302161 08/22/16 CITY OF CARMEL, INDIANA VENDOR: 366941
ONE CIVIC SQUARE HOOSIER PENN OIL CHECK AMOUNT: $*****1,051.06'
CARMEL, INDIANA 46032 DEPT 19 CHECK NUMBER: 302161
9'iroN PO BOX 6069 CHECK DATE: 08/22/16
INDIANAPOLIS IN 46206
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4232100 0987439-IN 95.16 GARAGE & MOTOR SUPPIE
1120 4232100 0987505-IN 955.90 GARAGE & MOTOR SUPPIE
VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201 (Rev.1995)
HOOSIER PENN OIL ALLOWED 20 ACCOUNTS PAYABLE VOUCHER
DEPT 19
IN SUM OF$ CITY OF CARMEL
PO BOX 6069 An invoice or bill to be properly itemized must show:kind of service,where performed,dates service
INDIANAPOLIS, IN 46206 rendered,by whom,rates per day,number of hours,rate per hour,number of units,price per unit,etc.
$1,051.06 . Payee
ON ACCOUNT OF APPROPRIATION FOR Purchase Order#
Carmel Fire 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
987439 42-321.00 $95.16 1 hereby certify that the attached invoice(s),or 8/10/16 987505 $955.90
1120 101 1120 101
987505 42-321.00 $955.9.0 bill(s)is(are)true and correct and that the 8/10/16 987439 $95.16
1120 1 101 1 materials or services itemized thereon for 1120 1 101
which charge is made were ordered and
received except
Friday,August 12,2016
David Haboush
Fire Chief
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
Invoice Page: 1
Hoosier Penn Oil Co., Inc.
Dept. 19 Invoice Number: 0987439-IN
o/l.Co Co PAY P.O. Box 6069
� .;. Invoice Date: 7/28/2016
Indianapolis, IN 46206-6069
(317)390-5406
Order Number: CB00143
Order Date 6/8/2016
Customer Number: CARMELF
Sold To: Ship To:
Carmel Fire Dept Carmel Fire Dept
2 Civic Square 2 Civic Square
Carmel,IN 46032 Carmel,IN 46032
Confirm To:
Denise Snyder
Customer P.O. Ship VIA F.O.B. Terms
Net 30
Item Number Unit Ordered Shipped Price Amount
NS772 55 Gallon Drum Funnel EA 2.00 2.00 47.58 95.16
Net Invoice: 95.16
Less Discount: 0.00
Freight: 0.00
Sales Tax: 0.00
Invoice Total: 95.16
1
HOOSIER PENN OIL CO.
0987505-IN
JG02398
7/29/2016
8/28/2016
CARMELF CARMEF1
XCarmel Fire Dept XCarmel Fire Dept
4925 E 106th Street 4925 E 106th Street
Carmel,IN 46033 Carmel,IN 46033
Jason Force Net 30 001
71360055 HP dexosl FS 5W20 1/55 DR 1.00 1.00 469.70 469.70
111125355 HP FS GF5 5w30 1/55 DR 1.00 1.00 486.20 486.20
955.90
0.00
955.90