191669 11/10/2010 CITY OF CARMEL, INDIANA VENDOR: 119835 Page 1 of 7
+L ONE CIVIC SQUARE HAMILTON COUNTY CO -OP INC CHECK AMOUNT: $2,394.92
�o CARMEL, INDIANA 46032 PO BOX 1106
NOBLESVILLE IN 46061 CHECK NUMBER: 191669
CHECK DATE: 11/1012010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2201 4231300 GTO18099 753.11 DIESEL FUEL
2201 4231300 GTO18116 1,044.73 DIESEL FUEL
1207 4231400 CT018176 597.08 GASOLINE
SALE 3482 MATE 10/26/10 13:32:33
COUNT: START 0.0 END 378.8
GROSS DELIVERY 378.8 GALLONS
4040 DIESELEX ULS UN DISTILLATI
MULTIPLE DELIVERIES AT SITE
HAMILTON COUNTY CO-OP
PO BOX 1106
NOBLESVILLE, IN 46061
CHARGE INVOICE
Driver: GT GARY TEETERS
Customer: 0000031175 Invoice GT 018116
CARMEL STREET DEPT Date: 10126/2010
3400 W 131ST STREET Tine: 13:35
CARMEL, IN 46074
Tros Terns Description It'ea Description Legend Quantity Unit Price Iteu Total
01 NORMAL 15,4040 DIESELEX ULS UN 19 E 265.2000 2.74000 726.65
01 NORMAL 124029 BEATER OIL-UN 1993 E 1116000 2.90000 329.44
01 NORMAL 194070 PETRO VOLUME DISCOUN 378.8000 0.03000 -11.36
Legend: d f Invoice Subtotal: 1,044.73
E=Metered, T= Taxable, Entered by Nand Indiana Sales Tax On: 0.00 0.00
Invoice Total: 1,044.73
HARNIRG PETROLEUM PRODUCTS NOT TO BE USED FOR STARTING OR KINDLING FIRES. SASOLINES NOT SOLD FOR
ILLUMINATING WELEANING PURPOSES. IN CASE OF EMERGENCY CONTACT CHEMTREC AT 1- 800-424 -9300 WE
APPRECIATE YOUR BUSINESS!!'
4
r
4 a
SALE 33465 DATE 10/22/10 14;37:33
COUNT: START 0.0 END 277.9
GROSS DELIVERY 277.9 GALLONS
4040 DIESELEX ULS UN DISTILLATI
MULTIPLE.DELIVERIES AT SITE
HAMILTON COUNTY CO-OP
PO BOX 1106
NOBLESVILLE, IN 46061
CHARGE INVOICE
Driver: GT GARY TEETERS
Customer: 0000031175 Invoice 4;: GT 018099
CARMEL STREET DEPT Date: 10/22/2010
3400 W 131ST STREET Tine: 14:40
CARMEL, IN 46074
Tr ®s Terms Description Itea V Description Legend Quantity Unit Price Item Total
01 NORMAL 154040 DIESELEX ULS UN 19 E 277.9000 2.74000 761.45
01 NORMAL 194070 PETRO VOLUME DISCOUN 277.9000 0.03000 -8.34
Legend: Invoice Subtotal: 753.11
E T Entered by Hand Indiana Sales Tax Ors: 0.00 0.00
Invoice Total: 753.11
WARNING PETROLEL14 PRODUCTS NOT TO BE USED FOR STARTING OR KINDLING FIRES. 6ASOLINES NOT SOLD FOR
ILLUMINATING OR (LEANING PURPOSES. IN CASE OF EMERGENCY CONTACT CHENTREC AT I- 800 424 -9360 WE
APPRECIATE YOUR BUSINESS!!!
VOUCHER NO. WARRA NO.
ALLOWED 20
Hamilton Co. Co -op
IN SUM OF
P. O. Box 1106
Noblesville, IN 46061
$1,797.84
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO# Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Member
2201 GTO18099 42- 313.00 $753.11 1 hereby certify that the attached invoice(s), or
2201 GT 018116 42- 313.00 $1,044.73
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
T oursday November 04, 2010
Street Commission�e
Street CTittemissioner
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))
10/22/10 GTO18099 $753.11
10/26/10 GT018116 $1,044.73
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
r
SALE 1851 DATE 11/04/10 14:35:85
COUNT: START 0. END 236.0
GROSS DELIVERY 236.0 GALLONS
GASOLINE 1
MULTIPLE DELIVERIES AT SITE
HAMILTON COUNTY CO —OP
PO BOX 1105
NOBLESVILLE, IN 46061
CHARGE INVOICE
Driver: GT GARY TEETERS
Custoser: BeM28761 Invoice ST 018176
BROOKSHIRE GOLF CLUB Date: 11/4/2010
CITY OF CARMEL Tiae: 14 :32
12120 BROOKSHIRE PKWY
CARMEL, IN 46033
Tros Teres Description item Description Legend Gluantity Unit Price Iteo Total
01 NORMAL 104817 UNLEADED GAS GOV'T E 236.0000 2.38000 561.68
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.Y.D.) ADDITIVE. CONFORMS TO�REGlUIREMENTS FOR A 9,0 P.S.1 MAX. RVP GASOLINE DURING THE MONTHS OF MAY 1ST
THROUGH SEPTEMBER 15TH.
Federal Road Tax 0100000 0.00
State Road Tax 0.18000 42.48
01 NORMAL 194070 PETRO VOLUME DISCOUN -236.0000 0.03000 —7.08
Legend: Invoice Subtotal: 597.08
Metered, T =Taxable, Entered by Hand Indiana Sales Tax On: 0.06 0.00
Invoice Total: 597.08
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 BUSINESS11°.
e
VOUCHER NO. WARRANT NO.
ALLOWED 20
Hamilton County CO -OP
IN SUM OF
P.O. Box 1106
Noblesville, IN 46061
$597.08
ON ACCOUNT OF APPROPRIATION FOR
Brookshire Golf Club
PO# Dept. INVOICE N0. ACCT #!TITLE AMOUNT Board Members
1207 GT 018176 42- 314.00 $597.08 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
Monday, November 08, 2010
Director, Brookshir 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))
11/04/10 GT 018176 Fuel $597.08
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