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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 „o 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 -------------------------------------------------------------------------------- FREIGHT PPD & ADD TO INVOICE -------------------------------------------------------------------------------- 19500 .0000 761884 9 . 760 19500.0000# .8120 15,834.00 1 .0000 # BULK SODIUM PERMANGANATE 20% NSF CARUSOL 1X BLK -------------------------------------------------------------------------------- QUESTIONS, CALL 317-898-8632 *************************************** * 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 ----------------- 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 ?fa`F 3 f 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