241102 01/13/15 1y ui,G4gMf
�;� ,� CITY OF CARMEL, INDIANA VENDOR: 366089
® i1 ONE CIVIC SQUARE NORTH CENTRAL CO-OP CHECK AMOUNT: $*******977.08*
r °: CARMEL, INDIANA 46032 Po Box 299 CHECK NUMBER: 241102
11'!" _.� WABASH IN 46992 CHECK DATE: 01/13/15
,� prod�°
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2201 4231300 GT407114 591.84 DIESEL FUEL
2201 4231300 GT407116 385.24 DIESEL FUEL
Warsaw Wabash Peru Goshen Angola Fremont Logansport Plymouth Rochester
17 Kokomo Huntington Auburn Constantine 574-753-3673 Star City
Call: 800-720-0550 Call:800-234-0573 800-807-3673 Call:574-224-2667
Branch Co. MI Hart MI Noblesville 877-615-2667
517-278-4561 231-873-2158 765-67§GLIE3818188 DATE 01/05/15 14:09:09
P.O. BOX 299 800-440-2667 317-77TIIUNT5 START 0.0 END 137.7
WABASH, IN 46992
GROSS DELIVERY 137.7 GALLONS
4033 K-1 HEATING DYED DISTILLATI
MULTIPLE DELIVERIES AT SITE
CHARGE INVOICE
Driver: GT GARY TEETERS
Customer: 0000921720 Invoice D: GT 407116
CARMEL STREET DEPT Date: 1/5/2015
3400 W 131ST STREET Time: 14:10
CARMEL, IN 46074
Tris Terms Description Item # Description Legend Quantity Unit Price Item Total
02 - DUE 02/20/2015 4040 SUPER DX-4 BIODIESEL E 56.50M 2.55000 144.08
02 DUE 02/20/2015 4033 K-1 HEATING DYED E 81.2000 2.97000 241.16
Legend: Invoice Subtotal: 385.24
E=Metered, T=Taxable, *=Entered by Hand Indiana Sales Tax On: 0.00 ..... 0.00
Invoice Total: 385.24
WARNING - 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:
CUSTOMER
Holm
Warsaw Wabash Peru Goshen Angola Fremont Logansport Plymouth Rochester
D A, I Kokomo Huntington Auburn Constantine 574-753-3673 Star City
Call: 800-720-0550 Call: 800-234-0573 800-807-3673 Call: 574-224-2667
Branch Co. MI Hart MI Noblesville 877-615-2667
517-278-4561 231-873-2158 765-67§A13818186 DATE 01/05/15 13:03:36
WABASH, IN 466992
P.O.BOX 2 800-440-2667 317-77XGUNT5 START 0.0 END 204.9
'_
GROSS DELIVERY 504.9 GALLONS
4033 K-1 HEATING DYED DISTILLATI
MULTIPLE DELIVERIES AT SITE
CHARGE INVOICE
Driver: GT GARY TEETERS
Customer: 0000921720 Invoice I#: GT 407114
CARMEL STREET DEPT Date: 1/5/2015
3400 W 131ST STREET Time: 13:07
CARMEL, IN 46074
Tris Terms Description Item # Description Legend Quantity Unit Price Item Total
02 DUE 02/20/2015 4040 SUPER DX-4 BIODIESEL E 39.8000 5.55000 101.49
02 DUE 02/20/2015 4033 K-1 HEATING DYED E 165.1000 2.9700 490.35
Legend: Invoice Subtotal: 591.84
E=Metered, T=Taxable, *--Entered by Hand Indiana Sales Tax On: 0.00 ..... 0.00
Invoice Total: 591.84
WARNING - 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 CHENTREC AT 1-800-424-9300 WE APPRECIATE YOUR BUSINESS!!!
Customer Signature:
i
(OUSTOMER
L — — ---- -------------------
--
VOUCHER NO. WARRANT NO.
ALLOWED 20
North Central Co-op
IN SUM OF$
P.O. Box*a-A62-4g
fila bWs fle, IN 46M
$977.08
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO#/Dept. INVOICE NO. ACCT#IrITLE AMOUNT Board Members
2201 GT 407116 42-313.00 $385.24 I hereby certify that the attached invoice(s), or
2201 GT 407114 42-313.00 $591.84 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
r
i 15
!.
( Street Commissioner
Title
i
Cost distribution ledger classification if
claim paid motor vehicle highway fund 5
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))
01/05/15 GT 407116 $385.24
01/05/15 GT 407114 $591.84
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