are properly classified, described, packaged, marked and labeled, and
are in proper condition for transportation according to the applicable regulations of the Department of Transportation.
Emergency Phone CHEMTRAC 1- 800 424 -9300
Placards:
Placards Offered Placards Refused Tie Down Offered []Tie Down Refused
Shipper: Carrier:
Per: Per:
Date: Date:
Customer Copy
Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No. 201 (Rev. 1995)
CITY OF CARMEL
An invoice or bill to be properly itemized must show: kind of service, where performed, dates service rendered, by
whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc.
Payee
Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
5 yS-,OS 73� 6 7�r 3 9
Total 4p 79.
1 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.
20
a
r�4. Clerk- Treasurer
4 F
VOUCHER NO. WARRANT NO.
ALLOWED
IN SUM OF
ON ACCOUNT OF APPROPRIATION FOR
9os �G C-
Board Members
PO# or INVOICE NO. ACCT #/TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
bill(s) is (are) true and correct and that the
materials or services itemized thereon for
which charge is made were ordered and
received except
S �.Z 20 6Y
Si g nn t
Cost distribution ledger classification if
Title
claim paid motor vehicle highway fund