HomeMy WebLinkAbout257257 04/05/16 0CITY OF CARMEL, INDIANA VENDOR: 366089
�/ ` ONE CIVIC SQUARE NORTH CENTRAL CO-OP CHECK AMOUNT: $"`""'441.41"
f9, ,?Q CARMEL, INDIANA 46032 Po Box 299 CHECK NUMBER: 257257
M,�T�N,�o. WABASH IN 46992 CHECK DATE: 04/05/16
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2201 4231300 GT 410015 441.41 DIESEL FUEL
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))
03/15/16 GT 410015 $441.41
2201 201
1 hereby certify that the attached invoice(s), or bill(s), is(are)true and correct and I have audited same in accordance
with IC 5-11-10-1.6
, 20
Clerk-Treasurer
VOUCHER NO. WARRANT NO.
ALLOWED 20
NORTH CENTRAL CO-OP
PO BOX 299 IN SUM OF$
WABASH, IN 46992
$441.41
ON ACCOUNT OF APPROPRIATION FOR
Street Department
PO#/Dept. INVOICE NO. ACCT#/Fund I AMOUNT Board Member
I GT 410015 I 42-313.00 I $441.41 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
Tues y, Marp h/1 5,
1.Ua"
Street Commissioner
Cost distribution ledger classification if
claim paid motor vehicle highway fund
North Central Co-op
P.O. BOX 299 WABASH, IN 46992
SALE 13450 DATE 03/15/16 08:17:11
Centered on you. COUNT: START 0.0 END 238.6
GROSS DELIVERY 238.6 GALLONS
4040 PREMIUM DX-4 off rDISTILLATI
MULTIPLE DELIVERIES AT SITE
�0)
CHARGE INVOICE
Driver: GT GARY TEETERS
Customer: 0000921720 Invoice g: 6T 410015
CARMEL STREET DEPT Date: 3/15/20.16
3400 W 131ST STREET Time: 09:08
CARMEL, IN 46074
Tris Terms Description Item # Description Legend Quantity Unit Price Item Total
02 DUE 04/20/2016 4040 PREMIUM DX-4 off rd E 238.6083 1.85000 441.41
Legend: Invoice Subtotal: 441.41
E=Metered, T=Taxable, *=Entered by Hand Indiana Sales Tax On: 0.00 ..... 0.00
Invoice Total: 441.41
WARNING - PETROLEUM PRODUCTS NOT TO BE USED FOR STARTING OR KINDLING FIRES. 6ASOLINES 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: Ch A04_,,�.
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