HomeMy WebLinkAbout205154 01/05/2012 CITY OF CARMEL, INDIANA VENDOR: 359584 Page 1 of 1
ONE CIVIC SQUARE BRENNTAG MID SOUTH INC CHECK AMOUNT: $5,160.00
CARMEL, INDIANA 46032 3796 RELIABLE PARKWAY
CHICAGO IL 60686 CHECK NUMBER: 205154
CHECK DATE: 1/5/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUN DESCRIPTION
601 5023990 139701 5,160.00 OTHER EXPENSES
BRENNTA.G
INVOICE BMS139701 INV DATE: 12/28/11 PAGE 1 OF 2
DUE DATE: 1/27/12
SOLD TO: SHIP TO:
CARMEL WASTE WATER CARMEL WATER, PLANT 5
3450 WEST 131ST STREET 5484 E. 126TH STREET
CARMEL IN 46074 CARMEL IN 46032
FEDERAL ID 610504545 DATE SHIPPED: 12/28/11 TERMS NET 30 DAYS
B/L 893681 -00 SHIP WHS: 29 SALESPRSN: 294
CUSTOMER 407542 SHIP VIA: OUR TRUCK PKG
CUSTOMER PO VERBAL JARED FOB DELIVERED
TAX EX# 356000972 -001 -9
UNITS SHIPPED PROD WGT /GAL TOTAL QTY UNIT PRICE EXTENDED
1.0000 253418 11.870 2000.0000# .2650 530.00
2000.0000 CYL CHLORINE, LIQUID (BMS ONLY)
>A RPK
80.0000 805002 1.000 4000.0000# 1.1250 4,500.00
50.0000 BAG SOD FLUORIDE GRAN
>A F/S
2.0000 873311 11.870 300.0000# .3500 105.00
150.0000 CYL CHLORINE, LIQUID (BMS ONLY)
>A RPK
Original Document
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3
BRENNTAG
ARM
INVOICE BMS139701 INV DATE: 12/28/11 PAGE 2 OF 2
DUE DATE: 1/27/12
SOLD TO: SHIP TO:
Attach to Invoice# BMS139701 CARMEL WATER, PLANT 5
UNITS SHIPPED PROD WGT /GAL TOTAL QTY UNIT PRICE EXTENDED
CONTINUED FROM PREVIOUS PAGE
2UESTIONS, CALL 317- 898 -8632
REMIT TO ADDRESS:
BRENNTAG MID SOUTH, INC
3796 RELIABLE PARKWAY
CHICAGO IL 60686 -0037 MERCHANDISE 5,135.00
INS SEC SURCHARGE 25.00
PAID ON OR PRIOR TO 1/27/12 INVOICE TOTAL 5,160.00
PAID AFTER 1/27/12 INVOICE TOTAL 5,263.20
Original Document
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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 12/30/2011
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
12/30/201' 139701 $5,160.00
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
VOUCHER 113383 WARRANT ALLOWED
359584 IN SUM OF
BRENNTAG MID -SOUTH INC
3796 RELIABLE PARKWAY WAS
CHICAGO, IL 60686 -0037 OPERATIONS
Carmel Water Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
139701 01- 6180 -03 $5,160.00
Voucher Total $5,160.00
Cost distribution ledger classification if
claim paid under vehicle highway fund