165793 11/12/2008 a CITY OF CARMEL, INDIANA VENDOR: 119835 Page 1 of 1
ONE CIVIC SQUARE HAMILTON COUNTY CO -OP INC
i' CHECK AMOUNT: $1,024.43
CARMEL, INDIANA 46032 Po Box 1106
NOBLESVILLE IN 46061 CHECK NUMBER: 165793
CHECK DATE: 11/12/2008
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DEPARTMENT ACCOUN PO NUMBE INVOICE NUMBER AMOUNT DESCRIPTION
2201 4237000 400727 9.60 REPAIR PARTS
1150 4237000 GTO13613 1,014.83 REPAIR PARTS
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Noblesville -Office Horton Feed Grain Sheridan Plant Food LP
773 -0870 758 -4463 758 -5858
m�ltonounty
Grain Terminal Noblesville Petroleum Gray Storage
COOPERATIVE ASSOCIATION, INC. 773 -2599 Plant Food Station 776 -4155
Merchandising 776 -4143
MwLp, villa- ii�axlE1 9 TBoc�trh�(wnNoblesville,lndiana asos� 773 -2685 <CHARGE SALE>
S J 1 IIGG Cyr 1
0 3400 V 131ST STREET
D WESTFIELD IN 46074
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ACCOUNT NO: I PURCHASE ORDER NO. SALES TAX LICENSE NUMBEI ALESMAN TERMS: INVOICE NO. DATE PAGE
PAYMENT DUE IN THE LAST DAY OF THE
RETURN FOLLOWING MUST BE AACC MP NIEDD BY
31175 CO THIS INVOICE. 400727 10/21/08 1
RRODUCT IDENTIFICATION e
REPAIR PARTS 814640 2.0000 EA 4.8000 9.60
LACK PIPE
All accounts subject to court RECEIVED IN GOOD ORDER AMOUNT PAID CASH DISCOUNT e
costs and attorney fees if legal
action is necessary to collect CUSTOMER X 2 c1
said amount. SIGNATURE
Emergency Contact: LATE CHARGE PER MONTH PER ANNUM
Chemtrec 1-800-424-9300 .00 CUSTOMER90?
i
Prescribed by State Board of Accounts City Form No. 201 (Rev. 1995)
4 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))
10/21/08 400727 $9.60
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.
ALLOWED 20
Hamilton Co. Co -op
IN SUM OF
P. O. 'Box 1106
Noblesville, IN 46061
$9.60
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO# Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Members
2201 400727 42- 370.00 $9.60 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
Friday, November 07, 2008
Street Com i "sioner
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
SALE 5470 DATE 10/29/08 10:46:58
COUNT: START 0.0 END 428.2
GROSS DELIVERY 428.2 GALLONS
NGAS GASOLINE GASOLINE 1
MULTIPLE DELIVERIES AT SITE
HAMILTON COUNTY CO -OP
PO BOX 1106
NOBLESVILLE, IN 46061
CHARGE INVOICE
Driver: GT GARY TEETERS
Customer: 0000028761 Invoice GT 013613
BROOKSHIRE GOLF CLUB Date: 10/29/2008
CITY OF CARMEL Tioe: 10 :50
12120 BROOKSHIRE PKWY
CARMEL, IN 46033- b
Tros Terms Description Item Description Legend Quantity Unit Price Item Total
01 NORMAL 104817 UNLEADED GAS GOV'T 428.2000 2.22000 950.60
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
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 77.08
01 NORMAL 194670 PETRO VOLUME DISCOUN 428.2000 0.03000 -12.85
Legend: Invoice Subtotal: 1,014.83
E T= Taxable, by Hand Indiana Sales Tax On: 0.00 0.00
Invoice Total: 1,014.83
WARNING PETROLEUM PRODUCTS NOT TO BE USED FOR STARTING OR KINDLING FIRES. GASOLINES NOT SOLD FOR
ILLUMINATING OR CLEANING Pl1RPOSES. IN CASE OF EMERGENCY CONTACT CHENTREC AT 1- 800 424 -9300 WE
APPRECIATE YOUR BUSINESS!!!
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))
Total
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.
ALLOWED 20
IN SUM OF
y /q�
ON ACCOUNT OF APPROPRIATION FOR
Board Members
PO# or INVOICE NO. ACCT #/TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
D 0!3!0!,3 Va 3 v f?k�l'3 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
20
Signature
Title
Cost distribution ledger classification if Director of
claim paid motor vehicle highway fund Golf