HomeMy WebLinkAbout220089 05/21/2013 CITY OF CARMEL, INDIANA VENDOR: 359584 Page 1 of 1
ONE CIVIC SQUARE BRENNTAG MID SOUTH INC
CARMEL, INDIANA 46032 3796 RELIABLE PARKWAY CHECK AMOUNT: $18,103.09
CHICAGO IL 60686 CHECK NUMBER: 220089
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CHECK DATE: 5/21/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
601 5023990 424441 18, 103 . 09 CHEMICALS
BRENNTA.G
BRENNTAG MID-SOUTH, INC.
1405 HIGHWAY 136 WEST
PO BOX 20
HENDERSON KY 42419-0020
INVOICE#: BMS424441 INV DATE: 4/08/13 *** PAGE 1 OF 1 ***
DUE DATE: 5/08/13
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: 4/08/13 TERMS NET 30 DAYS
B/L #. . . . 248405-00 SHIP WHS : 80 SALESPRSN: 294
CUSTOMER # . : 407542 SHIP VIA: CC - 3RD PARTY
CUSTOMER PO#: JERRY CLOUD FOB . . : LASALLE, IL-PPD & ADD
TAX EX# : 356000972-001-9
UNITS SHIPPED PROD # WGT/GAL TOTAL QTY UNIT PRICE EXTENDED
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FREIGHT PPD & ADD TO INVOICE
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19500 .0000 761884 9 . 760 19500.0000# .8120 15,834.00
1 .0000 # BULK SODIUM PERMANGANATE 20% NSF
CARUSOL 1X BLK
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QUESTIONS, CALL 317-898-8632
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* REMIT TO ADDRESS :
* BRENNTAG MID-SOUTH, INC
* 3796 RELIABLE PARKWAY * MERCHANDISE 15,834.00
* CHICAGO IL 60686-0037 * MERCHANDISE FREIGHT 2,234. 09
*************************************** INS & SEC SURCHARGE 35 .00
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PAID ON OR PRIOR TO 5/08/13 INVOICE TOTAL USD 18, 103 . 09
PAID AFTER 5/08/13 INVOICE TOTAL USD 18,465 . 15
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 5/11/2013
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
5/11/2013 424441 $18,103.09
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
5/17/3
Date Officer
VOUCHER # 131555 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
424441 01-6180-03 $18,103.09
Voucher Total $18,103.09
Cost distribution ledger classification if
claim paid under vehicle highway fund