HomeMy WebLinkAbout257258 04/05/16 0�/ \ CITY OF CARMEL, INDIANA VENDOR: 366089
31 ONE CIVIC SQUARE NORTH CENTRAL CO-OP CHECK AMOUNT: $*******482.13*
r. CARMEL, INDIANA 46032 PO Box 1106 CHECK NUMBER: 257258
9M,�TON�°` NOBLESVILLE IN 46060 CHECK DATE: 04/05/16
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4231300 00410033 482.13 DIESEL FUEL
escribed by State Board of Accounts City Form No.201 (Rev.1995)
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
n invoice or bill to be properly itemized must show: kind of service,where performed,dates service rendered, by
hom, rates per day, number of hours, rate per hour, number of units, price per unit, etc.
Payee
Purchase Order No.
Terms
Date Due
nvoice Invoice Description Amount
Date Number (or note attached invoice(s)or bill(s))
410033 $482.13
hereby certify that the attached invoice(s), or bill(s), is(are)true and correct and I have audited same in accordance
vith IC 5-11-10-1.6
20
Clerk-Treasurer
VOUCHER NO. WARRANT NO.
ALLOWED 20
North Central Co-Op
IN SUM OF$
PO Box 299
Wabash, IN 46992-0299
$482.13
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1120 410033 42-313.00 $482.13 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 ey q
sA® Q20 6.
I tl (Vd
Fire Chief
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
North Central Co-op
P.O. BOX 299 WABASH, IN 46992
SALE 13461 DATE 03/17/16 10:15:42
Centered .on ouCOUNT: START 0.0 END 213.9
y GROSS DELIVERY 213.9 GALLONS
4049 PREMIUM DX-4 on rdDISTILLATI
MULTIPLE DELIVERIES AT SITE
CHARGE INVOICE
Driver: GT GARY TEETERS
Customer: 0000921744 Invoice 8: GT 410033
CARMEL FIRE DEPT Date: 3/17/2016
2 CIVIC SQUARE Time: 11:07
CARD, IN 46032 -
Trms Terms Description Item A Description Legend Quantity Unit Price Item Total
02 DUE 04/20/2016 4049 PREMIUM DX-4 on rd E 213.90(80 1.85M 395.72
FEDERAL EXCISE TAX 0.24400 52.19
STATE EXCISE TAX 0.16000 34.22
Legend: Invoice Subtotal: 482.13
E--Metered, T=Taxable, *=Entered by Hand Indiana Sales Tax On: 0.00 ..... 0.00
Invoice Total: 482.13
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:
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
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