226930 12/11/2013 CITY OF CARMEL, INDIANA VENDOR: 359584 Page 1 of 1
ONE CIVIC SQUARE BRENNTAG MID SOUTH INC
CARMEL, INDIANA 46032 CHECK AMOUNT: $2,782.75
3796 RELIABLE PARKWAY
.o� CHICAGO IL 60686 CHECK NUMBER: 226930
CHECK DATE: 12/11/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
601 5023990 BMS605444 248 . 00 OTHER EXPENSES
601 5023990 BMS605445 2, 534 . 75 OTHER EXPENSES
BRENNTAG
BRENNTAG MID-SOUTH, INC.
1405 HIGHWAY 136 WEST
PO BOX 20
HENDERSON KY 42419-0020
INVOICE#: BMS605445 INV DATE: 11/26/13 *** PAGE 1 OF 1 ***
DUE DATE: 12/26/13
SOLD TO: SHIP TO:
CARMEL WASTE WATER CARMEL WATER, PLANT 5
3450 WEST 131ST STREET 5484 E. 126TH STREET
CARMEL IN 46074 CARMEL IN 46032
FEDERAL ID #: 610504545 DATE SHIPPED: 11/26/13 TERMS NET 30 DAYS
B/L #. . 497345-00 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
--------------------------------------------------------------------------------
40.0000 805002 1 .000 2000 .0000# 1 . 1700 2, 340 .00
50.0000 # BAG SODIUM FLUORIDE GRAN
>A F/S
--------------------------------------------------------------------------------
3 .0000 873311 11 . 870 450 .0000# . 3550 159 . 75
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 2,499 .75
INS & SEC SURCHARGE 35 .00
-----------------
PAID ON OR PRIOR TO 12/26/13 INVOICE TOTAL USD 2,534 .75
PAID AFTER 12/26/13 INVOICE TOTAL USD 2,585 .45
Original Document
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BRENNTAG n......
BRENNTAG MID-SOUTH, INC.
1405 HIGHWAY 136 WEST
PO BOX 20
HENDERSON KY 42419-0020
INVOICE#: BMS605444 INV DATE: 11/26/13 *** PAGE 1 OF 1 ***
DUE DATE: 12/26/13
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: 11/26/13 TERMS NET 30 DAYS
B/L #. . 497348-00 SHIP WHS : 29 SALESPRSN: 294
CUSTOMER # . : 407542 SHIP VIA: OUR TRUCK - PKG
CUSTOMER PO#: JERRY FOB . . : DELIVERED
TAX EX# : 35600972-001-9
UNITS SHIPPED PROD # WGT/GAL TOTAL QTY UNIT PRICE EXTENDED
--------------------------------------------------------------------------------
4.0000 873311 11 . 870 600 .0000## . 3550 213 .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 213 .00
INS & SEC SURCHARGE 35 .00
-----------------
PAID ON OR PRIOR TO 12/26/13 INVOICE TOTAL USD 248.00
PAID AFTER 12/26/13 INVOICE TOTAL USD 252 .96
Original Document
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3
VOUCHER# 133528 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,
1
Y
Board members
PO# INV# ACCT# AMOUNT Audit Trail Code
605445 01-6180-03 $2,534.75
X41 1 D
i
Voucher Total SQ?C Z_55;— 5
Cost distribution ledger classification if
claim paid under vehicle highway fund
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 12/5/2013
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
12/5/2013 605445 $2,534.75
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
A 113
Date Officer