240704 01/07/15 u ��q
CITY OF CARMEL, INDIANA VENDOR: 366941
® ONE CIVIC SQUARE HOOSIER PENN OIL CHECK AMOUNT: S"""""112.60'
x. =a CARMEL, INDIANA 46032 DEPT 19 CHECK NUMBER: 240704
<<oN PO Box 6069 CHECK DATE: 01/07/15
INDIANAPOLIS IN 46206
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4231500 575895 112.60 OIL
1
HOOSIER PENN OIL CO.
Dept. 19 0934481-IN
P.O. Box 6069
Indianapolis, IN 46206-6069 0575895
12/16/2014
1/15/2015
CARMELF
Carmel Fire Dept. Carmel Fire Dept.
City of Carmel City of Carmel
2 Civic Square 2 Civic Square
Carmel,IN 46032 Carmel,IN 46032
Net 30 001
111125205 HP FS GF5 5W20 1/5 PL 2.00 2.00 56.30 112.60
112.60
0.00
112.60
'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))
575895 $112.60
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
VOUCHER NO. WARRANT NO.
ALLOWED 20
Hoosier Penn Oil
Dept. 19 IN SUM OF $
PO Box 6069
Indianapolis, IN446206
$112.60
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1120 575895 42-315.00 $112.60 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
JA - 5 2015
Fire Chief
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund