219645 05/07/2013 CITY OF CARMEL, INDIANA VENDOR: 358405 Page 1 of 1
` ONE CIVIC SQUARE ASHLAND SPECIALTY CHEMICALS
;f CARMEL, INDIANA 46032 P 0 BOX 116232 CHECK AMOUNT: $23,816.00
ATLANTA GA 30368-6232 CHECK NUMBER: 219645
CHECK DATE: 5/7/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 130291840 23 , 816 . 00 OTHER EXPENSES
/ SH A 6113. INVOICE ORIGINAL
vr7i.�V� Page 1(1)
�r Invoice Number Invoice Date Due Date
0 130291840 19 Apr 2013 19 May 2013
0
Hercules Incorporated P.O.Number Payment Terms Payer Number
8145 Blazer Drive S13551 Net 30 Days 441113
ro Wilmington DE 19808
USA Shipped From ales Order Num Bill-To Number
AHWT GREENSBORO DYLE ST PL PKG 6443372 441113
Remittance instructions below
Bill of Lading Number Incoterms:DAP Dest Prepaid Ship-To Number
20305036 1442287
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
I
City. UoM Material Number Material Description Batch Billing City UOM Unit Price Amount
Number USD
8 IBC 657240 PRAESTOL K 274 FLX IBC 1000L 1304522 18,320 LB 1.3000 23,816.00
I �
Should you have any questions regarding this Invoice Total
invoice,please contact USD 23,816.00
GABE FLORES
at 866-869-2124
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 20 Apr 2013
visit us at www.ashiand.com
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 116232 Terms
Atlanta, GA 30368-6232 Due Date 5/2/2013
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
5/2/2013 130291840 $23,816.00
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
s113
Date Officer
VOUCHER # 135437 WARRANT # ALLOWED
358405 IN SUM OF $
ASHLAND SPECIALITY CHEMICALS
PO BOX 116232
Atlanta, GA 30368-6232
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO# INV# ACCT# AMOUNT Audit Trail Code
130291840 01-7182-05 $23,816.00
'Voucher Total's $23,816.00
Cost distribution ledger classification if
claim paid under vehicle highway fund
r