HomeMy WebLinkAbout232301 05/07/14 CITY OF CARMEL, INDIANA VENDOR: 366089
ONE CIVIC SQUARE NORTH CENTRAL CO-OP CHECK AMOUNT: $*******974.55*
?q. CARMEL, INDIANA 46032 Po Box 299 CHECK NUMBER: 232301
°M,iTON moo` WABASH IN 46992 CHECK DATE: 05/07/14
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2201 4231300 GT405245 974.55 DIESEL FUEL
HGMTWarsaw Wabash Peru Goshen ans ort Angola Fremont Lo Plymouth Rochester
CHM
9 Logansport Y
O t Kokomo Huntington Auburn Constantine 574-753-3673 Star City
Call: 800-720-0550 Call: 800-234-0573 800-807-3673 Call: 574-224-2667
C00 =0T) Branch Co. MI Hart MI Noblesville 877-615-2667
P.O.BOX 299 517-278-4561 231-873-2158 765-678A'L.P3E10003 DATE 04/29/14 08:22:31
317-77 0
WABASH, IN 46992 800-440-2667 �0���. 5TflRT 0.0 END 267.0
GROSS DELIVERY 267.0 GALLONS
4040 SUPER DX-4 BIODIESDISTILLATI
MULTIPLE DELIVERIES AT SITE
CHARGE INVOICE
Driver: GT GARY TEETERS
Customer: 0000921720 Invoice #: GT 405245
CARMEL STREET DEPT Date: 4/29/2014
3400 W 131ST STREET Time: 09:30
CARMEL, IN 46074
Tros Terms Description Item # Description Legend Quantity Unit Price Item Total
02 NORMAL CHARGE TERMS 4040 SUPER DX-4 BIODIESEL E 267.0000 3.65000 974.55
Legend: Invoice Subtotal: 974.55
E--Metered, T=Taxable, *--Entered by Hand Indiana Sales Tax On: 0.00 ..... 0.00
Invoice Total: 974.55
WARNING - PETROLEUM PRODUCTS NOT TO BE USED FOR STARTING OR KINDLING FIRES. GASOLINES NOT SOLD FOR ILLUMINATING OR CLEANING PURPOSE
S. IN CASE OF EMERGENCY CONTACT CHEMTREC AT 1-800-424-9300 WE APPRECIATE YOUR BUSINESS!!!
Customer Signature:
CUSTOMER
I
VOUCHER NO. WARRANT NO.
ALLOWED 20
North Central Co-op
IN SUM OF$
P. O.. Box 299
Wabash, IN 46992
$974.55
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO#/Dept. INVOICE NO. I ACCT#/TITLE I AMOUNT
Board Members
2201 I GT 405245 I 42-313.001 $974.55 1 hereby certify that the attached invoice(s), or
bill(s) is(are) true and correct and that the
materials or services itemized thereon for
which charge is made were ordered and
received except
lAhulldly, May 01, 2014
St:M re8tn' 0 on®oner
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
i
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 service rendered, by
whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc.
Payee
Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
04/29/14 GT 405245 $974.55
i
I
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
, 20
Clerk-Treasurer