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163764 09/17/2008 CITY OF CARMEL, INDIANA VENDOR: 119835 Page 1 of 1 0 ONE CIVIC SQUARE HAMILTON COUNTY CO -OP INC CARMEL, INDIANA 46032 PO BOX 1106 CHECK AMOUNT: $1,600.20 NOBLESVILLE IN 46061 CHECK NUMBER: 163764 CHECK DATE: 9/1712008 DEPARTMEN ACCO PO NU MBER IN VOICE NUMBE AMOUNT DESC 2201 4231300 BB 006861 1,600.20 DIESEL FUEL 4 i :1 HAMILTON COiNTY CO-OP 16222 ALLISONVIkLE RD NObLESVILLE, IN 46060 CHARGE INVOICE Driver: BB BRIAN BARNETT Customer: 0000031175 Invoice BB 006861 CARMEL STREET DEPT Date: 8/28/2008 3400 W 131ST STREET Tice: 15:48 WESTFIELD, IN 46074 Trms Teros Description Item B Description Legend Quantity Unit Price Item Total Tank D %Full /Gal 01 NORMAL 154040 DIESELEX ULS 420.0000 3.81000 1600.20 0 Legend: Invoice Subtotal: 1,600,20 E= Metered, :T =Taxable, *=Entered by Hand Indiana Sales Tax On: 0.00 0.00 Invoice Total: 1,600.20 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 CHENTREC AT 1- 800 424.9300 WE APPRECIATE YOUR BUSINESS!!! Customer PO Customer Signature: 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)) 08/28/08 BB 006861 $1,600.20 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 i VOUCHER NO. WAP.RANT N ALLOWED 20 Hamilton Co. Co -op IN SUM OF P. O. Box 1106 Noblesville, IN 46061 $1,600.20 ON ACCOUNT OF APPROPRIATION FOR Carmel Street Department PO# Dept. INVOICE NO. I ACCT #/TITLE AMOUNT Board Members 2201 BB 006861 42- 313.00 $1,600.20 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, September 11, 2008 Street C missioner Title Cost distribution ledger classification if claim paid motor vehicle highway fund