158920 04/30/2008 CITY OF CARMEL, INDIANA VENDOR: 359475 Page 1 of 1
ONE CIVIC SQUARE HELENA CHEMICAL CO
CARMEL, INDIANA 46032 98324 COLLECTION CENTER DR CHECK AMOUNT: $1,249.13
CHICAGO IL 60693 -0983
CHECK NUMBER: 158920
CHECK DATE: 4/30/2008
DEPARTMENT A CCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
905 4238900 73647041 1,249.13 OTHER MAINT SUPPLIES
(Liberty Center (IN)) Helena Chemical C
3073 S Main St Invoice 73647041
Liberty Center 46766
260 694:-6926
J''voice,Date 04/03/2008
BIII To: CITY OF CARMEL BROOKSHIPE GOLF COURSE Due Date 05/15!2008
12120 BROOKSHIRE PWY
CARMEL, IN 46033 Customer ID 3576723
Salesperson 17090
Shippin °g' Loc 1
Shi p To; 12120 BROOKSHIRE PWY
CARMEL, IN 46033
s Ticket(s),` 73637313
Quantity Description Unit Price Total'
5.000 BAG Grass Helena Pedigree Rye (50 Lb Bag)(Bag) 60.12 /BAG 300.60
3.000 BAG Grass Helena Caribbean Blue Bid (50 Lbs) 125.51 /BAG 376.53
2.000 GAL Podium (2x1 Gal)(Gal) 286.00 /GAL 572.00
d�
04 25 08 P01 :08 IN
,.Sub 16tal 1,249.13
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NOTE: By acceptance of the products or services reflected on this invoice, the purchaser agrees to be bound by Amount Due 1,249.13
all the terms and conditions of sale set forth in this invoice, including those on the reverse side of this invoice.
Remit To: Helena Chemical Company
98324 Collection Center Drive
Chicago IL 60693 -0983
Recommendation Was Made By or Provided to the Seller. Yes No Invoice 73647041
CITY OF CARMEL BROOKSHIPE GOLF COURSE
Pesticide N35567 Exp. Date 12/31/2008
TERMS AND CONDITIONS OF SALE
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CHIAHGE'i equal to the maximurn annnint al;3 Uy ah shat be', and coe, c� We unpaid n0mcm fmm Me Me of Wn nmwmy
staterneN netramn ndi;�ijscl until paytre! is received in It it ov Helena arociedited to purchascis acwuntn A! payment nace by
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TERMS, AND CONDFTiONSOF SALE INCLUI)FIG HELENA'S L.11AITED WARRANTY AND LIMIT ATION OF I IABILITY AND RFMED;ES,
LIMITED WARRANTY AND LIMITATION OF LIABILITY AND REMEDIES
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THE EXMTSWE REMEDY AGAINSPRAE SFUER FOR AM CMNE OF ACI ION IS A CLAIM FOR DAMAGFS Al IN NO
evEwTaHxuoAwAasS3on ANY OTHER nLcuvsR,opxmv KIND AGAINST SELLER EXCEED r*spmosoFrnsopeo/F/c
GOODS WHICH CALISF THE ALLEGED LOSS. DAMAGE, INJURY OR 01 C[.AlM, SELLER SHALL NOT BE LIABLE, AND ANY
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SEED WARRANTY
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IN CASE OF ERRORS OR INQUIRIES ABOUT YOUR B|LL
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(Liberty Center (IN)) Helena Chemi I C O. H Delivery Ticket 73637313
3073 S Main St Liberty Center, IN 46766 Loaded
Date 04/02/2008
Bill To: CITY OF CARMEL BROOKSHIPE GOLF COURSE Time 5:31:08 PM
12120 BROOKSHIRE PWY
CARMEL, IN 46033 Customer ID 3576723/-
Customer PO#
Salesperson 17090
Shipping Via. A B T TRUCKING
Ship To: 12120 BROOKSHIRE PWY Description
CARMEL, IN 46033
Ticket Type Pickup
Comments:
Quantity Description EPA Registration Load Amount Unit Price
5.000 BAG Grass Helena Pedigree Rye (50 Lb Bag)(Bag) 5.000 BAG
3.000 BAG Grass Helena Caribbean Blue Bid (50 Lbs) 3.000 BAG
2.000 GAL Podium (2x1 Gal)(Gal) 1.000 CS
Recommendation Was Made By or Provided to the Seller. DYesF 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 73637313
Pesticide N35567 Exp. Date 12/31/2008
"'ERW8S AND CONDITIONS {}F SALr-
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SEED WARRAFM!
1N CASE QF ERRORS DP|F ABOUT YOUR D00L
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SHIPPING ORDER
FROM: (Liberty Center (IN)) Helena Chemical Co. Ticket 73637313
3073 S Main St Date: 04/02/2008
Liberty Center, IN 46766 Phone: 260- 694 -6926
TO: CITY OF CARMEL BROOKSHIPE GOLF COURSE Field:
12120 BROOKSHIRE PWY
CARMEL, IN 46033
Package Unit HM Quantity Unit Product EPA Registration Weight(Ibs)
5.000 BAG 5.000 BAG Grass Helena Pedigree Rye (50 Lb Bag)(Bag) 250.000
3.000 BAG 3.000 BAG Grass Helena Caribbean Blue Bld (50 Lbs) 150.000
1.000 CS 2.000 GAL NOT REGULATED BY D.O.T.
Fungicides, N.O.I., Other than Poison (NMFC Item 102120, Class 60)
"Non -DOT Regulated"
Podium (2x1 Gal)(Gal) 20.000
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 �t
Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
V -3-D9 7 36 2a y i3
Total 7 7
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.
20
Clerk- Treasurer
VOUCHER NO. WARRANT NO.
ALLOWED 20
IN SUM OF
ON ACCOUNT OF APPROPRIATION FOR
Board Members
PO# or INVOICE NO. ACCT #/TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
05 7 L OW 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
y a� 200
Si ure
Cost distribution ledger classification if
J Title
claim paid motor vehicle highway fund
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