243516 3 /24/2015 v,ayR. CITY OF CARMEL, INDIANA VENDOR: 366941
`3 CHECK AMOUNT: $"'"""301.00'
ONE CIVIC SQUARE HOOSIER PENN OIL
4 ?Q CARMEL, INDIANA 46032 DEPT 19 CHECK NUMBER: 243516
PO BOX 6069 CHECK DATE: 03/24/15
INDIANAPOLIS IN 46206
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4231500 942637 301.00 OIL
111VOICe Page: 1
Hoosier Penn Oil Co., Inc.
OR[GMPAN Dept. 19 Invoice Number: 0942637-IN
P.O. Box 6069 Invoice Date: 3/19/2015
Indianapolis, IN 46206-6069
(317)390-5406
Order Number: 0583066
Order Date 3/18/2015
Customer Number: CARMELF
Sold To: Ship To:
Carmel Fire Dept. Carmel Fire Dept.
City of Carmel City of Carmel
2 Civic Square 2 Civic Square
Carmel,IN 46032 Carmel,IN 46032
Confirm To:
Denise Snyder
Customer P.O. Ship VIA F.O.B. Terms
Net 30
Item Number Unit Ordered Shipped Price Amount
11112535 HP FS GF5 5W30 1/5 PL 3.00 3.00 49.48 148.44
111125205 HP FS GF5 5W20 1/5 PL 3.00 3.00 49.19 147.57
/FUELSC Fuel Surcharge 4.99
Net Invoice: 301.00
Less Discount: 0.00
Freight: 0.00
Sales Tax: 0.00
Invoice Total: 301.00
VOUCHER NO. WARRANT NO.
ALLOWED 20
Hoosier Penn Oil
Dept. 19 IN SUM OF$
PO Box 6069
Indianapolis, IN 46206
i
$301.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1120 942637 42-315.00 $301.00 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
MAR 2 3 2015
WOO)d
Fire Chief
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))
942637 Oil $301.00
1 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