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185763 05/26/2010 CITY OF CARMEL, INDIANA VENDOR: 119835 Page 1 of 1 ONE CIVIC SQUARE HAMILTON COUNTY CO -OP INC CHECK AMOUNT: $6,138.86 CARMEL, INDIANA 46032 PO Box ttos NOBLESVILLE IN 46061 CHECK NUMBER: 185763 CHECK DATE: 5/26/2010 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 601 5023990 W09245 016960 4,000.26 FUEL 2201 4231300 GT 016967 1,038.45 DIESEL FUEL 1207 4231400 GT 017025 1,100.15 GASOLINE SALE 2525 DATE 05/14/10 08:42:45 COUNT: START 0.0 END 402.5 GROSS DELIVERY 402.5 GALLONS 4040 DIESELEX ULS DISTILLATI MULTIPLE DELIVERIES AT SITE HAMILTON COUNTY CO-OP PD BOX 1106 NOBLESVILLE, IN 4606: CHARGE INVOICE Driver: GT GARY TEETERS+ Customer: 0000031175 Invoice R: GT 016967 CARMEL STREET DEPT Date: 5/14/2010 3400 W 131ST STREET Tine: 08:51 WESTFIELD, IN 46074 i Trus Terns Description Item D Description Legend Quantity Unit Price Item Total 01 NORMAL 154040 DIESELEX ULS E 402.5000 2.61M 1050.53 01 NORMAL 194070 PETRO VOWNE DISCOUN 402.5000 0.03000 -12.08 Legend: Invoice Subtotal: 1,038.45 E=Metered, T =Taxable, Entered by,Hand Indiana Sales Tax On: 0.00 0.00 Invoice Total: 1,038.45 WARNING PETROLEUM PRODUCTS NOT TO BE USED FOR STARTING OR KINDLING FIRES. GASOLINES NOT SOLD FOR ILLUMINATING OR MEANING PURPOSES. IN CASE OF EMERGENCY CONTACT CHEMTREC AT I-M -424 -9300 WE APPRECIATE YOUR BUSINESS'!' 1 VOUCHER NO_ WARRANT NO. ALLOWED 20 Hamilton Co. Co -op IN SUM OF P. 0. Box 1106 Noblesville, IN 46061 $1,038.45 ON ACCOUNT OF APPROPRIATION FOR Carmel Street Department PO# Dept. INVOICE NO. ACCT# /TITLE AMOUNT Board Members 2201 GT 016967 42- 313.00 $1,038.45 1 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, y 20,2 SY I -_iZ -r Street Commissioner' �Gr ^a Title 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)) 05/14/10 GT 016967 $1,038.45 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 SALE 1327 DATE 05120110 15:09:19 COUNT: START 0.0 END 172.4 GROSS DELIVERY 172.4 GALLONS 4817 UNLEADED GAS 60VBASOLINE i MULTIPLE DELIVERIES AT SITE� SALE 2572 DATE 05/20/10 15:07:57 COUNT: START 0.0 END 271.8 GROSS DELIVERY 271.9 GALLONS 404@ DIESELEX ULS DISTILLATi MULTIPLE DELIVERIES AT SITE HAMILTON COUNTY CO-OP PO BOX 1166 NOBLESVILLE, IN 46061 CHARGE INVOICE Driver: GT GARY TEETERS Customer: 0000028761 Invoice ST 017025 BROOKSHIRE GOLF CLUB Date: 5/20/2010 CITY OF CARMEL Tioe: 15:16 12120 BROOKSHIRE PKWY i CARMEL, IN 46033 Tros Terms Description Item Description Legend Quantity Unit Price Itea Total 01 NORMAL 104817 UNLEADED GAS GOVT E 172.4000 2.29000 394.80 WARNING CONVENTIONAL GASOLINE r THIS PRODUCT DOES NOT MEET THE REQUIREMENTS FOR REFORMULATED GASOLINE AND MAY NOT BE USED IN ANY REFORMULATED GASOLINE COVERED AREA. THIS PRODUC T CONTAINS PRESCRIBED LEVELS OF INTAKE VALVE DETERGENT (I.V.D.) ADDITIVE. CONFORMS TO REQUIREMENTS FOR A 9.0 P.S.I MAX. RVP GASOLINE DURING THE MONTHS OF MAY 1ST THROUGH