HomeMy WebLinkAbout257492 04/12/16 / CITY OF CARMEL, INDIANA VENDOR: 366089
® ONE CIVIC SQUARE NORTH CENTRAL CO-OP CHECK AMOUNT: S*******428.28*
f\ a CARMEL, INDIANA 46032 PO BOX 299 CHECK NUMBER: 267492
WABASH IN 46992 CHECK DATE: 04/12/16
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2201 4231300 00410139 428.28 DIESEL FUEL
VOUCHER NO. WARRANT NO.
ALLOWED 20
NORTH CENTRAL CO-OP
PO BOX 299 IN SUM OF$
WABASH, IN 46992
$428.28
ON ACCOUNT OF APPROPRIATION FOR
Street Department
PO#/Dept. INVOICE NO. ACCT#/Fund AMOUNT Board Member
00410139 I 42-313.00 I $428.28 1 hereby certify that the attached invoice(s), or
2201 201
bill(s) is (are) true and correct and that the
materials or services itemized thereon for
which charge is made were ordered and
received except
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Tu� iiir6'�$�D�3'
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))
04/01/16 00410139 $428.28
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
North Central Co-op
P.O. Boz 1106 * Noblesville,IN 46061-1106
Centered on you. M:317-773-0870 Fax: 317-776-4149
NCC - Hamilton County Petro =_________= PAGE 1
16222 Allisonville Road INVOICE INVOICE NO. 00410139
PO Box 1106 =_________= ORDER DATE 04/01/16
Noblesville IN 46060 ACCOUNT NO. 0000921720
317-773-0870 BATCH 482 GT
CARMEL STREET DEPT
- 3400 W 131ST STREET
CARMEL IN 46074
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P.O.# SHIP DATE TERMS SLS LOC
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04/01/16 DUE 05/20/2016 GT 256
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ITEM NO DESCRIPTION UNITS SOLD UNIT PRICE EXTENDED
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4040 PREMIUM DX-4 off rd 231.5000 GAL 1.85000 428 .28
TOTAL DUE $$ 428 .28