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Home My WebLink About304090 10/10/16 CITY OF CARMEL, INDIANA VENDOR: 366089 �l ONE CIVIC SQUARE NORTH CENTRAL CO-OP CHECK AMOUNT: $R R R■R R R 922.57 CARMEL, INDIANA 46032 Po Box 299 CHECK NUMBER: 304090 WABASH IN 46992 CHECK DATE: 10/10/16 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 2201 4238900 00006705 43.00 OTHER MAINT SUPPLIES 1207 4231300 GT 411433 473.02 DIESEL FUEL 1207 4231400 GT 411433 406.55 GASOLINE VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201(Rev.1995) NORTH CENTRAL CO-OP ALLOWED 20 ACCOUNTS PAYABLE VOUCHER PO BOX 299 IN SUM OF$ 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. $43.00 Payee ON ACCOUNT OF APPROPRIATION FOR Purchase Order# 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 00006705 42-389.00 $43.00 1 hereby certify that the attached invoice(s),or 9/29/16 00006705 $43.00 2201 201 2201 201 bill(s)is(are)true and correct and that the materials or services itemized thereon for which charge is made were ordered and received except Tuesday, October 04, 2016 Dave Huffman Director I hereby certify that the attached invoice(s),or bill(s),is(are)true and correct and I have audited same in accordance with IC 5-11-10-1.6 ' 20— Cost 20Cost distribution ledger classification if claim paid motor vehicle highway fund. Clerk-Treasurer VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201 (Rev.1995) NORTH CENTRAL CO-OP ALLOWED 20 ACCOUNTS PAYABLE VOUCHER PO BOX 299 IN SUM OF$ 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. $879.57 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 411433 42-314.00 $406.55 1 hereby certify that the attached invoice(s),or 9/26/16 GT 411433 Gas $406.55 1207 101 1207 101 GT 411433 42-313- $473.02 bill(s)is(are)true and correct and that the 9/26/16 GT 411433 Diesel $473.02 1207 101 materials or services itemized thereon for 1207 101 which charge is made were ordered and received except Monday, October 03,2016 l 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 46992 SALE 10459 DATE 09/29/16 16:50:11 COUNT: START 0.0 END 237.7 GROSS DELIVERY 237.7 GALLONS Centered on you. 4040 PREMIUM DX-4 off rDISTILLATI MULTIPLE DELIVERIES AT SITE SALE 4819 DATE 09/29/16 17:03:51 COUNT: START 0.0 END 196.4 GROSS DELIVERY 196.4 GALLONS 4011 87 E-10 PLUS GASOLINE 1 MULTIPLE DELIVERIES AT SITE CHARGE INVOICE Driver: GT GARY TEETERS Customer: 0000918936 Invoice D: GT 411433 BROOKSHIRE GOLF CLUB Date: 9/29/2016 CITY OF CARMEL Time: 15:43 12120 BROOKSHIRE PKWY CARMEL, IN 46033- Tris Terms Description Item # Description Legend Quantity Unit Price Item Total 02 DUE 10/20/2016 4011 87 E-10 PLUS E 196.4000 1.89000 371.20 STATE EXCISE TAX 0.18000 35.35 02 DUE 10/20/2016 4040 PREMIUM DX-4 off rd E 237.7000 1.99000 473.02 Legend: Invoice Subtotal: 879.57 E=Metered, T=Taxable, *=Entered by Hand Indiana Sales Tax On: 0.00 ..... 0.00 Invoice Total: 879.57 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 1-800-424-9300 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 North Central Co-op P.O. Box 1106 * Noblesville,IN 46061-1106 Centered on you. PH: 317-773-0870 Fax: 317-776-4149 NCC - Hamilton County Petro =_________= PAGE 1 16222 Allisonville Road INVOICE INVOICE NO. 00006705 PO Box 1106 =_________= ORDER DATE 09/29/16 Noblesville IN 46060 ACCOUNT NO. 0000921720 317-773-0870 BATCH 404 LGB CARMEL STREET DEPT 3400 W 131ST STREET CARMEL IN 46074 -------------------------------------------------------------------------------- P.O.# SHIP DATE TERMS SLS LOC =------------------------------------------------------------------------------- 09/29/16 DUE 10/20/2016 LGB 256 -------------------------------------------------------------------------------- -------------------------------------------------------------------------------- ITEM NO DESCRIPTION UNITS SOLD UNIT PRICE EXTENDED -------------------------------------------------------------------------------- 91000000 MISC. OTHER PETRO. PRODUCTS 2 EA 21.50000 43 . 00 drum wrenches TOTAL DUE $$ 43 . 00