244756 04/29/15 CITY OF CARMEL, INDIANA VENDOR: 366089
4
ONE CIVIC SQUARE NORTH CENTRAL CO-OP CHECK AMOUNT: $*****2,328.32*
s, ?Q CARMEL, INDIANA 46032 Po Box 299 CHECK NUMBER: 244756
'M�yoN- WABASH IN 46992 CHECK DATE: 04/29/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
l 1207 4231300 GT407753 733.94 DIESEL FUEL
1207 4231400 GT407753 777.47 GASOLINE
2201 4231300 GT407805 816.91 DIESEL FUEL
No= Warsaw Wabash Peru Goshen Angola Fremont Logansport Plymouth Rochester
Cm
O t Kokomo Huntington Auburn Constantine 574-753-3673 Star City
Call: 1100-720-0550 Call: 1100-234-0573 800-807-3673 Call: 74-224-2667
�a 0 Branch Co. MI Hart MI Noblesville 877-615-2667
P.O. BOX 299 517-278-4561 231-873-2158 765-67% LE3811904 DATE 04/24/15 07:55:02
WABASH, IN 46992 800-440-2667 317-77 0F0 START 0.0 END 334.8
GROSS DELIVERY 334.8 GALLONS
4040 PREMIUM DX-4 off rDISTILLATI
#* MULTIPLE DELIVERIES AT SITE
CHARGE INVOICE
Driver: GT GARY TEETERS
Customer: 0000921720 Invoice #: GT 407805
CARMEL STREET DEPT Date: 4/24/2015
3400 W 131ST STREET Time: 08:57
CARMEL, IN 46074
Trms Terms Description Item # Description Legend Quantity Unit Price Item Total
02 DUE 05/20/2015 4040 PREMIUM DX-4 off rd E 334.8000 2.44000 816.91
Legend: Invoice Subtotal: 816.91
E=Metered, T=Taxable, *=Entered by Hand Indiana Sales Tax On: 0.00 ..... 0.00
Invoice Total: 816.91
WARNING — PETROLEUM PRODUCTS NOT TO BE USED FOR STARTING OR KINDLING FIRES. GASOLINES NOT SOLD FOR ILLUMINATING OR CLEANING PURPOSE
S. IN CASE OF EMERGENCY CONTACT CHENTREC AT 1-800-424-9300 WE APPRECIATE YOUR BUSINESS!!!
Customer Signature: �6
I
II�
I '
OCUSTMER
VOUCHER NO. WARRANT NO.
ALLOWED 20
North Central Co-op
Zqq IN SUM OF$
P.Q. -Re*4446. V/r ,K
4-ki—All—I In
$816.91
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO#/Dept. INVOICE NO. ACCT#/TITLE
p AMOUNT Board Members
2201 j GT 407805 42-313.00 $816.91 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
#jiay, April 24, 2015
#611(�
Street Com i sioner
btrest Col 1111 Ilssionee
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))
04/24/15 GT 407805 $816.91
I'
I hereby certify that the attached invoice(s),or bill(s), is(are)true and correct and I have audited same in accordance
with IC 5-11-10-1.6
" 20
Clerk-Treasurer
Warsaw Wabash Peru Goshen Angola Fremont Logansport Plymouth Rochester
Cmmw
Kokomo Huntington Auburn Constantine 574-753-3673 Star City
Call: 1100-720-05,90 Call: 800-234-0573 800-807-3673 Call: 574-224-2667
0 T) Branch Co. MI Hart MI Noblesville 877-615-2667
517-278-4561 231-873-2158 765-675-2538
P.O.BOX 299 800-440-2667 317-773SOV70 6624 DATE 04/16/15 08:21:57
WABASH, IN 46992 COUNT: START 0.0 END 386.8
GROSS DELIVERY 386.8 GALLONS
4011 87 E-10 PLUS GASOLINE 1
MULTIPLE DELIVERIES AT SITE
SALE 11862 DATE 04/16/15 08:16:51
COUNT: START 0.0 END 276.8
GROSS DELIVERY 276.8 GALLONS
f 4040 SUPER DX-4 BIODIESDISTILLATI
* MULTIPLE DELIVERIES AT SITE ##
CHARGE INVOICE
Driver: GT GARY TEETERS
Customer: 0000918936 Invoice D: GT 407753
BROOKSHIRE GOLF CLUB Date: 4/16/2015
CITY OF CARMEL Time: 09:19
12120 BROOKSHIRE PKWY
CARMEL, IN 46033-
Tris Terms Description Item # Description Legend Quantity Unit Price Item Total
02 DUE 05120/2015 4011 87 E-10 PLUS E 386.8000 2.01000 777.47
STATE EXCISE TAX 0.18000 69.62
02 DUE 05/20/2015 4040 SUPER DX-4 BIODIESEL E 276.8000 2.40000 664.32
Legend: Invoice Subtotal: 1,511.41
E=Metered, T=Taxable, *=Entered by Hand Indiana Sales Tax On: 0.00 ..... 0.00
Invoice Total: 1,511.41
WARNING - PETROLEUM PRODUCTS NOT TO BE USED FOR STARTING OR KINDLING FIRES. GASOLINES NOT SOLD FOR ILLUMINATING OR CLEANING PURPOSE
S. IN CASE OF EMERGENCY CONTACT CHENTREC AT 1-800-424-9300 WE APPRECIATE YOUR BUSINESS!!'.
Customer Signature:
CUSTOMER
VOUCHER NO. WARRANT NO.
ALLOWED 20
North Central Co-op
IN SUM OF$
P.O. Box 299
Wabash, IN 46992
$1,511.41
ON ACCOUNT OF APPROPRIATION FOR
Brookshire Golf Club
PO#/Dept. INVOICE NO. ACCT#!TITLE AMOUNT Board Members
1207 GT 407753 42-314.00 $777.47 1 hereby certify that the attached invoice(s), or
1207 GT 407753 42-313.00 $733.94 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
Tuesday, April 21, 2015
Director, Brookshi olf Club
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))
` 04/16/15 GT 407753 Gas $777.47
04/16/15 GT 407753 Diesel $733.94
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