HomeMy WebLinkAbout235168 07/22/14 �� .�,\. CITY OF CARMEL, INDIANA VENDOR: 366089 ,�,,,,
(: e 1 ONE CIVIC SQUARE NORTH CENTRAL CO-OP CHECK AMOUNT: $ 790.60
;. ,� CARMEL, INDIANA 46032 PO BOX 299 CHECK NUMBER: 235168
9���ON�� WABASH IN 46992 CHECK DATE: 07/22/14
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2201 4231300 GT405830 790.60 DIESEL FUEL
HomwWarsaw Wabash Peru Goshen Angola Fremont Logansport Plymouth Rochester
ID L Kokomo Huntington Auburn Constantine 574-753-3673 Star City
Call: 800-720-0650 Call: 800-234-0573 800-807-3673 Call: 574-224-2667
� 4877-615-2667� Branch Co. MI Hart MI Noble
517-278-4561 231-873-2158 765-67�!'r3810357 DATE 07/15/14 14:13:12
P.O. Box 299 800-440-2667 317-775=ii 'D START 0.0 END 234.6
WABASH, IN 46992 GROSS DELIVERY 234.6 GALLONS
4040 SUPER DX-4 BIODIESDISTILLATI
MULTIPLE DELIVERIES AT SITE *#
CHARGE INVOICE
Driver: GT GARY TEETERS
Customer: 0000921720 Invoice #: GT 405830
CARMEL STREET DEPT Date: 7/15/2014
3400 W 131ST STREET Time: 15:18
CARMEL, IN 46074
Trms Terms Description Item # Description Legend Quantity Unit Price Item Total
02 NORMAL CHARGE TERMS 4040 SUPER DX-4 BIODIESEL E 234.6000 3.37000 790.60
Legend: Invoice Subtotal: 790.60
E=Metered, T=Taxable, *=Entered by Hand Indiana Sales Tax On: 0.00 ..... 0.00
Invoice Total: 790.60
14ARNING — 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:
it
II�
CUSTOMER
VOUCHER NO. WARRANT NO.
riLLVVVL.0 GV
North Central Co-op
IN SUM OF $
P.O. Box 1106
Noblesville, IN 46060
$790.60
ON ACCOUNT OF APPROPRIATION FOR — --
Carmel Street Department
PO#/Dept. INVOICE NO-. vz ACCT#/TITLE AMOUNT
�____... ._..__.,___,__I Board Members
2201 I GT 405830 I 42-313.001 $790.60 1 hereby certify that the attached invoice(s), or
l 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
m
y 2014
Street Commissioner
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
i
Prescribed by State Board of Accounts g q�+ City Form No.201 (Rev.1995)
AC�0U��T� PAYABLE �. OUCH `]Eu
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))
07/15/14 GT 405830 $790.60
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