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Home My WebLink About260267 06/28/16 r C_Aq- �i" "''F• CITY OF CARMEL, INDIANA VENDOR: 366089 {; r: ONE CIVIC SQUARE NORTH CENTRAL CO-OP CHECK AMOUNT: $*****1,230.12* ,. r CARMEL, INDIANA 46032 PO Box 299 CHECK NUMBER: 260267 9�„�roN�� WABASH IN 46992 CHECK DATE: 06/28/16 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1207 4231300 GT 410624 580.57 DIESEL FUEL 2201 4231300 GT 410717 649.55 DIESEL FUEL VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201(Rev.1995) ALLOWED 20 ACCOUNTS PAYABLE VOUCHER NORTH CENTRAL CO-OP Po Box 299 IN SUM OF$ 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. $649.55 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 410717 42-313.00 $649.55 ►hereby certify that the attached invoice(s),or 6/20/16 GT 410717 $649.55 2201 201 2201 201 bill(s)is(are)true and correct and that the materials or services itemized thereon for which charge is made were ordered and received except Tuesday,June 21,2016 0 I hereby certify that the attached invoice(s),or bill(s),is(are)true and correct and I have audited same in accordance with IC 5-11-10-1.6 , 20- Cost 20Cost distribution ledger classification if claim paid motor vehicle highway fund. Clerk-Treasurer North Central Co-op 0 P.O. BOX 299 • WABASH IN 46992 � b SALE 13926 DATE 06/20/16 11:19:06 COUNT: START 0.0 END 296.6 GROSS DELIVERY 296.6 GALLONS Centered on you. 4040 PREMIUM DX-4 off rDISTILLATI MULTIPLE DELIVERIES AT SITE CHARGE INVOICE Driver: GT GARY TEETERS Customer: 0000921720 Invoice #: GT 410717 CARMEL STREET DEPT Date: 6/20/2016 3400 W 131ST STREET Time: 12:08 CARMEL, IN 46074 Trms Terms Description Item # Description Legend Quantity Unit Price Item Total 02 DUE 07/20/2016 4040 PREMIUM DX-4 off rd E 296.6000 2.19000 649.55 Legend: Invoice Subtotal: 649.55 E=Metered, T=Taxable, *=Entered by Hand Indiana Sales Tax On: 0.00 ..... 0.00 Invoice Total: 649.55 WARNING - PETROLEUM PRODUCTS NOT TO BE USED FOR STARTING OR KINDLING FIRES. GASOLINES NOT SOLD FOR ILLUMINATING OR CLEANING PURPOSE S. IN CASE OF EMERGENCY CONTACT CHEMTREC AT 1-800-424-9300 WE APPRECIATE YOUR BUSINESS!!! 1 Customer Signature: I Warsaw Wabash Peru Goshen Angola Fremont Logansport Plymouth Rochester Kokomo Huntington Auburn Constantine 574-753-3673 Star City Call: 800-720-0550 Call: 800-234-0573 800-807-3673 Call:574-224-2667 877-615-2667 Branch Co. MI Hart MI Noblesville 517-278-4561 231-873-2158 855-773-0870 800-942-6765 888-591-8211 317-773-0870 cusToMEsa VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201(Rev.1995) NORTH CENTRAL CO-OP ALLOWED 20 ACCOUNTS PAYABLE VOUCHER PO BOX 299 IN SUM OF$ 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. $580.57 Payee ON ACCOUNT OF APPROPRIATION FOR Purchase Order# 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 410624 42-313.00 $580.57 1 hereby certify that the attached invoice(s),or 6/7/16 GT 410624 Diesel Fuel $580.57 1207 101 1207 101 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 Monday,June 20,2016 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 distribution ledger classification if claim paid motor vehicle highway fund. Clerk-Treasurer � North Central Co-op P.O. BOX 299 • WABASH IN 46992 SALE 13867 DATE 06/07/16 13:16:21 Centered on you. COUNT: START 0.0 END 265.1 GROSS DELIVERY 265.1 GALLONS 4040 PREMIUM DX-4 off rDISTILLATI m* MULTIPLE DELIVERIES AT SITE SALE 8084 DATE 06/07/16 13:24:31 COUNT: START 0.0 END 169.6 GROSS DELIVERY 169.6 GALLONS 4011 87 E-10 PLUS GASOLINE 1 MULTIPLE DELIVERIES AT SITE # CHARGE INVOICE Driver: GT GARY TEETERS Customer: 00009189336 Invoice #: GT 410624 BROOKSHIRE GOLF CLUB Date: 6/7/2016 CITY OF CARMEL Time: 14:05 12120 BROOKSHIRE PKWY 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 169.6000 2.09000 354.46 STATE EXCISE TAX 0.18000 30.53 02 DUE 06/20/2016 4040 PREMIUM DX-4 off rd E 265.1000 2.19000 580.57 Legend: Invoice Subtotal: 965.56 E=Metered, T=Taxable, *=Entered by Hand Indiana Sales Tax On: 0.00 ..... 0.00 Invoice Total: 965.56 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 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 CUSTOMER