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197218 05/11/2011
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: $2,458.82 NOBLESVILLE IN 46061 CHECK NUMBER: 197218 CHECK DATE: 5/11/2011 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1207 4231400 GT 019280 1,587.98 GASOLINE 2201 4231300 GT 19230 870.84 DIESEL FUEL SALE 4483 DATE 04/28111 15:40:51 COUNT: START 0.0 END 236.0 GROSS DELIVERY 236.0 GALLM 4040 DIESELEX ULS UN DISTILLATI KULTIPLE DELIVERIES AT SITE MILTON COUNTY CO -OP j PC BOX 1106 NOBLESVILLE, IN 45061 CHARGE INVOICE Driver: GT GARY TEETERS Custooer: 0000031175 Invoice D: GT 019830 CARKEL STREET DEPT Date: 4/2812011 3400 N 131ST STREET i Time: 15:39 CARMEL, IN 46074 f Tr ©s Teras Description Itea Description Legend Quantity Unit Price Iteo Total 01 NORMAL 154040 DIESELEX ULS UN 19 E 236.0000 3.75000 877.3" 01 NORMAL 1 -94070 PETRO VOLUME DISCOLNd 236.0000 0.03000 -7.08 Legend: Invoice Subtotal: 870.84 E= Metered, T= Taxable, =Entered by Hand Indiana Sales Tax On: 0.00 0.00 Invoice Total: 870.84 WARNING PETROLEUM PRODUCTS NOT TO BE USED FOR STARTING OR KINDLING FIRES. GASOLINES NOT SOLD FOR ILLUMINATING OR CLEANING PUR► S: IN CASE OF EMERGENCY CONTACT CHENTREC AT 1- 800 424 -9300 WE APPRECIATE YOUR BUSINESS!'! i f t V NO. WARRANT NO. ALLOWED 20 Hamilton Co. Co op IN SUM OF P. O. Box 1106 Noblesville, IN 46061 $870.84 ON ACCOUNT OF APPROPRIATION FOR Carmel Street Department PO# Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Member; 2201 GTO19230 42- 313.00 $870.84 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 /Thurs May 05, 2011 1. Street Comm issif ner 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)) 04/28/11 GTO19230 $870.84 I hereby certify that the attached invoice(s), or bill(s), is (are) true and correct and I have audited same in accordance with IG 5- 11- 10 -1.6 ,20 Clerk- Treasurer x SALE 2213 DATE 05106/11 10:28:32 COUNT: START 0.0 END 150.1 GROSS DELIVERY 150.1 GALLONS 4017 UNLEADED GAS UN GASOLINE 1 MULTIPLE DELIVERIES AT SITE SALE 4530 DATE 05/06/11 10 :24:28 COUNT: START 0.0 END 277.4 GROSS DELIVERY 277.4 GALLONS 4040 DIESELEX ULS UN DISTILLATI MULTIPLE DELIVERIES AT SITE HAMILTON COUNTY CO-OP j PO BOX 1106 NOBLESVILLE, IN 46061 CHARGE INVOICE Driver: GT GARY TEETERS Custoser: 0000028761 Invoice GT 015280 BROOKSHIRE GOLF CLUB 1 Date: 5/6/2011 CITY OF CARTEL Time: 10:25 12126 BROOKSHIRE PKWY CARMEL, IN 46033 Tras Terms Description Item Description Legend Quantity Unit Price Iteo Total 01 NORMAL 104817 UNLEADED GAS GOV'T E 150.1000 3161000 541.86 WARNING CONVENTIONAL GASOLINE THIS PRODUCT DOES NOT MEET THE REQUIREMENTS FOR REFORMULATED GASOLINE AND MAY NOT BE USED IN ANY REFOPULATED GASOLINE COVERED AREA. THIS PRODUC T CONTAINS PRESCRIBED LEVELS OF INTAKE VALVE DETERGENT (I.V.D.) ADDITIVE. CONFORMS TO 4001REMENTS FOR A 9.0 P. S. I MAX. RVP GASOLINE DURING THE MONTHS OF MAY 1ST THROUGH SEPTEMBER 15TH. f State Road Tax 0.18000 27.02 i t Oi NORMAL 154040 DIESELEX ULS UN 19 E 277.4000 3.72000 1031.93 01 NORMAL 194070 PETRO VOLUME DISC0UN 427.5000 0.03000 -12.83 Legend: Invoice Subtotal: 1,587.98 E=Netered, T= Taxable•, =Entered by Hand Indiana Sales Tax On: 0.00 0.00 Invoice Total: 1,587.98 WARNING PETROLEUM PRODUCTS NOT TO BE USED FOR STARTING OR KINDLING FIRES. 6MINES NOT SOLD FOR ILLUMINATING OR CLEANING PURPOSES: IN CASE OF EMERGENCY CONTACT CHENTREC AT 1- 800 -424 -9300 WE APPRECIATE YOUR BUSINESS''' r t `fi VOUCHER NO. WARRANT NO. ALLOWED 20 Hamilton County CO -OP IN SUM OF P.O. Box 1106 Noblesville, IN 46061 $1,587.98 ON ACCOUNT OF APPROPRIATION FOR Brookshire Golf Club PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members 1207 GT 019280 42- 314.00 $1,587.98 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 Monday, May 09, 2011 Director, Bro shire 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. 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)) 05/06/11 GT 019280 Fuel $1,587.9 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