245567 05/20/15 .CAA .
�'� "' CITY OF CARMEL, INDIANA VENDOR: 366089
® i'. ONE CIVIC SQUARE NORTH CENTRAL CO-OP CHECK AMOUNT: $*****1,802.24*
CARMEL, INDIANA 46032 PO BOX 299 CHECK NUMBER: 245567
�0',�>0��` WABASH IN 46992 CHECK DATE: 05/20/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1207 4231300 GT407924 479.23 DIESEL FUEL
1207 4231400 GT407924 835.98 GASOLINE
2201 4231300 GT407958 487.03 DIESEL FUEL
HommWarsaw Wabash Peru Goshen Angola Fremont Logansport Plymouth Rochester
Cmq
p e Kokomo Huntington Auburn Constantine 574-753-3673 Star City
Call: 800-720-0550 Call: 800-234-0573 800-807-3673 Call: 574-224-2667
CO-01)
877-615-2667
Branch Co. MI Hart MI Noblesville
517-278-4561 231-873-2158 765-675-2538
P.O.BOX 299 800-440-2667 317-773GME7012001 DATE 05/15/15 07:82:18
WABASH, IN 46992
COUNT: START 0.0 END 186.6
GROSS DELIVERY 186.6 GALLONS
4040 PREMIUM DX-4 off rDISTILLATI
MULTIPLE DELIVERIES AT SITE
CHARGE INVOICE
Driver: GT GARY TEETERS
Customer: 0000921720 Invoice #: GT 407958
CARMEL STREET DEPT Date: 5/15/2015
3400 W 131ST STREET Time: 07:59
CARMEL, IN 46074
Trus Terms Description Item # Description Legend Quantity Unit Price Item Total
02 DUE 06/20/2015 4040 PREMIUM DX-4 off rd E 186.6000 2.61000 487.03
Legend: Invoice Subtotal: 487.03
E=Metered, T=Taxable, *=Entered by Hand Indiana Sales Tax On: 0.00 ..... 0.00
Invoice Total: 487.63
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!!!
A
J
Customer Signature: I
CUSTOMEr"a
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))
05/15/15 GT 407958 $487.03
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
North Central Co-op
IN SUM OF $
P.O. Box 1106
Noblesville, IN 46060
$487.03
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO#/Dept. INVOICE NO. I ACCT#/TITLE I AMOUNT Board Members
2201 I GT 407958 I 42-313.00 I $487.03 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
I y, May 15, 2015
Stree8taeolip,K pioner
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
HommWarsaw Wabash Peru Goshen Angola Fremont Logansport Plymouth Rochester
a Kokomo Huntington Auburn Constantine 574-753-3673 Star City
Call: 800-720-0550 Call: 800-234-0573 800-807-3673 Call: 574-224-2667
cs=wBranch Co. MI Hart MI Noblesville 877-615-2667
517-278-4561 231-873-2158 765-67551811978 DATE 05/12/15 06:38:49
P.O.BOX 299 800-440-2667 317-77
WABASH, IN 46992 START 0.0 END 320.3
GROSS DELIVERY 320.3 GALLONS
4040 PREMIUM DX-4 off rDISTILLATI
** MULTIPLE DELIVERIES AT SITE
SALE 6717 DATE 05/12/15 06:43:54
COUNT: START 0.0 END 204.8
GROSS DELIVERY 204.8 GALLONS
4011 87 E-10 PLUS GASOLINE 1
MULTIPLE DELIVERIES AT SITE
CHARGE INVOICE
Driver: GT GARY TEETERS
Customer: 0000918936 Invoice S ,6T 407924
BROOKSHIRE GOLF CLUB Datec'5/12/2015
CITY OF CARMEL Time:;07:42
12120 BROOKSHIRE PKWY
CARMEL, IN 46033—
Trms Terms Description Item # Description Legend Quantity Unit Price Item Total
02 DUE 06/20/2015 4011 87 E-10 PLUS E 284.8M 2.16M 442.37
STATE EXCISE TAX 0.18000 36.86
02 DUE 06/20/2015 4040 PREMIUM DX-4 off rd E 320.3000 2.61000 835.98
Legend: Invoice Subtotal: 1,315.21
E=letered, T=Taxable, }=Entered by Hand Indiana Sales Tax On: 0.00 ..... 0.00
Invoice Total: 1,315.21
WARNING — PETROLEUM PRODUCTS NOT TO BE USED FOR STARTING OR KINDLING FIRES. BW0LINES 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:
I
CU
I
OmErFo�
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))
05/12/15 GT 407924 Fuel $835.98
05/12/15 GT 407924 Fuel $479.23
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
VOUCHER NO. WARRANT NO.
ALLOWED 20
North Central Co-op
IN SUM OF $
P.O. Box 299
Wabash, IN 46992
$1,315.21
ON ACCOUNT OF APPROPRIATION FOR
Brookshire Golf Club
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1207 GT 407924 42-314.00 $835.98 1 hereby certify that the attached invoice(s), or
1207 GT 407924 42-313.00 $479.23 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
Thursday, May 14, 2015
Director, BrookshirN%
lf Club
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund