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Home My WebLink About304707 10/31/16 CITY OF CARMEL, INDIANA VENDOR: 366089 ONE CIVIC SQUARE NORTH CENTRAL CO-OP CHECK AMOUNT: $*****1,186.16* ?Q; CARMEL, INDIANA 46032 PO BOX 1106 CHECK NUMBER: 304707 NOBLESVILLE IN 46061-1106 CHECK DATE: 10/31/16 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1120 4231300 411618 826.77 DIESEL FUEL 2201 4231300 GT 411463 359.39 DIESEL FUEL VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201 (Rev.1995) NORTH CENTRAL CO-OP ALLOWED 20 ACCOUNTS PAYABLE VOUCHER PO BOX 299 IN SUM OF$ 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. $359.39 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 GT 411463 42-313.00 $359.39 1 hereby certify that the attached invoice(s),or 10/4/16 GT 411463 $359.39 2201 201 2201 201 bill(s)is(are)true and correct and that the materials or services itemized thereon for which charge is made were ordered and received except Tuesday, October 11, 2016 Dave Huffman Director I hereby certify that the attached invoice(s),or bill(s),is(are)true and correct and I have audited same in accordance with IC 5-11-10-1.6 ,20— Cost 20Cost distribution ledger classification if claim paid motor vehicle highway fund. Clerk-Treasurer North Central Co-op P.O. BOX 299 WABASH, IN 46992 SALE 10479 DATE 10/04/16 12:50:06 COUNT: START 0.0 END 180.6 CROS DELIVERY 180.6 GALLONS Centered on you. 4040 PREMIUM DX-4 off rDISTILLATI MULTIPLE DELIVERIES AT SITE CHARGE INVOICE Driver: GT GARY TEETERS Customer: 0000921720 Invoice V: GT 411463 CARMEL STREET DEPT Date: 10/4/2016 3400 W 131ST STREET Time: 11:40 CARMEL, IN 46074 Trms Terms Description Item # Description Legend Quantity Unit Price Item Total 02 DUE 11/20/2016 4040 PREMIUM DX-4 off rd E 180.6000 1.99000 359.39 Legend: Invoice Subtotal: 359.39 E--Metered, T=Taxable, *=Entered by Hand Indiana Sales Tax On: 0.00 ..... 0.00 Invoice Total: 359.39 WARNING — PETROLEUM PRODUCTS NOT TO BE USED FOR STARTING OR KINDLING FIRES. GASOLINES NOT SOLD FOR ILLUMINATING OR CLEANING PURPOSE S. IN CASE OF EMERGENCY CONTACT CHE4TREE AT 1-800-424-9300 WE APPRECIATE YOUR BUSINESS!!! Customer Signature: G% Warsaw Wabash Peru Goshen Angola Fremont Logansport Plymouth Rochester Star City Kokomo Huntington Auburn Constantine 574-753-3673 Call: 574-224-2667 Call:800-720-0550 Call: 800-234-0573 800-807-3673 877-615-2667 Branch Co. MI Hart MI Berrien Co. MI Noblesville 517-278-4561 231-873-2158 269-461-4222 855-773-0870 800-942-6765 888-591-8211 800-761-4222 317-773-0870 CUSTOMER VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201 (Rev.1995) NORTH CENTRAL CO-OP ALLOWED 20 ACCOUNTS PAYABLE VOUCHER PO BOX 1106 IN SUM OF$ CITY OF CARMEL An invoice or bill to be properly itemized must show:kind of service,where performed,dates service NOBLESVILLE, IN 46061-1106 rendered,by whom,rates per day,number of hours,rate per hour,number of units,price per unit,etc. $826.77 Payee Purchase Order# ON ACCOUNT OF APPROPRIATION FOR 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 411618 42-313.00 $826.77 1 hereby certify that the attached invoice(s),or 10/26/16 411618 $826.77 1120 101 1120 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 Wednesday, October 26,2016 David Haboush Fire Chief 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 o . North Central Co-op P.O. Box 1106 * Noblesville,IN 46061-1106 Centered on you. PH: 317-773-0570 Fax: 317-776-4149 NCC - Hamilton County Petro =_________= PAGE 1 16222 Allisonville Road INVOICE INVOICE NO. 00411618 PO Box 1106 =_________= ORDER DATE 10/24/16 Noblesville IN 46060 ACCOUNT NO. 0000921744 317-773-0870 BATCH 481 GT CARMEL FIRE DEPT 2 CIVIC SQUARE CARMEL IN 46032 P.O.# SHIP DATE TERMS SLS LOC -------------------------------------------------------------------------------- 10/24/16 DUE 11/20/2016 GT 256 ----------------------------------------------------- ITEM NO DESCRIPTION UNITS SOLD UNIT PRICE EXTENDED -------------------------------------------------------------------------------- 4049 PREMIUM DX-4 on rd 331 .5000 GAL 2 . 09000 692 .84 FEDERAL EXCISE TAX 331 .5000 GAL 0.24400 80 . 89 STATE EXCISE TAX 331 .5000 GAL 0 . 16000 53 . 04 TOTAL DUE $$ 826 .77