HomeMy WebLinkAbout308214 02/13/17 •CAA
CITY OF CARMEL, INDIANA VENDOR: 366089
ONE CIVIC SQUARE NORTH CENTRAL CO-OP CHECK AMOUNT: $*******384.42*
CARMEL, INDIANA 46032 Po Box 299 CHECK NUMBER: 308214
94j,TON moo, WABASH IN 46992 CHECK DATE: 02/13/17
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2201 4231300 GT412263 384.42 DIESEL FUEL
VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201 (Rev.1995)
Vendor# 366089 ALLOWED 20 ACCOUNTS PAYABLE VOUCHER
NORTH CENTRAL CO-OP IN SUM OF$ CITY OF CARMEL
PO BOX vqq
l An invoice or bill to be properly itemized must show:kind of service,where performed,dates service
rendered,by whom,rates per day,number of hours,rate per hour,number of units,price per unit,etc.
IN n�4-djn6 q(041,7Z
Payee
$384.42
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 412263 42-313.00 $384.42 1 hereby certify that the attached invoice(s),or 1/27/17 GT 412263 $384.42
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, January 31,2017
Huffman, Dave
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 2 B
99 WABASH, IN 46992
SALE 11042 DATE 01/27/17 11:22:01
COUNT: START 0.0 END 156.4
GROSS DELIVERY 156.4 GALLONS
Centered on you. 4040 PREMIUM DX-4 off rDISTILLATI
MULTIPLE DELIVERIES AT SITE
CHARGE INVOICE
Driver: GT GARY TEETERS
Customer: 00921720 Invoice R: GT 412263
CARMEL STREET DEPT Date: 1/27/2017
3400 W 131ST STREET Time: 09:05
CARMEL, IN 46074
Tris Terms Description Item 0 Description Legend Quantity Unit Price Item Total
02 DUE 02/20/2017 4040 PREMIUM DX-4 off rd E 109.5000 2.23000 244.19
02 DUE 02/20/2017 4033 HEATING DYED E 46.9000 2.99000 140.23
Legend: Invoice Subtotal: 384.42
E=Metered, T=Taxable, entered by Hand Indiana Sales Tax On: 0.N ..... 0.00
Invoice Total: 384.42
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:
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Call:800-720-0550 Call: 800-234-0573 800-807-3673 877-615-2667
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