SEPTEMBER 15TH. Federal Road Tau 0.0000M 0.00 State Road Tax 0.18000 31.03 01 NORMAL 154040 DIESELEX ULS E 271.8000 2.53000 587.65 01 NORMAL 194070 PETRO VOLUME DI9COUN e 444.20M 0.03000 -13.33 Legend, Invoice Subtotal: 1,100.15 E4ietered, T=Taxable, entered by Hand Indiana Sales Tax On: 0.00 0.00 Invoice Total: 1,100.15 WARNING PETROLEUM PRODUCTS NOT TO BE USED FOR STARTING OR KINDLING FIRES. GASOLINES NOT SOLD FOR ILLUMINATING OR CLEANING PURPOSES. IN CASE OF EMER68%0 CONTACT CHEMTREC AT 1800 -424 -9300 WE APPRECIATE YOUR BUSINESS!!! i VOUCHER NO. WARRANT NO. ALLOWED 20 Hamilton County CO -OP IN SUM OF P.O. Box 1106 Noblesville, IN 46061 $1,100.15 ON ACCOUNT OF APPROPRIATION FOR Brookshire Golf Club PO# Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Members 1207 GT 017025 42- 314.00 $1,100.15 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 Monday, May 24, 2010 4 Director, Brooks e Golf Club Title Cost distribution ledger classification if claim paid motor vehicle highway fund Prescribed by Slate Board of Accounts City Form No. 201 (Rev, 199! 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)) 05/20/10 GT 017025 Fuel $1,100.1 1 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 SALE 2517 DATE 05/13110 11:82:45 COUNT: START 0.0 END 1562.6 GROSS DELIVERY 1562.6 GALLONS 4840 DIESELEX ULS DISTILLATI H MULTIPLE DELIVERIES AT SITE HAMILTON COUNTY CO -OP PD Box 11@6 NOBLESVILLE, IN 46061 CHARGE INVDICE Driver: ST GARY TEETERS Customer: @088031209 Invoice 8: GT 816960 CARVE WATER DEPT Date: 5/13/2010 3450 W 131ST STREET Tiae: 14':3 WESTFIELD, IN 46074 -82671 Trms Terns Description iteD B Description Legend Quantity Unit Price IteB Total 01 NORMAL 154840 DIESELEX ULS E 1562.6@!0 2.61000 4078.39 81 NORMAL. 194870 PETRO VOLUME DISCOUN 1562.6080 0.05000 -78.13 Legend: Invoice Subtotal: 4,080.26 E=Metered, T= Taxable, Entered by Hand Indiana Sales Tax On: 0.08 @.8H Invoice Total: 4,008.26 WARNING PETROLEUM! PRODUCTS NOT TO BE Lw FOR STARTING OR KINDLING FIRES. GASOL.INES NOT SOLD FOR ILLUMINATING OR CLEANING PURPOSES. IN CASE OF EMERGENCY CONTACT CHEMTREC AT 1- 888 -5380 WE APPRECIATE YOUR BUSINESS r, CEnrEn DAB a 0 P©# ACCT# USE s W i VOUCHER 101599 WARRANT ALLOWED 19835 IN SUM OF HAMILTON COUNTY CO -OP INC PO BOX 1106 NOBLESVILLE, IN 46061 co Carmel Water Utility ON ACCOUNT OF APPROPRIATION FOR Board members PO INV ACCT AMOUNT Audit Trail Code 016960 01- 6160 -03 $4,000.26 Voucher Total $4,000.26 Cost distribution ledger classification if claim paid under 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 of service rendered, by whom, rates per day, number of units, price per unit, etc. Payee 119835 HAMILTON COUNTY CO -OP INC Purchase Order No. PO BOX 1106 Terms NOBLESVILLE, IN 46061 Due Date 5/18/2010 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) Amount 6/18/2010 016960 $4,000.26 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 Date O c