HomeMy WebLinkAbout239084 11/11/14 (9,
CITY OF CARMEL, INDIANA VENDOR: 366089
ONE CIVIC SQUARE NORTH CENTRAL CO-OP CHECK AMOUNT: $*******925.61*
CARMEL, INDIANA 46032 PO Box 299 CHECK NUMBER: 239084
WABASH IN 46992 CHECK DATE: 11/11/14
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2201 4231300 GT406675 925.61 DIESEL FUEL
NORMWarsaw Wabash Peru Goshen Angola Fremont Logansport Plymouth Rochester
(cm1mvia Kokomo Huntington Auburn Constantine 574-753-3673 Star City
Call: 800-720-0550 Call: 800-234-0573 800-807-3673 Call: 574-224-2667
(CC-OT) Branch Co. MI Hart MI Noblesville 877-615-2667
517-278-4561 231-873-2158 765-67SALE3810993 DATE 11/04/14 10:21:03
WABASH,IN 466992
P.O. BOX 2 800-440-2667 317-77EGUNTO START 0.0 END 301.5
GROSS DELIVERY 301.5 GALLONS
4040 SUPER DX-4 BIODIESDISTILLATI
MULTIPLE DELIVERIES AT SITE
CHARGE INVOICE
Driver: GT GARY TEETERS
Customer: 0000921720 Invoice I1: GT 406675
CARMEL STREET DEPT Date: 11/4/2014
3400 W 1331ST STREET Time: 10:24
CARMEL, IN 46074
Trms Terms Description Item D Description Legend Quantity Unit Price Item Total
02 DUE 11/20/2014 4040 SUPER DX-4 BIODIESEL E 301.5000 3.07000 925.61
Legend: Invoice Subtotal: 925.61
E=Metered, T=Taxable, *--Entered by Hand Indiana Sales Tax On: 0.00 ..... 0.00
Invoice Total: 925.61
WARNING — PETROLEUM PRODUCTS NOT TO BE USED FOR STARTING OR KINDLING FIRES. 6ASOLINES NOT SOLD FOR ILLUMINATING OR CLEANING PURPOSE
S. IN CASE OF EMERGENCY CONTACT CHENTREC AT 1-800-424-9300 WE APPRECIATE YOUR BUSINESS!!!
Customer Signature:
CUSTOMER
VOUCHER NO. WARRANT NO.
North Central Co-op ALLOWED 20
IN SUM OF$
P.O. Box 44-9
c-t 2-
$925.61
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO#/Dept. INVOICE NO. I ACCT#/TITLE AMOUNT Board Members
2201 GT 406675 j 42-313.00 $925.61 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
Fri N 014
%1001 kev
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))
11/04/14 GT 406675 $925.61
I
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