HomeMy WebLinkAbout173717 06/24/2009 CITY OF CARMEL, INDIANA VENDOR: 358405 Page T of 1
ONE CIVEC SQUARE ASHLAND SPECIALTY CHEMICALS
CARMEL, INDIANA 46032 P 0 BOX 116735 CHECK AMOUNT: $758.11
ATLANTA GA 30368.6735 CHECK NUMBER: 173717
CHECK DATE: 6/24/2009
DEPAR ACCO PO NUMBER INVOICE NUMBE AMOUNT DESCRIPTION
1110 4231500 21025 92512891 758.11 OIL
�S�rIL�NUm REMITTANCE ADVICE ORIGINAL
t' Page 1(1)
Invoice Number Invoice Date Due Date
92512891 28 May 2009 27 Jun 2009
P.O.Number Payment Terms Payer Number
N 05/2212009 Net 30 Days 344796
ri
rn
Shipped From Carrier Bill -To Number
NOBLESVILLE HERRIMAN BLVD PKGD ASHLAND FLEET INDIANAPOLIS 15280 344796
Bill of Lading Number Incoterms DDP Dest. Frt Prepaid Ship -To Number
1800848 344796
Billing address Shipping address
CARMEL POLICE DEPARTMENT CARMEL POLICE DEPARTMENT
3 CIVIC SO 3 CIVIC SO
CARMEL IN 46032 -2584 CARMEL IN 46032 -2584
Qty. UoM Material Number Material Description Batch Billing Oty UoM Unit Price Amount
Number USD
2 DR UM741 ULTRAMAX 5W30 DR 55 GA 2 DR 376.9150 753 -83
Fuel /EnergySurcharge 4.28
Should you have any questions regarding this Invoice Total
invoice, please contact USD 758.11
ROBIN GOOLMAN
at 859- 357 -2318
Remit to ACH Credit Wire transfer
P.O. Box 116735 Ashland Inc. Ashland Inc.
ATLANTA GA 30368 -6735 Account Number0968468 Account Number40502427
Mellon Bk NA Citibank NA
Bank -ID: 043000261 Bank -ID: 021000089
Please refer to the invoice number on the remittance.
Please return remittance advice with your payment.
Comments:
Valvoline.
Federal ID number 20- 0865835 D -U-N-S number 00 -500 -3264
The terms and conditions of this sale are set forth at http /www.ashland.com /salesterms.
Print date 29 May 2009
visit us at www.ashiand.com
0 INDIANA RETAIL TAX EXEMPT PAGE
II Carmel CERTIFICATE NO. 003120155 002 0 f
+T.,
JL PURCHASE ORDER NUMBER
PoUce Depa FEDERAL EXCISE TAX EXEMPT 21025
35- 60600972
3 ONE' CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES, A/P
CARMEL, INDIANA 46032 2584 VOUCHER, DELIVERY MEMO, PACKING SLIPS,
SHIPPING LABELS AND ANY CORRESPONDENCE.
FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL 1997
PURCHASE ORDER DATE DATE REQUIRED REOUISITION NO. VENDOR NO. DESCRIPTION
Tune 2009 oil
VENDOR Ashland SHIP City of Carmel Police Department
P.O. Box 116735 TO 3 Civic Square
Atlanta, AAA 30368 --6735 Carml, IN 46032
CONFIRMATION BLANKET CpNTRACT PAYMENTTERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRIGS EXTENSION
2 55 gall &n drums of oil 376.91 753.83
T
1 0
All
e
Send Invoice To:
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
1110 3 coil PAYMENT
3 A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O.
NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND
VOUCHER HAS THE PROP SWORN SWORN AFFIDAVIT ATTACHED.
SHIPPING INSTRUCTIONS I HEREBY CERTIFY IS AN UNOBLIGATED BALANCE IN
SHIP REPAID.
THIS APPROPRIATION SU TO PAY FOR THE ABOVE ORDER.
C.O.D. SHIPMENTS CANNOT BE ACCEPTED. ORDERED BY
PURCHASE ORDER NUMBER MUST APPEAR ON ALL
SHIPPING LABELS. �j�
THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945 TITLE A ss i tant Chief of Police
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
CLERK TREASURER
DOCUMENT CONTROL NO. VP. V. COPY -SIGN AND RETURN TO CLERK'S OFFICE
V01 UCHER NO. WARRAN i NO.
ALLOWED 20
IN THE SUM OF
ON ACCOUNT OF APPROPRIATION FOR
Board Members
PO# or INVOICE NO. ACCT #!TITLE AMOUNT
DEFT. 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.
20
Signature
Title
Cost distribution ledger classification if
claim paid motor 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 service rendered, by
whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc.
Payee
A shland Purchase Order No. 21025F
P .O. Box 116735 Terms
A tlanta, GA 30368 -6735 Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
5/28/09 92512891 payment for oil 758.11
Total
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
VO J JCHER NO. WARRANT NO.
ALLOWED 20
i
A shland IN SUM OF
P.O. Box 116735
Atlanta, GA 30368 -6735
758.11
ON ACCOUNT OF APPROPRIATION FOR
policedgeneral fund
Board Members
Po# or INVOICE NO. ACCT /TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
21025F 92512891 315 758.11 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
June 17 2009
Signature
Chief of Police
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund