HomeMy WebLinkAbout253940 01/26/16 y;,r_S�A,y
�/ CITY OF CARMEL, INDIANA VENDOR: 366089
® ONE CIVIC SQUARE NORTH CENTRAL CO-OP CHECK AMOUNT: $*******448.06`
r CARMEL, INDIANA 46032 PO BOX 299 CHECK NUMBER: 253940
"9 �_ CHECK DATE: 01/26/16
M�iioN�. WABASH IN 46992
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2201 4231300 GT409717 448.06 DIESEL FUEL
North Central Co-op
® P.O. BOX 299 - WABASH IN 46992
SALE 13219 DATE 01/22/16 14:35:04
COUNT: START 0.0 END 227.8
Centered on you. GROSS DELIVERY 227.8 GALLONS
4040 PREMIUM DX-4 off r•DISTILLATI
MULTIPLE DELIVERIES AT SITE
CHARGE INVOICE
Driver: GT GARY TEETERS
Customer: 0000921720 Invoice #: GT 409717
CARMEL STREET DEPT Date: 1/22/2016
3400 W 131ST STREET Time: 14:25
CARMEL, IN 46074
Tris Terms Description Item # Description Legend Quantity Unit Price Item Total
02 DUE 02/20/2016 4040 PREMIUM DX-4 off rd E 159.5000 1.79000 285.51
02 DUE 02/20/2016 4033 HEATING DYED E 68.3000 2.38000 162.55
Legend: Invoice Subtotal: 448.06
E--Metered, T=Taxable, *=Entered by Hand Indiana Sales Tax On: 0.00 ..... 0.00
Invoice Total: 448.06
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:
Warsaw Wabash Peru Goshen Angola Fremont Logansport Plymouth Rochester Star City
Kokomo Huntington Auburn Constantine 574-753-3673 Call:574-224-2667
Call:800-720-0550 Call:800-234-0573 800-807-3673 877-615-2667
Branch Co. MI Hart MI Berrien Co. MI Noblesville
517-278-4561 231-873-2158 269-461-4222 855-773-0870
800-942-6765 888-591-8211 800-761-4222 317-773-0870 CUSTOMER
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))
01/22/16 GT 409717 $448.06
2201 201
I hereby certify that the attached invoice(s), or bill(s), is(are)true and correct and I have audited same in accordance
with IC 5-11-10-1.6
, 20
Clerk-Treasurer
VOUCHER NO. WARRANT NO.
NORTH CENTRAL CO-OP ALLOWED 20
PO BOX 299 IN SUM OF$
WABASH, IN 46992
$448.06
ON ACCOUNT OF APPROPRIATION FOR
Street Department
PO#/Dept. INVOICE NO. ACCT#/Fund AMOUNT Board Member
I GT 409717 I 42-313.00 I $448.06 1 hereby certify that the attached invoice(s), or
2201 201
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
Friday, January 22, 2016
IT014f ,
l
Street Commissioner
Cost distribution ledger classification if
claim paid motor vehicle highway fund