189814 09/14/2010 CITY OF CARMEL, INDIANA VENDOR: 119835 Page 1 of 1
0 it ONE CIVIC SQUARE HAMILTON COUNTY CO -OP INC CHECK AMOUNT: $1,973.47
CARMEL, INDIANA 46032 PO Box 1106
NOBLESVILLE IN 46061 CHECK NUMBER: 189814
CHECK DATE: 9/14/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1207 4231400 GT 0175575 1,040.16 GASOLINE
2201 4231300 GT 017777 933.31 DIESEL FUEL
SALE 3194 DATE 09/07/10 16:64:07
COUNT: START 0.0 END 368.9
GROSS DELIVERY 368.9 GALLONS
4040 DIESELEX ULS UN DISTILLATI
MULTIPLE DELIVERIES AT SITE
HAMILTON COUNTY L`lt -OP
PO BOX 1106
NOBLESVILLE, •IN 46061
CHARGE INVOICE
Driver: GT GARY TEETERS
Customer: 0000031175 Invoice 6T 017777
CARMEL STREET DEPT Date: 917/2010
3400 H 131ST STREET Time: 16 :08
CARMEL, IN 46074
Tras Teros Description Item Description Legend Quantity Unit Price Item Total
61 NORMAL 154040 DIESELEX OILS UN 19 E 368.9000 2.56000 944.38
01 NORMAL. 194070 PETRO VOLUME DISCOUN 368.%@@ 0.030X 1.1.07
Legend: Invoice Subtotal: 933.31
E= Metered, T= Taxable, Entered by Hand Indiana Sales Tau On: 0.00 0.00
Invoice Total: 933.31
WARNING PETROLEUM PRODUCTS NOT TO BE USED FOR STARTING OR KINDLING FIRES. 6ASOLINES NOT SOLD FOR
ILLUMINATING OR CLEANING PURPOSES. IN CASE OF EMERGENCY CONTACT CHEMTREC AT I -800- 424 -9300 WE
APPRECIATE YOUR BUSINESS'''
VOUCHER NO. WARRANT NO.
ALLOWED 20
Hamilton Co. Co -op
IN SUM OF
P. O. Box 1106
Noblesville, IN 46061
$933.31
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO# Dept. INVOICE NO. ACCT #!TITLE AMOUNT
Board Member:
2201 GTO17777 42- 313.00 $933.31 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
f, Thursday; September 09, 201C
Street Commissioner
f ri
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))
09/07/10 GTO17777 $933.31
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 1683 DATE 09102/10 13:52:@2
COUNT: START 0.0 END 228.1
GROSS DELIVERY 228.1 GALLONS
4817 UNLEADED GAS GOVGASOLINE 1
MULTIPLE DELIVERIES AT SITE
SALE 3179 DATE 04/02/10 13:49:59
COUNT: START 0.0 END 205.3
GROSS DELIVERY 205.3 GALLONS
4040 DIESELEX ULS UN DISTILLATI
MULTIPLE DELIVERIES AT SITE
WILTON COUNTY CO-OP
PO BOX 1106
NOBLESVILLE, IN 46061
CHARGE INVOICE
Driver: GT GAR't'TEETERS
Customer: 0000028761 Invoice 4: GT 017757
BROOKSHIRE GOLF CLUB Date: 9/212010
CITY OF CAAEL Tice: 13 :54
121201ROOK9HIRE PKWY
CARNEL' s
Trms Terms Description Item R Description Legend Quantity Unit Price Iteo Total
01 NORMAL 104817 UNLEADED GAS GOV'T E 228.0000 2.17M 494.76
WARNING CONVENTIONAL GASOLINE 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 NAY 1ST
THROUGH SEPTEMBER 15TH.
Federal Road Tax 0,00000 0.00
State Road Tax 0.18000 41.04
01 NORMAL 154040 DIESELEX ULS UN 19 E 205.3000 2.52000 517.36
01 NORMAL 194070 PETRO VOLUME DISCOUN 433.3000 0.03000 -13.00
Legend: Invoice Subtotal: 1,040.16
E= Metered, T- Taxable, *centered by Hand Indiana Sales Tax On: 0.00 0.00
Invoice Total: 1,040.16
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 CHEW. REC AT 1 -800- 424 -9300 WE t
APPRECIATE YOUR BUSINESS!!'
4
y
VOUCHER NO. WARRANT NO.
ALLOWED 20
Hamilton County CO -OP
IN SUM OF
P.O. Box 1106
Noblesville, IN 46061
$1,040.16
ON ACCOUNT OF APPROPRIATION FOR
Brookshire Golf Club
PO# Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Members
1207 GT 017757 42- 314.00 1 $1,040.16 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
Friday, September 10, 2010
Director, Brookshi Golf Club
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))
09/02 /10 GT 017757 Fuel $1,040.16
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