HomeMy WebLinkAbout234361 07/01/14 +o!..GAHM
J`/ \� CITY OF CARMEL, INDIANA VENDOR: 366089
s® �I ONE CIVIC SQUARE NORTH CENTRAL CO-OP CHECK AMOUNT: $*****2,671.31*
�_� CARMEL, INDIANA 46032 Po Box 299 CHECK NUMBER: 234361
M,�*oN�. WABASH IN 46992 CHECK DATE: 07/01/14
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1207 4231300 GT405673 973.26 DIESEL FUEL
1207 4231400 GT405673 1,698.05 GASOLINE
Warsaw Wabash Peru Goshen Angola Fremont Logansport Plymouth Rochester
�D . Kokomo Huntington Auburn Constantine 574-753-3673 Star City
Call: 1100-720-0550 Call: 1100-234-0573 800-807-3673 Call: 574-224-2667
Q D Branch Co. MI Hart MI Noblesville 877-615-2667
517-278-4561 231-873-2158 765-67gA�3810267 DATE 06/86/14 08:59:50
P.O. BOX 299 800-440-2667 31 (�1'.
7-77" 0
WABASH, IN 46992 t; START 0.0 END 889.0
GROSS DELIVERY 289.0 GALLONS
4040 SUPER DX-4 BIODIESDISTILLATI
## MULTIPLE DELIVERIES AT SITE
SALE 5683 DATE 06/26/14 09:08:17
COUNT: START 0.0 END 274.9
GROSS DELIVERY 274.9 GALLONS
4011 87 E-10 PLUS GASOLINE 1
# MULTIPLE DELIVERIES AT SITE
CHARGE INVOICE
Driver: GT GARY TEETERS
Customer: 0000918936 Invoice B: GT 405673
BROOKSHIRE GOLF CLUB Date: 6/27/8014
CITY OF CARMEL Time: 10:07
12120 BROOKSHIRE PKWY
CARMEL, IN 46033—
Trms Terms Description Item D Description Legend Quantity Unit Price Item Total
02 NORMAL CHARGE TERMS 4011 87 E-10 PLUS E 274.9000 3.35000 920.92
State Road Tax 0.18000 49.48
02 NORMAL CHARGE TERMS 4040 SUPER DX-4 BIODIESEL E 288.8000 3.37000 973.26
02 NORMAL CHARGE TERMS 5574301 ADV HD DED 15IJ40—DRU # 55.0000 13.23000 727.65
Legend: Invoice Subtotal: 2,671.31
E=Metered, T=Taxable, *--Entered by Hand Indiana Sales Tax On: 0.00 ..... 0.00
Invoice Total: 2,671.31
WARNING — PETROLEUM PRODUCTS NOT TO BE USED FOR STARTING OR KINDLING FIRES. GA5OLINES 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: + t
i
(OUSTOME 'ro-'a
VOUCHER NO. WARRANT NO.
ALLOWED 20
North Central Co-op
IN SUM OF $
P.O. Box 299
Wabash, IN 46992
$2,671.31
ON ACCOUNT OF APPROPRIATION FOR
Brookshire Golf Club
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1207 GT 405673 42-313.00 $973.26 1 hereby certify that the attached invoice(s), or
1207 GT 405673 42-314.00 $1,698.05 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, June 27, 2014
Director, Brookshi 'golf Club
Title
Cost distribution ledger classification if
claim paid motor 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 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))
06/26/14 GT 405673 Diesel Fuel $973.26
06/27/14 GT 405673 Fuel $1,698.05
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