Loading...
HomeMy WebLinkAbout253158 01/11/16 �c CITY OF CARMEL, INDIANA VENDOR: 366089 ONE CIVIC SQUARE I NORTH CENTRAL CO-OP CHECK AMOUNT: $*******554.31 CARMEL, INDIANA 46032 Po Box 299 CHECK NUMBER: 253158 9%irori��r WABASH IN 46992 CHECK DATE: 01/11/16 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 2201 4231300 00409533 264.91 DIESEL FUEL 1115 R4231300 33377 GT409519 137.00 DIESEL FUEL 1115 R4231300 33377 GT409520 152.40 DIESEL FUEL I I c© INDIANA RETAIL TAX EXEMPT Page 1 of-1 y,itofc � �� CERTIFICATE NO.0031201550020 PURCHASE ORDER NUMBER ((� FEDERAL.EXCISE TAXEXEMPT 33377 ONE CIVIC SQUARE 35-6000972 THIS NUMBER MUST APPEAR ON INVOICES,A/P CARMEL;INDIANA 46032-2584 VOUCHER,DELIVERY MEMO,PACKING SLIPS, SHIPPING LABELS AND ANY CORRESPONDENCE FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL-1997 i PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION 12/9/2015 % 119835 CO-OP INC Communications VENDOR PO BOX 1106 SHIP 31 1st Avenue N.W. TO Carmel, IN 46032- NOBLESVILLE, IN 46061 - (317)571-2576 CONFIRMATION BLANKET I CONTRACT PAYMENT TERMS FREIGHT QUANTITY . UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION Department. 1115 Account., 42-313.00 Fund: 101 General Fund - 1 Each Diesel fuel $500.00 $500.00 Sub Total $500.00 I I Send Invoice To: Communications . 31 list Avenue N.W. i Carmel, IN.46032- (317)571-2576 PLEASE INVOICE IN DUPLICATE DEPARTMENT ACCOUNT PROJECT PROJECTACCOUNT AMOUNT $500. PAY 00 MENT SHIPPING INSTRUCTIONS 'AIP VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O. NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND VOUCHER HAS THE PROPER SWORN 'SHIP PREPAID. AFFIDAVIT ATTACHED:'I HEREBY CERTIFY THAT THERE IS ANUNOBUGATED BALANCE IN :C.O.D.SHIPMENT CANNOT BE ACCEPTED. THIS APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER. . 'PURCHASE ORDER NUMBER MUST APPEAR ON ALL SHIPPING LABEL 'THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 ORDERED -BY � AND ACTS AMENDATORY THEREOF'AND SUPPLEMENT THERETO. TITLE Terry Crockett, Director CONTROL NO. =33377 CLERK-TREASURER I a orth en rat . o-op i i t April 4,2012 i Vendor: f Please accept this letter as notice of the merger of North Central Cooperative,Inc.of Wabash, IN and Hamilton County Farm Bureau Cooperative Association, Inc.of Noblesville, IN with North Central Cooperative as the surviving entity effective March 11,2012. This is a complete corporate merger according to our legal counsel. ? z For additional information, please contact Kent Kercheval at 317-773-0870 x 202. ' i Sincerely, ( s I Kent E Kercheval Division Controller North Central Cooperative i s. I I I (I I1 I I j 2025 S. li'ahash R. "1-10 Bov 29.9 �11'ahnsh, IX 46992-0299 260-563-8381 Fay 260-563-3021 j 16222 i111isomville Rd PO'Boi' 1106 Nohlesrille, hV 46061-1106*317-773-0870 Eta 317-776-4149 Entail: lee.Coop Ivlm'.nee.coop i I No t� h Central CO-®p . BOX 299 WABASH 4 , IN 6992 r SALE 13064 DATE 12/21/15 15:49:10 Centered on you. COUNT: START 0.0 END 123.2 GROSS DELIVERY 123.2 GALLONS 4040 PREMIUM DX-4 off rDISTILLATI MULTIPLE DELIVERIES AT SITE CASH INVOICE Driver: GT GARY TEETERS Customer: 0000921736 Invoice #: GT 409519 CARMEL COMMUNICATIONS Date: 12/21/2015 31 IST AVE. N.W. Time: 16:00 CARMEL, IN 46032 Tr®s Terms Description Item # Description Legend Quantity Unit Price Item Total 01 Cash 4040 PREMIUM DX-4 off rd 0.0000 1.95000 0.00 01 Cash 4033 K-1 HEATING DYED 25.0000 2.48000 62.00 01 Cash 63400 SERVICE CHARGE * 1.0000 75.00000 75.00 Legend: Invoice Subtotal: 137.00 E--Metered, T=Taxable, *=Entered by Hand Indiana Sales Tax On: 0.00 ..... 0.00 Invoice Total: 137.00 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!!! i Customer Signature: Warsaw Wabash Peru Goshen Angola Fremont Logansport Plymouth Rochester Kokomo Huntington Auburn Constantine 574-753-3673 Star City Call:800-720-0550 _ Call: 800-234-0573 __ __`a00.80Z-367.3 _Call:_574224-2667_ Branch Co. MI Hart MI Noblesville 877-615-2667 517-278-4561 231-873-2158 855-773-0870 800-942-6765 888-591-8211 317-773-0870 CUSTOMER i � North Central Co-op X P.O. 2 O O 99 • WABASH, IN 46992 Centered on you. ,I I CHARGE INVOICE Driver: GT GARY TEETERS Customer: 0000921736 �� �' Invoice #: GT 4095,00 CARMEL COM14UNICATIONS Date: 12/2112015 31 1ST AVE. N.W. Time: 16:01 CARMEL, IN 46032 Trms Terms Description Item # Description Legend Quantity Unit Price Item Total 02 DUE 01/20/2016 4040 PREMIUM DX-4 off rd 25.7000 1.95000 50.12 02 DUE 01/20/2016 4033 K-1 HEATING DYED * 11.0000 2.48000 27.28 02 DUE 01/20/2016 63400 SERVICE CHARGE * 1.0000 75.00000 75.00 Legend: Invoice Subtotal: 152.40 E=Metered, T=Taxable, *=Entered by Hand Indiana Sales Tax On: 0.00 ..... 0.00 Invoice Total: 152.40 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: i i I Warsaw Wabash Peru Goshen Angola Fremont I Logansport I Plymouth Rochester 877-615-2667 Branch Co. MI Hart MI Noblesville 517-278-4561 231-873-2158 855-773-0870 800-942-6765 888-591-8211 317-773-0870 CUSTOMER VOUCHER NO. WARRANT NO. NORTH CENTRAL CO-OP ALLOWED 20 PO BOX 299 IN SUM OF$ WABASH, IN 46992 $289.40 ON ACCOUNT OF APPROPRIATION FOR PO#/Dept. INVOICE NO. ACCT#/Fund AMOUNT Board Member: 33377 I GT 409520 I 42-313.00 I $152.40 I hereby certify that the attached invoice(s), or 1115 Encumbered 101 Prior Year 33377GT 409519 42-313.00 $137.00 bill(s) is (are)true and correct and that the 1115 LEncumbered I 101 Prior Year materials or services itemized thereon for which charge is made were ordered and received except Monday, January 04, 2016 Terry Crockett, Director 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 Date Invoice# Description Amount- Dept. Fund# (or note attached invoice(s) or bill(s)) 12/21/15 GT 409520 $152.40 1115 101 12/21/15 GT 409519 $137.00 1115 101 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 20Clerk-Treasurer North Central - Co-op I Centered on you. NCC - Hamilton County Petro =_________= PAGE 1 16222 Allisonville Road INVOICE INVOICE NO. 00409533 PO Box 1106 =_________= ORDER DATE12/23/15 Noblesville IN 46060 ACCOUNT NO. 0000921720 317.-773-0870 BATCH 483 GT CARMEL STREET DEPT 3400 W 131ST STREET CARMEL IN 46074 -------------------------------------------------------------------------------- P.O.#. SHIP DATE TERMS SLS LOC ------------------------I-------------------------------------------------------- 12/23/151 DUE 01/20/2016 GT 256 ITEM NO DESCRIPTION UNITS- SOLD UNIT PRICE EXTENDED -----------------------i-------------------------------------------------------- 4040 ------------------------------------------------------- 4040 PREMIUM DX-4 off rd 87.9000 GAL 1.95000 171.41 4033 K-1 HEATING DYED 37 .7000 GAL 2 .48000 93 .50 121034 FILTER FUEL TANK 3/4" 1 EA TOTAL DUE $$ 264.91 ' I I I VOUCHER NO. WARRANT NO. ALLOWED 20 NORTH CENTRAL CO-OP PO BOX 299 f IN SUM OF$ WABASH, IN 46992 $264.91 ON ACCOUNT OF APPROPRIATION FOR PO#/Dept. INVOICE NO. ACCT#/Fund AMOUNT Board Member 00409533 42-313.00 $264.91 2201 201 ,Prior Year I hereby certify that the attached invoice(s), or I 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 Thursd y, Decef Ler �, 015 Street Commissionar Cost distribution ledger classification if claim paid motor vehicle highway fund