206130 02/14/2012 CITY OF CARMEL, INDIANA VENDOR: 358405 Page 1 of 1
i ONE CIVIC SQUARE ASHLAND SPECIALTY CHEMICALS CHECK AMOUNT: $22,716.80
CARMEL, INDIANA 46032 P 0 BOX 116232
ATLANTA GA 30368 -6232
CHECK NUMBER: 206130
CHECK DATE: 2/14/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 95752997 22,716.80 OTHER EXPENSES
ASHLANAE INVOICE ORIGINAL
Page 1(1)
Invoice Number Invoice Date F 22 e Date
0 95752997 23 Jan 2012 Feb 2012
t`
M Hercules Incorporated P.O.Number Payment Terms Payer Number
N Hercules Plaza S12sss Days 441113
r
Ln
1313 North Market Street
Wilmington DE 19894 -0001 Shipped From ales Order Num Bill -To Number
USA I AHWT GREENSBORO DYLE ST PL PKG 4598192 441113
Remittance instructions below Bill of Lading Number Incoterms DAP Dest Prepaid Ship -To Number
3587650 442287
Billing address Shipping address
CITY OF CARMEL CITY OF CARMEL
WATER WASTEWATER UTILITIES WATER WASTEWATER UTILITIES
760 3RD AVE SW 9609 HAZEL DELL PKWY
CARMEL IN 46032 INDIANAPOLIS IN 46280
Qty. UoM Material Number Material Description Batch Billing Qty UoM Unit Price Amount
Number USD
8 IBC 657240 PRAESTOL K 274 FLX IBC 1000L 1201517 18,320 LB 1.2400 22,716.80
1201537
Should you have any questions regarding this Invoice Total
invoice, please contact USD 22,716.80
THERESA BOES
at 999-999-9999
Remit to ACH Credit Wire transfer
P.O. Box 116232 Hercules Incorporated Hercules Incorporated
ATLANTA GA 30368 -6232 Account Number:71522253 Account Number:30813889
Clearing House EPN (Electron Citibank NA
Bank-ID: 021052053 bank-ID: 021000089
Please refer to the invoice number on the remittance.
Please return remittance advice with your payment.
Comments:
Federal ID number 51- 0023450
The terms and conditions of this sale are set forth at http:/ /www.ashland.com /salesterms.
Print date 24 Jan 2012
visit us at www.ashland.com
VOUCHER 116706 WARRANT ALLOWED
358405 IN SUM OF
ASHLAND SPECIALITY CHEMICALS
PO BOX 116735
Atlanta, GA 30368
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
95752997 01- 7182 -05 $22,716.80
Voucher Total $22,716.80
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
358405
ASHLAND SPECIALITY CHEMICALS Purchase Order No.
PO BOX 116735 Terms
Atlanta, GA 30368 Due Date 2/6/2012
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
2/6/2012 95752997 $22,716.80
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