193113 12/22/2010 CITY OF CARMEL, INDIANA VENDOR: 119835 Page 1 of 1
ONE CIVIC SQUARE HAMILTON COUNTY CO -OP INC
CARMEL, INDIANA 46032 PO BOX 1106 CHECK AMOUNT: $585.48
NOBLESVILLE IN 46061
CHECK NUMBER: 193113
CHECK DATE: 12122/2010
DEPARTMENT A CCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2201 4231300 GTO18460 585.48 DIESEL FUEL
SALE 3792 DATE 12/15/10 12;47:32
COUNT: START 0.0 END 2a.3
GROSS DELIVERY 203.3 GALLONS
4040 DIESELEX ULS UN DISTILLATI
MULTIPLE DELIVERIES AT SITE
HAMILTON COUNTY CO -OP
PO BOX 11@6
NOBLESVILLE, IN 45061
CHARGE INVOICE
Driver: GT GARY TEETERS
Customer: 0000031175 Invoice GT 018460
CARMEL STREET DEPT Date: 12/15/2010
3400 W 131ST STREET Tioe: 11:47
CARPEL, IN 46@74
Tros Teras Description Item Description Legend Ouaatity Unit' Price Itee Total
61 NORMAL 154040 IIIESELEX ULS UN 19 E 140.20x00 2.83 396.77
01 NORMAL 124029 HEATER OIL -UN 1993 E 6@. 1000 3.24060 194.72
01 NORMAL 194070 PETRO VOLUME DISCOUN 200.3000 0.03000 4.01
Legend: Invoice Subtotal: 585.48
'E'= Netered, T=Taxable, Entered by Hand Indiana Sales Tau On: 0.00 0.00
Invoice Total: 585.48
WARNING PETROLEUM PRODUCTS NOT TO BE USED FOR STARTING OR KINDLING FINS. GASOLINES NOT SOLD FOR
ILLIMINATING OR CLEANING PURPOSES. IN CASE OF EIAERGtNCY CONTACT CHEMTREC AT 1- 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
$585.48
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO# Dept. INVOICE NO. ACCT #!TITLE AMOUNT Board Members
2201 GTO18460 42- 313.00 $585.48 1 hereby certify that the attached invoice(s), or
bills) is (are) true and correct and that the
materials or services itemized thereon for
which charge is made were ordered and
received except
Thursday, December 16, 2010
Lo
Street Commissl ?ner
Street Comjrjtless ions 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))
12/15/10 GTO18460 $585.48
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