HomeMy WebLinkAbout259122 05/31/16 CITY OF CARMEL, INDIANA VENDOR: 366089
® t`I ONE CIVIC SQUARE NORTH CENTRAL CO-OP CHECK AMOUNT: $*••.•1,430.88"
CARMEL, INDIANA 46032 Po Box 299 CHECK NUMBER: 259122
WABASH IN 46992 CHECK DATE: 05/31/16
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1207 4231300 GT410457 902.74 DIESEL FUEL
1207 4231400 GT410457 528.14 GASOLINE
VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201 (Rev.1995)
NORTH CENTRAL CO-OP ALLOWED 20 ACCOUNTS PAYABLE VOUCHER
PO BOX 299 IN SUM OF$ CITY OF CARMEL
An invoice or bill to be properly itemized must show!kind of service,where performed,dates service
WABASH, IN 46992 rendered,by whom,rates per day,number of hours,rate per hour,number of units,price per unit,etc.
$1,430.88 Payee
Purchase Order#
ON ACCOUNT OF APPROPRIATION FOR
Brookshire Golf Course Terms
Date Due
PO#- ACCT# DATE INVOICE# DESCRIPTION
DEPT# INVOICE# Fund# AMOUNT Board Members DEPT# FUND# (or note attached invoice(s)or bill(s)) AMOUNT
GT 410457 42-31°3, $902.74 I hereby certify that the attached invoice(s),or 5/17/16 GT 410457 Diesel Fuel $902.74
1207 101 1207 101
GT 41057 42-314.00 $528.14 bill(s)is(are)true and correct and that the 5/17/16 GT 41057 Gasoline $528.14
1207 101 materials or services itemized thereon for 1207 1 101
which charge is made were ordered and
received except
Monday, May 23,2016
' 4
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
Cost distribution ledger classification if claim paid motor vehicle highway fund. Clerk-Treasurer
North Central Co-op
P.O. BOX 299 WABASH, IN 46992
SALE 13747 DATE 05/17/16 10:37:47
COUNT: START 0.0 END 444.7
Centered on you. GROSS DELIVERY 444.7 GALLONS
4040 PREMIUM DX-4 off rDISTILLATI
** MULTIPLE DELIVERIES AT SITE **
SALE 7980 DATE 05/17/16 10:47:34
COUNT: START 0.0 END 237.9
GROSS DELIVERY 237.9 GALLONS
4011 87 E-10 PLUS GASOLINE i
** MULTIPLE DELIVERIES AT SITE **
CHARGE INVOICE
Driver: GT GARY TEETERS
Customer: 0000918936 Invoice #: GT 410457
BROOKSHIRE GOLF CLUB Date: 5/17/2016
CITY OF CARMEL Time: 11:31
12120 BROOKSHIRE PKW
CARMEL, IN 46033-
Tris Terms Description Item # Description Legend Quantity Unit Price Item Total
02 DUE 06/20/2016 4011 87 E-10 PLUS E 237.9000 2.04000 485.32
STATE EXCISE TAX 0.18000 42.82
02 DUE 06/20/2016 4040 PREMIUM DX-4 off rd E 444.7000 2.03000 902.74
Legend: Invoice Subtotal: 1,430.88
E=Metered, T=Taxable, *--Entered by Hand Indiana Sales Tax On: 0.00 ..... 0.00
Invoice Total: 1,430.88
NARNING - 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:
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Call:800-720-0550 Call: 800-234-0573 800-807-3673 Call:574-224-2667
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800-942-6765 888-591.8211 317-773-0870 CUSTOMER