HomeMy WebLinkAbout232869 05/21/14 a�.Coq*
;� CITY OF CARMEL, INDIANA VENDOR: 366089
® ONE CIVIC SQUARE NORTH CENTRAL CO-OP CHECK AMOUNT: $*****2,846.65*
CARMEL, INDIANA 46032 PO BOX 299 CHECK NUMBER: 232869
9��tON�d WABASH IN 46992 CHECK DATE: 05/21/14
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1207 4231300 GT405361 1,448.55 DIESEL FUEL
1207 4231400 GT405361 1,398.10 GASOLINE
NommWarsaw Wabash Peru Goshen Angola Fremont Logansport Plymouth Rochester
Cmg
p Kokomo Huntington Auburn Constantine 574-753-3673 Star City
Call: 800-720-0550 Call: 800-234-0573 800-807-3673 Call: 574-224-2667
cc-OT) Branch Co. MI Hart MI Noblesville 877-615-2667
517-278-4561 231-873-2158 765-675-2538
' P.O.BOX 299 800-440-2667 317-773-0870
WABASH, IN 46992iF€RE—PRINT
CHARGE INVOICE
Driver: GT GARY TEETERS
Customer: 0000918936 Invoice #: 6T 405361
BROOKSHIRE GOLF CLUB Date: 5/14/2014
CITY OF CARMEL Time: 13:56
12120 BROOKSHIRE PKWY
CARMEL, IN 46033-
1 Trms Terms Description Item # Description Legend Quantity Unit Price Item Total
02 NORMAL CHARGE TERMS 4011 87 E-10 PLUS E 410.0000 3.23000 1324.30
State Road Tax 0.18000 73.80
02 NORMAL CHARGE TERMS 4040 SUPER DX-4 BIODIESEL E 394.7000 3.67000 1448.55
Legend: Invoice Subtotal: 2,846.65
E=Metered T=Taxables *=Entered by Hand Indiana Sales Tax On: 0.00 ..... 0.00
Invoice Total: 2,846.65
WARNING - PETROLEUM PRODUCTS NOT TO BE USED FOR STARTING OR KINDLING FIRES. GASOLINES NOT SOLD FOR ILLUMINATING OR CLEANING PURPOSE
i S. IN CASE OF EMERGENCY CONTACT CHENTREC AT 1-800-424-9300 WE APPRECIATE YOUR BUSINESS!!!
Customer Signature:
I
CUSTOMER
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))
05/14/14 GT 405361 Fuel $1,448.55
05/14/14 GT 405361 Fuel $1,398.10
1 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
VOUCHER NO. WARRANT NO.
ALLOWED 20
North Central Co-op
IN SUM OF $
P.O. Box 299
Wabash, IN 46992
$2,846.65
ON ACCOUNT OF APPROPRIATION FOR
Brookshire Golf Club
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1207 GT 405361 42-313.00 j $1,448.55 1 hereby certify that the attached invoice(s), or
1207 GT 405361 42-314.00 1 $1,398.10 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
Friday, May 16, 2014
Director, Brook Ire Golf Club
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund