315972 9/12/2017 t' CITY OF CARMEL, INDIANA VENDOR: 366089
ONE CIVIC SQUARE CERES SOLUTIONS CHECK AMOUNT: $*****1,108.21*
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CARMEL, INDIANA 46032 PO BOX WABASH W9 asssz CHECK NUMBER: 315972
�roM CHECK DATE: 09/12/17
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1207 4231300 GT413676 670.33 DIESEL FUEL
1207 4231400 GT413676 437.88 GASOLINE
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North Central Co-op
P.O. BOX 299 • WABASH, IN 46992
SALE 12045 DATE 08/25/17 13:12:38
COUNT: START 0.0 END 295.3
Centered onou. GROSS DELIVERY 295.3 GALLONS
Y 4040 PREMIUM DX-4 off rDISTILLATI
MULTIPLE DELIVERIES AT SITE
SALE 5987 DATE 08/25/17 13:29:01
CVT: START 0.0 END 192.9
GROSS DELIVERY 192.9 GALLONS
4011 87 E-10 PLUS GASOLINE 1
** MULTIPLE DELIVERIES AT SITE
CHARGE INVOICE
Driver: GT GARY TEETERS
Customer: 0000918936 Invoice #: GT 413676
BROOKSHIRE GOLF CLUB Date: 8/25/2017
CITY OF CARMEL Time: 11:47
12120 BROOKSHIRE PKWY
CARMEL, IN 46033-
Tros Terms Description Item # Description Legend Quantity Unit Price Item Total
02 DUE 09/20/2017 4011 87 E-10 PLUS E 192.9000 1.99000 383.87
IN FUEL TAX& SURCHG 0.280 54.01
02 DUE 09/20/2017 4040 PREMIUM DX-4 off rd E 295.3000 2.27000 670.33
Legend: Invoice Subtotal: 1,108.21
E=Metered, T=Taxable, *=Entered by Hand Indiana Sales Tax On: 0.00 ..... 0.00
Invoice Total: 1,108.21
WARNING - PETROLEUM PRODUCTS NOT TO BE USED FOR STARTING OR KINDLING FIRES. GASOLINES NOT SOLD FOR ILLUMINATING OR CLEANING PURPOSE
S. IN CASE OF EMERY 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