161384 07/11/2008 CITY OF CARMEL, INDIANA VENDOR: 119835 Page 1 of 1
ONE CIVIC SQUARE HAMILTON COUNTY CO -OP INC
s� CARMEL, INDIANA 46032 PO BOX 1106 CHECK AMOUNT: $3,140.15
t <:oa`o NOBLESVILLE IN 46061 CHECK NUMBER: 161384
CHECK DATE: 7/11/2008
DEPARTMENT ACCOUNT PO NU MBER IN VOICE NUMBER AMOUNT DESCRIPTION
905 4231400 GTO12800 3,140.15 GASOLINE
SALE 9376 DATE 06126/08 12:19:05
i COUNT: START 0.0 END 285.2
GROSS DELIVERY 285.2 GALLONS
4040 DIESELEX ULS DISTILLATi
MULTIPLE DELIVERIES AT SITE*
SALE. 5040 DATE 06/26/08 12:22.39
COUNT: START 0.0 END 524.7
GROSS DELIVERY 524.7 GALLONS
4817 UNLEADED GAS GOVGASOLINE 1
MULTIPLE DELIVERIES AT SITE
HAMILTON COUNTY CO -OP
PO BOX 1106
NOBLESVILLE, IN 46561
CHARGE INVOICE
Driver: OT GARY TEETERS
Cu5tooer: 000002876i Invoice GT 012800
BROOKSHIRE GOLF CLUB Data: 6126/2008
CITY OF CARMEL Tine: 12:31
12120 BROOKS14IRF PKWY
CARMEL, IN 46033-
i'
Tres Terms Description Item Description Legend Quantity Unit Price item Total
01 NORMAL 104817 UNLEADED GAS GOV'T E 524.7000 3.55000 1862.69
WARNING CONVENTIONAL GASOLINE THIS PRODUCT DOES NOT MEET THE REll4JIREMENTS FOR REFORMVLATED GASOLINE AND MAY NOT BE
USED IN ANY REFORMULATED GASOLINE COVERED AREA. THIS PRODUC T CONTAINS PRESCRIBED LEVELS OF INTAKE VALVE DETERGENT
USED IN ANY REFORMULATED GASOLINE COVERED AREA. THIS PRODUC
(I.V.D.) ADDITIVE. CONFORMS TO REQUIREMENTS FOR A 9.0 P.S.I MAX. RVP GASOLINE DURING THE MONTHS OF MAY 1ST
THROUGH SEPTEMBER 15TH.
Federal Road Tax 0.00000 0.00
State Road Tax 0.18000 94.45
01 NORMAL 154040 DIESELEX ULS E 285.2000 4.29000 122
01 NORMAL 194070 PETRO VOLUME DISCOUN 809.9000 0.05000 -40.50
Legend: invoice Subtotal: 3,140.15
E= Metered, T= Taxable, Entered by Hand Indiana Sales Tax On: 0.0<0 0.00
Invoice Total: 3,140.15
WARPIING 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 BUSINESS !11
M�
STATEMENT
m Coun Grai n Merchandising 773 -2685 Amount
a j i tO�L �y Grain Terminal 773 -2599 Enclosed:
Horton 758 -4463 PAGE 1
COOPERATIVE ASSOCIATION, INC Noblesville Petroleum /Plant Food 776 -4143 06/30/08
SPND INQUIRIES TO:
PO Box 1106 Noblesville, Indiana 46061 PAY THIS AMOUNT $5,949.32
(317) 773 -0870 Fax (317) 776 -4149
0000028761 BROOKSHIRE GOLF CLUB 7 CUSTOMERS IN TIPTON AND ATLANTA CAN NOW CALL TOLL FREE
CITY OF CARMEL THE NEW NUMBER IS 765- 675 -2538
12120 BROOKSHIRE PKWY
CARMEL IN 46033
L PLEASE RETURN THIS PORTION WITH REMITTANCE
05/31/08 BALANCE FORWARD J J 6,863.94
06/04/08 159901 002 PAYMENT THANK YOU 4,054.77- 2,809.17
06/26/08 012800 010 INVOICE 3,140.15 5,949.32
524.7000 GAL UNLEADED GAS GOV' 3.7300 1957.14
285.2000 GAL DIESELEX ULS 4.2900 1223.51
809.9000 -EA PETRO VOLUME DISCOU .0500 40.50
07-07-08 A10:46 IN
CREDITTERMS ENTIRE ACCOUNT IS SUBJECT TO AGED ANALYSIS OF BALANCE
OOOPER MONTH ANNUAL RATE 00 o CURRENT 1 -30 DAYS 31 90 DAYS OVER 90 DAYS o
FINANCE CHARGE OF
IF PAYMENT NOT RECEIVED BY: 07/31/08 3140.15 2809.17 .00 .00 5,949.32
YOUR ACCT# IS 0000028761 THANK YOU... HAMILTON CO FARM BUR CO -OP 16222 ALLISONVILLE RD NOBLESVILLE, IN 46061
EXPLANATIONS:
1. The monthly period is from the first day of the month to the last day of the month.
2. "Payment now due" is the portion of the total that will be due on or before the due
date. Any account not paid by this date is considered "past due".
NOTICE TO CUSTOMER: If you pay the New Balance on or before the Due Date
there will not be a finance charge.
A Finance Charge will be added when the account becomes pasfedue. The due date
or time period of the credit terms is on the front side of this statement. To avoid a
FINANCE CHARGE, the Payment Now Due must be received on or before Due Date.
FINANCE CHARGE is computed by using the Periodic Rate (per month) applied to
amount past due as of the closing date, or the Minimum Finance Charge, as shown,
The Annual Finance Charge rate is shown in the Annual Rate box. The finance,
charge is made as of the closing date.
IN CASE OF ERRORS OR INQUIRIES ABOUT YOUR BILL: Send your written inquiry
to the address shown on the front of this statement so that we receive it within 60 days
after the bill was mailed to you. Your written inquiry must include: 1. Your Name and
Account Number (if any): 2. A Description of the Error; and 3. The Dollar Amount of
the Suspected Error. You remain obligated to pay the parts of the bill not in dispute.
During that same time, we may not take any action to collect disputed amounts or
report disputed amounts as delinquent.
This is a summary of your rights; a full statement of your rights and the creditor's
responsibilities under the Federal Fair Credit Billing Act will be sent to you both upon
request and is response to a billing error notice.
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 nn
L ,4A-u� Purchase Order No.
Ij
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
��a�i i 01 3 4 0 1 _S
Total. IS
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
VOUCHER NO. WARRANT NO.
W 0 .Oo�
ALLOWED 20
IN SUM OF
ON ACCOUNT OF APPROPRIATION FOR
UAL C..
Board Members
PO# or INVOICE NO. ACCT #/TITLE AMOUNT
DEPT. 22 I hereby certify that the attached invoice(s), or
p C CI��cc� Jl 3 lLAu, IS 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
2 �k:`C
f
Sign rl
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund