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HomeMy WebLinkAbout301736 08/08/16 +.44q q`/ t. CITY OF CARMEL, INDIANA VENDOR: 366089 j; ® ONE CIVIC SQUARE NORTH CENTRAL CO-OP CHECK AMOUNT: $*******674.03* ?� CARMEL, INDIANA 46032 Po Box 299 CHECK NUMBER: 301736 9M�:.,;,o. WABASH IN 46992 CHECK DATE: 08/08/16 +TOX� DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 2201 4231300 GT410983 674.03 DIESEL FUEL VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201 (Rev.1995) NORTH CENTRAL CO-OP ALLOWED 20 ACCOUNTS PAYABLE VOUCHER PO BOX 299 IN SUM OF$ 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. $674.03 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 410983 42-313.00 $674.03 1 hereby certify that the attached invoice(s),or 8/2/16 GT 410983 $674.03 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,August 02, 2016 Dave Huffman Director 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 10157 DATE 08/02/16 11:16:48 COUNT: START 0.0 END 322.5 Centered on you. GROSS DELIVERY 322.5 GALLONS 4040 PREMIUM DX-4 off rDISTILLATi + MULTIPLE DELIVERIES AT SITE � CHARGE INVOICE Driver: GT GARY TEETERS Customer: 0004921720 Invoice #: GT 410983 CARMEL STREET DEPT Date: 8/2/2016 3400 W 131ST STREET Time: 10:14 CARMEL, IN 46074 Tris Terms Description Item R Description Legend Quantity Unit Price Item Total 02 DUE 09/20/2016 4040 PREMIUN DX-4 off rd E 322.5000 2.09000 674.03 Legend: Invoice Subtotal: 674.03 E=letered, T=Taxable, Entered by Hand Indiana Sales Tax On: 0.00 ..... 0.00 Invoice Total: 674.03 WARNING - PETROLEUM PRODUCTS NOT TO BE USED FOR STARTING OR KINDLING FIRES. GASOLINES NOT SOLD FOR ILLUMINATING OR CLEANING PURPOSE S. IN CASE OF EIURGENCY CONTACT DWREC AT 1-800-424-9300 WE APPRECIATE YOUR BUSINESS!!! Customer Signature: Warsaw Wabash Peru Goshen Angola Fremont Logansport Plymouth Rochester Star City Kokomo Huntington Auburn Constantine 574-753-3673 Call:574-224-2667 Call: 800-720-0550 Call: 800-234-0573 800-807-3673 877-615-2667 Branch Co. MI Hart MI Berrien Co. MI Noblesville 517-278-4561 231-873-2158 269-461-4222 855-773-0870 800-942-6765 888-591-8211 800-761-4222 317-773-0870 CUSTOMER