181572 01/20/2010 CITY OF CARMEL, INDIANA VENDOR: 119835 Page 1 of 1
ONE CIVIC SQUARE HAMILTON COUNTY CO -OP INC
i CHECK AMOUNT: $1,057.20
CARMEL, INDIANA 46032 PO sox 1106
,74
NOBLESVILLE NOBLESVILLE IN 46061 CHECK NUMBER: 181572
CHECK DATE: 1/20/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2201 4231300 GT016233 1,057.20 DIESEL FUEL
E I
SALE 1858 DATE 01/12/10 11:48 :30
COUNT: START 0.0 END 150.0
GROSS DELIVERY 150.0 GALLONS
4040 DIESELEX ULS DISTILLAT1
MULTIPLE DELIVERIES AT SITE ee
SALE 1859 DATE 01/12/10 11 :53:31
COUNT: START 0.0 END 250.0
GROSS DELIVERY 250.0 GALLONS
4040 DIESELEX ULS DISTILLATI
MULTIPLE DELIVERIES AT SITE
HAMILTON COUNTY CO-OP
PO BOX 1106
NOBLESVILLE, IN 46061
CHARGE INVOICE
Driver: GT GARY TEETERS
Customer: 00100031175 Invoice 0: GT 016233
CARMEL STREET DEPT Date: 1/12/2010
3400 W 131ST STREET Tice 11 :52
WESTFIELD, IN 46074
Tres Terms Description Iten Description `Legend Quantity Unit Price Itee Total
01 NORMAL 154040 DIESELEX ULS 280.2000 2.58m 722.40
01 NORMAL 124029 HEATER OIL ff 120. .get 346.80
01 NORMAL 194070 PETRO VOLUME DISCOUN 0.03000
Legend: Invoice Subtotal: 1,057.20
E$ietered, T= Taxable, $Entered by Hand Indiana Sales Tax On 0." 0. k"f
Invoice Total: 1,057.20
WARNING PETROLEUM PRODUCTS NOT TO BE USED FOR STARTING OR KINDLING FIRES. GASOLINES NOT SOLD FOR
ILLUMINATING OR CLEANING PURPOSES. IN CASE OF EMERGENCY CONTACT CHEMTREC AT 1- 800 424 -9300 WE
APPRECIATE YOUR BUSINESS!!!
04
1
VOUCHER NO. WARRANT NO.
ALLOWED 20
Hamilton Co. Co -op
IN SUM OF
P. O. Box 1106
Noblesville, IN 46061
$1,057.20
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO# Dept. INVOICE NO. ACCT /TITLE AMOUNT
Board Member:
2201 GT016233 42- 313.00 $1,057.20 I hereby certify that the attached invoice(s), or
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
Thursday�J
a/ 14, 2010
1/
Street Commissiner
v
Street CQrrirTrt&ikn; r
Cost distribution ledger classification if
claim paid motor vehicle highway fund
Prescribed by State Board of Accounts City Form No. 201 (Rev. 1995)
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
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.
Payee
Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
01/13/10 GT016233 $1,057.20
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
Clerk- Treasurer