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246462 06/17/15 CITY OF CARMEL, INDIANA VENDOR: 366089 ® I ONE CIVIC SQUARE NORTH CENTRAL CO-OP CHECK AMOUNT: $*****2,610.23* ?� CARMEL, INDIANA 46032 Po Box 299 CHECK NUMBER: 246462 ,, _ WABASH IN 46992 CHECK DATE: 06/17/15 t �fON� DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 609 5023990 408058 1,116.79 OTHER EXPENSES 1207 4231300 GT408093 669.47 DIESEL FUEL 1207 4231400 GT408093 350.78 GASOLINE 2201 4231300 GT408113 473.19 DIESEL FUEL Warsaw Wabash Peru Goshen Angola Fremont Logansport Plymouth Rochester p Kokomo Huntington Auburn Constantine 574-753-3673 Star City co.00 Call: 800-720-0550 Ca11: 800-234-0573 800-807-3673 Call: 574-224-2667 � Branch Co. MI Hart MI Noblesville 877615-2667 P.O. BOX 299 517-278-4561 231-873-2158 765-675-2538 WABASH, IN 46992 800-440-2667 317-773-0870 SALE -12096 DATE 06/03/15 10:17:44 COUNT: START 0.0 END 256.5 GROSS DELIVERY 256.5 GALLONS 4040 PREMIUM DX-4 off rDISTILLATI MULTIPLE DELIVERIES AT SITE ff SALE 6822 DATE 06/03/15 10:24:03 COUNT: START 0.0 END 138.1 GROSS DELIVERY 138.1 GALLONS 4011 87 E-10 PLUS GASOLINE 1 MULTIPLE DELIVERIES AT SITE CHARGE INVOICE Driver: GT GARY TEETERS Customer: 0000918936 Invoice #: GT 408093 BROOKSHIRE GOLF CLUB Date: 6/3/2015 CITY OF CARMEL Time: 11:17 12120 BROOKSHIRE PKWY CARMEL, IN 46033— Trms Terms Description Item D Description Legend Quantity Unit Price Item Total 02 DUE 07/20/2015 4011 87 E-10 PLUS E 138.1000 2.36019 325.92 STATE EXCISE TAX 0.18000 24.86 02 DUE 07/20/2015 4040 PREMIUM DX-4 off rd. E 256.5000 2.61000 669.47 Legend: Invoice Subtotal: 1,020.25 EAlletered, T=Taxable, *=Entered by Hand Indiana Sales Tax On: 0.00 ..... 0.00 Invoice Total: 1,020.25 WARNING — PETROLEUM PRODUCTS NOT TO BE USED FOR STARTING OR KINDLING FIRES. GASOLINES NOT SOLD FOR ILLUMINATING OR CLEANING PURPOSE S. IN CASE OF EMERGENCY CONTACT CHEMTREC AT 1-800-424-9300 WE APPRECIATE YOUR BUSINESS!!! Customer Signature: VOUCHER NO. WARRANT NO. ALLOWED 20 North Central Co-op IN SUM OF$ P.O. Box 299 Wabash, IN 46992 $1,020.25 ON ACCOUNT OF APPROPRIATION FOR Brookshire Golf Club PO#/Dept. INVOICE NO. ACCT#riITLE I AMOUNT Board Members 1207 GT 408093 42-314.00 j $350.78 1 hereby certify that the attached invoice(s), or 1207 GT 408093 42-313.00 $669.47 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, June 09, 2015 Director, Brookshire olflClub 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)) 06/03/15 GT 408093 Fuel $350.78 06/03/15 GT 408093 Diesel $669.47 I hereby certify that the attached invoice(s), or bill(s), is(are)true and correct and I have audited same in accordance with IC 5-11-10-1.6 120 Clerk-Treasurer NOMEWarsaw Wabash Peru Goshen ans ort Angola Fremont Lo Plymouth Rochester CHM 9 Logansport Y M Kokomo Huntington Auburn Constantine 574-753-3673 Star City 281 Call: 800-720-0550 Call: 800-234-0573 800-807-3673 Call: 574-224-2667 Cc--DT Branch Co. MI Hart MI Noblesville 877-615-2667 517-278-4561 231-873-2158 765-675SAM- 812117 DATE 06/05/15 10:40:57 P.O. BOX 299 800-440-2667 317-772GOUNP START 0.0 END 181.3 WABASH, IN 46992 GROSS DELIVERY 181.3 GALLONS 4040 PREMIUM DX-4 off rDISTILLATI MULTIPLE DELIVERIES AT SITE . CHARGE INVOICE Driver: GT GARY TEETERS Customer: 0000921720 Invoice #: GT 408113 CARMEL STREET DEPT Date: 6/5/2015 3400 W 131ST STREET Time: 11:38 CARMEL, IN 46074 Trms Terms Description Item # Description Legend Quantity Unit Price Item Total 02 DUE 07/20/2015 4040 PREMIUM DX-4 off rd E 181.3000 2.61000 473.19 Legend: Invoice Subtotal: 473.19 E=4etered, T=Taxable, *=Entered by Hand Indiana Sales Tax On: 0.00 ..... 0.00 Invoice Total: 473.19 WARNING — PETROLEUM PRODUCTS NOT TO BE USED FOR STARTING OR KINDLING FIRES. GASOLINES NOT SOLD FOR ILLUMINATING OR CLEANING PURPOSE S. IN CASE OF EMERGENCY CONTACT CHEMTREC AT 1-800-424-9300 WE APPRECIATE YOUR BUSINESS!!! Customer Signature: CU O�DT VOUCHER NO. WARRANT NO. ALLOWED 20 North Central Co-op IN SUM OF$ P.O. Box 1106 Noblesville, IN 46060 $473.19 ON ACCOUNT OF APPROPRIATION FOR Carmel Street Department PO#/Dept. INVOICE NO. I ACCT#!TITLE I AMOUNT Board Members 2201 I GT 408113 I 42-313.00 I $473.19 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 Thursday, June 11, 2015 s L. A 114.4,A eA eet Com s o Street CgMmissloner 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)) 06/05/15 GT 408113 $473.19 I hereby certify that the attached invoice(s), or bill(s), is(are)true and correct and I have audited same in accordance with IC 5-11-10-1.6 20 Clerk-Treasurer North Central Co-op Centered on you. NCC - Hamilton County Petro =_________= PAGE 1 16222 Allisonville Road INVOICE INVOICE NO. 00408058 PO Box 1106 =_________= ORDER DATE 05/29/15 Noblesville IN 46060 ACCOUNT NO. 0000921864 317-773-0870 BATCH 485 GT CITY OF CARMEL UTILITIES DEPT 30 W MAIN. STREET CARMEL IN 46032 P.O.$# SHIP DATE TERMS SLS LOC -------------------------------------------------------------------------------- 05/29/15 DUE 06/20/2015 GT 256 - - -------------------------------------------------- ITEM NO DESCRIPTION UNITS SOLD UNIT PRICE EXTENDED -------------------------------------------------------------------------------- 4040 PREMIUM DX-4 off rd 412 . 1000 GAL 2 .71000 1116 . 79 SUBTOTAL 1116 . 79 SALES TAX 8 TOTAL DUE $$ Prescribed by State Board of Accounts Form No.301(Rev.1995) ACCOUNTS PAYABLE VOUCHER TO ADDRESS Invoice Date Invoice Number Item Amount I 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 Mo. Day Yr. Signature Title 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. Mo. Day Yr. Officer Title Voucher No. Warrant No. ACCOUNTS PAYABLE DETAILED ACCOUNTS MUNICIPAL WATER DEPT. ACCT. CARMEL, INDIANA NO. �9OC� Favor Of n �1 �00�e l 162 Asoy,V l /�.�3' �oyc /Q liij�sUr �C 1/l/ Total Amount of Voucher $ ` Deductions yo �b 7-/ S . 8 Amount of Warrant $ Month of Yr VOUCHER RECORD Acct. No. Source of Supply Water Treatment I Transmission and Dist. Customer Accounts Administrative and General Operation-Maintenance Utility Plant in Service Constr.Work in Progress Materials and Supplies Customers Deposits Total i Allowed I, Board of Control Filed Official Title i BOYCE FORMS•SYSTEMS 1-800-382-8702 325 I