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Home My WebLink About303490 09/26/16 CITY OF CARMEL, INDIANA VENDOR: 366089 ONE CIVIC SQUARE NORTH CENTRAL CO-OP CHECK AMOUNT: 1,348.44* CARMEL, INDIANA 46032 PO BOX 299 CHECK NUMBER: 303490 WABASH IN 46992 CHECK DATE: 09/26/16 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1207 4231300 GT411224 623.29 DIESEL FUEL 1207 4231400 GT411224 228.98 GASOLINE 2201 4231300 GT411316 496.17 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. $852.27 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 411224 42-313.00 $623.29 1 hereby certify that the attached invoice(s),or 9/6/16 GT 411224 Fuel $228.98 1207 101 1207 101 bill(s)is(are)true and correct and that the GT 411224 42-314/,40 $228.98 9/6/16 GT 411224 Diesel Fuel $623.29 1207 101 materials or services itemized thereon for 1207 101 which charge is made were ordered and received except Friday, September 09,2016 r9' 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 10316 DATE 09/06/16 14:43:45 COUNT: START 0.0 END 289.9 Centered on .ouGROSS DELIVERY 289.9 GALLONS y 4040 PREMIUM DX-4 off rDISTILLATI ** MULTIPLE DELIVERIES AT SITE SALE 4707 DATE 09/06/16 14:58:55 COW: START 0.0 END 107.5 GROSS DELIVERY 107.5 GALLONS 4011 87 E-10 PLUS GASOLINE 1 MULTIPLE DELIVERIES AT SITE CHARGE INVOICE Driver: ST GARY TEETERS Customer: 0000918936 Invoice #: GT 411224 BROOKSHIRE GOLF CLUB Date: 9/6/2016 CITY OF CARMEL Time: 13:38 12120 BROOKSHIRE PKWY CARMEL, IN 46033- Trms Terms Description Item # Description Legend Quantity Unit Price Item Total 02 DUE 10/20/2016 4011 87 E-10 PLUS E. 107.5000 1.95M 209.63 STATE EXCISE TAX 0.18000 19.35 02 DUE 10/20/2016 4040 PREMIUM DX-4 off rd E 289.9000 2.15000 623.29 Legend: Invoice Subtotal: 852.27 E=Metered, T=Taxable, *=Entered by Hand Indiana Sales Tax On: 0.00 ..... 0.00 Invoice Total: 852.27 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 CHENTREC AT 1-8 -424-9310 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 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. $496.17 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 411316 42-313.00 $496.17 1 hereby certify that the attached invoice(s),or 9/16/16 GT 411316 $496.17 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, September 20, 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 10380 DATE 09/16/16 14:26:51 COUNT: START 0.0 END 237.4 GROSS DELIVERY 237.4 GALLONS Centered on you. 4040 PREMIUM DX-4 off rDISTILLATi MULTIPLE DELIVERIES AT SITE CHARGE INVOICE Driver: GT GARY TEETERS Customer: 0000921720 Invoice #: GT 411316 CARMEL STREET DEPT Date: 9/16/2016 3400 W 131ST STREET Time: 13:20 CARMEL, IN 46074 Trms Terms Description Item 0 Description Legend Quantity Unit Price Item Total 02 DUE 10/20/2016 4040 PREMIUM DX-4 off rd E 237.4M 2.09000 496.17 Legend: Invoice Subtotal: 496.17 E=Metered, T=Taxable, *=Entered by Hand Indiana Sales Tax On: 0.00 ..... 0.00 Invoice Total: 496.17 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 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