217380 02/13/2013 CITY OF CARMEL, INDIANA VENDOR: 366923 Page 1 of 1
t ONE CIVIC SQUARE UNIVAR USA INC
CARMEL, INDIANA 46032 13009 COLLECTIONS CTR DR CHECK AMOUNT: $1,240.00
-`� CHICAGO IL 60693
<o„� CHECK NUMBER: 217380
CHECK DATE: 2/1312013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 IN943929 1, 240 . 00 OTHER EXPENSES
HH Page 1 of 1
1
V P.O. BOX 34325 ORIGINAL UNIVAR INDIANAPOLIS
unIVAR SEATTLEMA 98124-1325 INVOICE 7425 EAST 30TH STREET
INDIANAPOLIS IN 46219-1110
www.univarusa.com
317-547-4811
Page 1 OF 1
CUST.NO./SHIP TO
3.1.731 1 MB 0.404 35411S11.ps 720219 - 1 Pgs 720219 001
1111111IIII't 111111-1111..1I1tt.It11Iti111.1111 liiiit �Ilillti1 CITY OF CARMEL
CITY OF CARMEL 9609 HAZEL DELL PKWY
9609 HAZEL DELL PKWY INDIANAPOLIS IN 46280
INDIANAPOLIS IN 46280-2935
FREIGHT TERMS FOB
COLLECT SHIP POINT
INVOICE NO. INV.DATE I ORDER NO. CUSTOMER P.O.NUMBER WAREHOUSE LOCATION ON TIME DELIVERY
IN943929 01/18/13 695815 S13452 INDIANAPOLIS WILL CALL IMMEDIATE RLSE
_ SHIP DATE TA_X_EXEMPT NO. SALES REP. SALES DEPARTMENT ENTERED BY
01%18/13 INDIANAPOLIS HOUSE INDUSTRIAL CHEMICAL BARBARA BAXTER-SONGER
PRODUCT DESCRIPTION TAX QUANTITY QUANTITY BILLING QTY./ EXTENDED
ORDERED SHIPPED B.O. UNIT PRICE AMOUNT
661149 PROPYLENE GLYCOL Y 2 .00 2 .00 2 .00 1160.00
480. 0000 LB DR 580.0000
UNIVAR INDUST LIQ NUPO DRM DR DR DR
LOT #: CB082846185
322870 DRUM 1H1/Y1 .5/100 DEPOSIT Y 2 . 00 2 .00 2 .00 80.00
1.0000 EA EA SSG POLY IC DEPOSIT ONLY 40.0000
UNIVR CT **** **** EPOL DRM EA EA EA
********************************************************
• DUE TO DECREASING FUEL COSTS WE HAVE LOWERED OUR
• TEMPORARY FUEL SURCHARGE FOR EACH DELIVERY.
• EFFECTIVE 01-01-13 THE NEW FUEL SURCHARGE WILL BE $70
• WE WILL CONTINUE TO MONITOR AND ADJUST AS CIRCUMSTANCE
• DICTATE. THANK YOU FOR YOUR UNDERSTANDING.
MERCHANDISE: 1160.00
DEPOSIT: 8
SALES TAX: 81 .20
TERMSi NET 30� INVOICE TO L.: 1321.20
Buyer agrees that all orders or purchases are subiect to Univar's Standard Terms and Conditions of Sale as of the date of shipment available at www.unlvarusa.com/salesterms.All sales and orders are
ezpressry limited to such terms,whicn may be updated from time to time.No other terms and conditions apply to any purchase order unless agreed to in writing by both parties.
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
366923
UNIVAR USA, INC. Purchase Order No.
13009 COLLECTIONS CTR DR Terms
CHICAGO, IL 60693 Due Date 2/7/2013
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
2/7/2013 IN943929 $1,240.00
hereby certify that the attached invoice(s), or bill(s) is (are) true and
:orrect and I have audited same in accordance with IC 5-11-10-1.6
Z-/)-/3
Date Officer
i
VOUCHER # 126633 WARRANT # ALLOWED
366923 IN SUM OF $
UNIVAR USA, INC.
13009 COLLECTIONS CTR DR
CHICAGO, IL 60693
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO# INV# ACCT# AMOUNT Audit Trail Code
IN943929 01-7182-05 $1,240.00
Voucher Total $1,240.00
Cost distribution ledger classification if
claim paid under vehicle highway fund