329601 09/05/18 r Gqq
«`.% f. CITY OF CARMEL, INDIANA VENDOR: 318025
`'`® i`. CHECKAMOUNT: $********35.32*
.�; �!• ONE CIVIC SQUARE DAVID R VANDERBECK
:� ?�, CARMEL, INDIANA 46032 703 BENNETT ROAD CHECK NUMBER: 329601
n,,�roN�. CARMEL IN 46032 CHECK DATE: 09/05/18
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4231400 35.32 GASOLINE"
VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201(Rev.1995)
Vendor# 318025 ALLOWED 20 ACCOUNTS PAYABLE VOUCHER
DAVID R VANDERBECK IN SUM OF$ CITY OF CARMEL
703 BENNETT ROAD 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.
CARMEL, IN 46032
Payee
$35.32
ON ACCOUNT OF APPROPRIATION FOR Purchase Order#
Carmel Police 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
0 42-314.00 $35.32 1 hereby certify that the attached invoice(s),or 8/17/18 0 gas purchase reimbursement $35.32
1110 101 1110 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
Friday,August 31,2018
&...' et.6 W
Jim Barlow
Chief
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
8/17/2018 6:11 :45 AM
Order Number: 2406042
Circle K 2368
545 S RANGE LINE RD
CARMEL, IN 46032-2140 t .
(317) 574-1021
Register:2 *, Robin-W-740522
Fuel Sale
Bump # 1 1 - UNLEADED
11.976 Gallons @ $2.949/Gal $35.32
Sub. Total: $35.32 j
Tax: $0.00
Total : $35.32
Discount Total: $0.00
T(Ji TA L $35m .3 i
Debit: $35.32
Change % $0 .00
Debit
Card Num : XXXXXXXXXXXX8412
CustomerName:
Approval : 291739
Invoice #: 380675
PIN USED
Save at least $0,05/gal on every fuel
purchase with INSTANT GOLD STATUS.
Download the Fuel Rewards app and join
today!
Thank You
Come .Aga i n
Vaeidell e-c K
8/17/2018 6:11 :45 AM
Order Number: 2tic)60_02
Circle K 2368
545 S RANGE LINE RD
CARMEL, IN 46032-2140
(317) 574-1021
Register:2 Robin-W-740522
Fuel Sale
Pump 4 1 1 - UNLEADFD
11 .976 Gallons lug $2.949/Gal $35.32
Sub. Total : $35.32.
Tax: $0.00
Total : $35.32
Discount Total : — _ $0.00
Debit: $35.32
Ct� ra � C . CIBC!
Debit
Card Num : XXXXXXX,X,XXXX8412
CustomerName:
Approval : 291739
Invoice 4: 380675
PIPJ USED -
Save at least $0.05/gal on every fuel
purchase with INSTANT GOLD STATUS.
Download the Fuel Rewards app and join
today!
Th'sarik You
C oiTi(3 Aga i n