HomeMy WebLinkAbout259649 06/14/16 (9,
CITY OF CARMEL, INDIANA VENDOR: 366089
ONE CIVIC SQUARE NORTH CENTRAL CO-OP CHECK AMOUNT: $*******448.73*
CARMEL, INDIANA 46032 PO Box 299 CHECK NUMBER: 259649
WABASH IN 46992 CHECK DATE: 06/14/16
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2201 4231300 GT410557 448.73 DIESEL FUEL
VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201 (Rev.1995)
ALLOWED 20 ACCOUNTS PAYABLE VOUCHER
NORTH CENTRAL CO-OP
PO BOX 299 IN SUM OF$ 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.
$448.73 Payee
Purchase Order#
ON ACCOUNT OF APPROPRIATION FOR
Street Department 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 410557 42-313.00 $448.73 1 hereby certify that the attached invoice(s),or 5/31/16 GT 410557 $448.73
2201 201 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
Tuesday, May 31,2016
01
Mtreet Commissioner
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-
Cost
20Cost distribution ledger classification if claim paid motor vehicle highway fund. Clerk-Treasurer
North Central Co-op
® P.O. BOX 299 - WABASH IN 4
6992
SALE 13820 DATE 05/31/16 10:55:57
COUNT: START 0.0 END 204.9
GROSS DELIVERY 204.9 GALLONS
Centered on you. 4040 PREMIUM DX-4 off rDISTILLATI
MULTIPLE DELIVERIES AT SITE
CHARGE INVOICE
Driver: GT GARY TEETERS
Customer: 0000921720 Invoice #: 6T 410557
CARMEL STREET DEPT Date: 5/31/2016
3400 W 131ST STREET Time: 11:45
CARMEL, IN 46074
Tris Terms Description Item # Description Legend Quantity Unit Price Item Total
02 DUE 06/20/2016 4040 PREMIUM DX-4 off rd E 204.9000 2.19000 448.73
Legend: Invoice Subtotal: 448.73
E=Metered, T=Taxable, *=Entered by Hand Indiana Sales Tax On: 0.00 ..... 0.00
Invoice Total: 448.73
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 CHEMTREC AT 1-800-424-9300 WE APPRECIATE YOUR BUSINESS!!!
Customer Signature:
Warsaw Wabash Peru Goshen Angola Fremont Logansport Plymouth Rochester
Kokomo Huntington Auburn Constantine 574-753-3673 Star City
Call: 800-720-0550 Call: 800-234-0573 800-807-3673 Call: 574-224-2667
877-615-2667
Branch Co. MI Hart MI Noblesville
517-278-4561 231-873-2158 855-773-0870
800-942-6765 888-591-8211 317-773-0870
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