209938 06/20/2012 CITY OF CARMEL, INDIANA VENDOR: 359584 Page 1 of 1
0 ONE CIVIC SQUARE BRENNTAG MID SOUTH INC
CARMEL, INDIANA 46032 3796 RELIABLE PARKWAY CHECK AMOUNT: $20,357.80
CHICAGO IL 60686 CHECK NUMBER: 209938
CHECK DATE: 6/20/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
601 5023990 224971 14,277.80 OTHER EXPENSES
601 5023990 229656 555.00 OTHER EXPENSES
601 5023990 229657 235.00 OTHER EXPENSES
601 5023990 229658 765.00 OTHER EXPENSES
601 5023990 232531 4,525.00 OTHER EXPENSES
BRENNTAG
BRENNTAG MID SOUTH, INC.
1405 HIGHWAY 136 WEST
PO BOX 20
HENDERSON KY 42419 -0020
INVOICE BMS232531 INV DATE: 6/05/12 PAGE 1 OF 1
DUE DATE: 7/05/12
SOLD TO: SHIP TO:
CITY OF CARMEL UTILITIES CARMEL WATER, PLANT 5
3450 WEST 131ST STREET 5484 E. 126TH STREET
CARMEL IN 46074 CARMEL IN 46032
FEDERAL ID 610504545 DATE SHIPPED: 6/05/12 TERMS NET 30 DAYS
B/L 8244 -00 SHIP WHS: 29 SALESPRSN: 294
CUSTOMER 407542 SHIP VIA: OUR TRUCK PKG
CUSTOMER PO JERRY FOB :.DELIVERED
TAX EX# 356000972 -001 -9
UNITS SHIPPED PROD WGT /GAL TOTAL QTY UNIT PRICE EXTENDED
80.0000 805002 1.000 4000.0000# 1.1250 4,500.00
50.0000 BAG SOD FLUORIDE GRAN
>A F/S
QUESTIONS, CALL 317- 898 -8632
REMIT TO ADDRESS:
BRENNTAG MID SOUTH, INC
3796 RELIABLE PARKWAY
CHICAGO IL 60686 -0037 MERCHANDISE 4,500.00
INS SEC SURCHARGE 25.00
PAID ON OR PRIOR TO 7/05/12 INVOICE TOTAL 4,525.00
PAID AFTER 7/05/12 INVOICE TOTAL 4,615.50
Original Document
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BRENNTAG
BRENNTAG MID SOUTH, INC.
1405 HIGHWAY 136 WEST
PO BOX 20
HENDERSON KY 42419 -0020
INVOICE BMS229656 INV DATE: 5/30/12 PAGE 1 OF 1
DUE DATE: 6/29/12
SOLD TO: SHIP TO:
CITY OF CARMEL UTILITIES CARMEL WATER, PLANT 4
3450 WEST 131ST STREET 10675 N. GRAY ROAD
CARMEL IN 46074 CARMEL IN 46032
FEDERAL ID 610504545 DATE SHIPPED: 5/30/12 TERMS NET 30 DAYS
B/L 3969 -00 SHIP WHS: 29 SALESPRSN: 294
CUSTOMER 407542 SHIP VIA: OUR TRUCK PKG
CUSTOMER PO VERBAL 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
QUESTIONS, CALL 317- 898 -8632
REMIT TO ADDRESS:
BRENNTAG MID SOUTH, INC
3796 RELIABLE PARKWAY
CHICAGO IL 60686 -0037 MERCHANDISE 530.00
INS SEC SURCHARGE 25.00
PAID ON OR PRIOR TO 6/29/12 INVOICE TOTAL 555.00
PAID AFTER 6/29/12 INVOICE TOTAL 566.10
Original Document
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BRENNTAG
BRENNTAG MID SOUTH, INC.
1405 HIGHWAY 136 WEST
PO BOX 20
HENDERSON KY 42419 -0020
INVOICE BMS229657 INV DATE: 5/30/12 PAGE 1 OF 1
DUE DATE: 6/29/12
SOLD TO: SHIP TO:
CITY OF CARMEL UTILITIES CARMEL WATER, PLANT 3
3450 WEST 131ST STREET 4425 E. 126TH STREET
CARMEL IN 46074 CARMEL IN 46032
FEDERAL ID 610504545 DATE SHIPPED: 5/30/12 TERMS NET 30 DAYS
B/L 3962 -00 SHIP WHS: 29 SALESPRSN: 294
CUSTOMER 407542 SHIP VIA: OUR TRUCK PKG
CUSTOMER PO VERBAL FOB DELIVERED
TAX EX# 35600972 -001 -9
UNITS SHIPPED PROD WGT /GAL TOTAL QTY UNIT PRICE EXTENDED
4.0000 873311 11.870 600.0000# .3500 210.00
150.0000 CYL CHLORINE, LIQUID (BMS ONLY)
>A RPK
QUESTIONS, CALL 317- 898 -8632
REMIT TO ADDRESS:
BRENNTAG MID SOUTH, INC
3796 RELIABLE PARKWAY
CHICAGO IL 60686 -0037 MERCHANDISE 210.00
INS SEC SURCHARGE 25.00
PAID ON OR PRIOR TO 6/29/12 INVOICE TOTAL 235.00
PAID AFTER 6/29/12 INVOICE TOTAL 239.70
Original Document
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i
BRENNTAG
BRENNTAG MID SOUTH, INC.
1405 HIGHWAY 136 WEST
PO BOX 20
HENDERSON KY 42419 -0020
INVOICE BMS229658 INV DATE: 5/30/12 PAGE 1 OF 1
DUE DATE: 6/29/12
SOLD TO: SHIP TO:
CITY OF CARMEL UTILITIES CARMEL WATER, PLANT 5
3450 WEST 131ST STREET 5484 E. 126TH STREET
CARMEL IN 46074 CARMEL IN 46032
FEDERAL ID 610504545 DATE SHIPPED: 5/30/12 TERMS NET 30 DAYS
B/L 3971 -00 SHIP WHS: 29 SALESPRSN: 294
CUSTOMER 407542 SHIP VIA: OUR TRUCK PKG
CUSTOMER PO VERBAL 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
4.0000 873311 11.870 600.0000# .3500 210.00
150.0000 CYL CHLORINE, LIQUID (BMS ONLY)
>A RPK
QUESTIONS, CALL 317- 898 -8632
REMIT TO ADDRESS:
BRENNTAG MID SOUTH, INC
3796 RELIABLE PARKWAY
CHICAGO IL 60686 -0037 MERCHANDISE 740.00
INS SEC SURCHARGE 25.00
PAID ON OR PRIOR TO 6/29/12 INVOICE TOTAL 765.00
PAID AFTER 6/29/12 INVOICE TOTAL 780.30
Original Document
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i
BRENNTAG
BRENNTAG MID SOUTH, INC.
1405 HIGHWAY 136 WEST
PO BOX 20 ,,11
HENDERSON KY 42419- 0020'V
INVOICE BMS224971 INV DATE: 5/23/12 PAGE 1 OF 1
DUE DATE: 6/22/12
SOLD TO: SHIP TO:
CITY OF CARMEL UTILITIES CARMEL UTILITIES PLT 1
3450 WEST 131ST STREET 4915 E 106 ST
CARMEL IN 46074 CARMEL IN 46033
FEDERAL ID 610504545 DATE SHIPPED: 5/23/12 TERMS NET 30 DAYS
B/L 997879 -00 SHIP WHS: 29 SALESPRSN: 294
CUSTOMER 407542 SHIP VIA: OUR TRUCK -BULK
CUSTOMER PO JERRY FOB DELIVERED
TAX EX# 356000972 -001 -9
UNITS SHIPPED PROD WGT /GAL TOTAL QTY UNIT PRICE EXTENDED
44540.0000 437426 10.280 44540.0000# .3200 14,252.80
1.0000 BULK HYDROFLUOSILICIC ACID 23%
>A BLK
QUESTIONS, CALL 317- 898 -8632
REMIT TO ADDRESS:
BRENNTAG MID SOUTH, INC
3796 RELIABLE PARKWAY
CHICAGO IL 60686 -0037 MERCHANDISE 14,252.80
INS SEC SURCHARGE 25.00
PAID ON OR PRIOR TO 6/22/12 INVOICE TOTAL 14,277.80
PAID AFTER 6/22/12 INVOICE TOTAL 14,563.36
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 6/11/2012
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
6/11/2012 232531 $4,525.00
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 121140 WARRANT ALLOWED
359584 IN SUM OF
BRENNTAG MID -SOUTH INC
3796 RELIABLE PARKWAY
CHICAGO, IL 60686 -0037
Carmel Water Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
232531 01- 6180 -03 $4,525.00
ILA a 17. 1 3b
Voucher Total $4,525.00
Cost distribution ledger classification if
claim paid under vehicle highway fund