165253 10/29/2008 CITY OF CARMEL, INDIANA VENDOR: 119835 Page 1 of 1
ONE CIVIC SQUARE HAMILTON COUNTY CO -OP INC
0 CHECK AMOUNT: $3,176.50
CARMEL, INDIANA 46032 Po Box 1106
NOBLESVILLE IN 46061 CHECK NUMBER: 165253
CHECK DATE: 10/29/2008
DEPARTMENT ACCOUNT PO NUMBE INV OICE NUMBER AMOUNT DESCRIPTION
2201 4231500 104472 665.50 OIL
651 5023990 400724 230.00 OTHER EXPENSES
1150 4231400 GTO13465 2,281.00 GASOLINE
Noblesville -Office Horton Feed Grain Gray Storage
0 H 773 -0870 758 -4463 776 -4155
C Grain Terminal Noblesville Petroleum Merchandising
COOPERATIVE ASSOCIATION, INC. 773 -2599 Plant Food Station 773 -2685
776 -4143
16222 Allisonville Road P. O. Box 1106 Noblesville, Indiana 46061
S CARMEL STREET DEPT (CHARGE SALE)
L 3400 W 131ST STREET
D T WES'TF I ELD IN 46074
ACCOUNT NO PURCHASE ORDER NO. SALES TAX LICENSE NUMBER SALESMAN TERMS: INVOICE NO. DATE PAGE
PAYMENT DUE ON THE LAST DAY OF THE
MONTH FOLLOWING MONTH OF PURCHASE.
3 117 �5 Co
RETURN ITEMS MUST BE ACCOMPANIED BY 1 10 03 f 08 1
THIS INVOICE.
UNT
LUKE OIL
194050 55.0000 GAL 12.1000 65. S
151440
�r
All accounts subject to court CEEI ED GOOD ORDER ;AMOUNT PAID CASH DISCOUNT
costs and attorney fees if legal z;
action is necessary to collect CUSTOMER 00 665, 50
said amount SIGNATURE
Emergency Contact: LATE CHARGE PER MONTH PER ANNUM
Chemtrec 1 -800- 424 -9300 CUSTOMER COPY
Prescribed by State Board of Accounts Citf 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))
10/03/08 104472 $665.50
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.
Hamilton C6. Co -op ALLOWED 20
IN SUM OF
P. O. Box 1106
Noblesville, IN 46061
$665.50
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT
p Board Member:
2201 104472 42 315.00 $665.50 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
J /Thursdiy,,/October 23, 2008
Street Commissio L
;'r -et 7ggnmissioner
Cost distribution ledger classification if
claim paid motor vehicle highway fund
Noblesville -Office Horton Feed Grain Sheridan Plant Food LP
773 -0870 758 -4463 758 -5858
C ounty Grain Terminal Noblesville Petroleum Gray Storage
COOPERATIVE ASSOCIATION, INC. 773 -2599 Plant Food Station 776 -4155
Merchandising 776 -4143
4fi222,�gLpr�vllle�ieac}t i p. Noblesville, Indiana 4sos1 773 2ss5 <CHARGE SALE>
S
9609 HAZEL DELL PINY
D INDIANAPOLIS I.N 46280
T
0
'ACCOUNT NO: PURCHASE ORDER NO.', _'SALES TAX`LICENSE NUMBER SALESMAN PAYMENT DUE ON LAST DAY OF THE INVOICE NO.',",' DATE PAGE
MONTH FOLLOWING MONTH OF PURCHASE.
31204 CO TH IIINVOI( MUST BE ACCOMPANIED BY 400724 10 15 0 8 1
HOME
GLYFOS (GEN. ROUNDUP) 32383 5.0000 GAL 46.0000 230.00
REV Or, T 15 2008
0
All accounts subject to court RECEIVED IN GOOD ORDER AMOUNT PA6
CASH DISCOUNT
costs and attorney fees if legal
action is necessary to collect CUSTOMER
said amount. SIGNATURE
Emergency Contact: LATE CHARGE PER MONTH PER ANNUM
E emtrec Contact:
0� CUSTO�C(�POY
Prescribed by State Board of Accounts City Form No. 201 (Rev 1995) j,
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice or bill to be properly itemized must show, kind of service, where
performed, dates of service rendered, by whom, rates per day, number of units,
price per unit, etc.
Payee
119835
HAMILTON COUNTY CO -OP INC Purchase Order No.
PO BOX 1106 Terms
NOBLESVILLE, IN 46061 Due Date 10/21/2008
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
,10/21 /20M 400724 $230.00
hereby certify that the attached invoice(s), or bill(s) is (are) true and
orrect and I have audited same in accordance with IC 5- 11- 10 -1.6 r
Date Officer
VOUCHER 086477 WARRANT ALLOWED
119835 IN SUM OF
HAMILTON COUNTY CO -OP INC
PO BOX 1106
NOBLESVILLE, IN 46061
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
400724 01- 7202 -05- v(, $230.00
Voucher Total $230.00
Cost distribution ledger classification if
claim paid under vehicle highway fund
SALE 9959 DATE 10/09/08 17:29:07
COUNT: START 0.0 END 207.3
GROSS DELIVERY 207.3 GALLONS
4540 PREMIUM DIESEL -R UDISTILLATI
MULTIPLE DELIVERIES AT SITE
3 1 SALE 5405 DATE 10/09/08 17:34:07
COUNT: START 0.0 END 526.8
GROSS DELIVERY 526.8 GALLONS
GASOLINE I
MULTIPLE DELIVERIES AT SITE
HAMILTON COUNTY CO-OP
PO BOX 1106
NOBLESVILLE, IN 46061
CHARGE INVOICE
Driver: GT GARY TEETERS
Custo@er: 0000028761 Invoice GT 013465
BROOKSHIRE GOLF CLUB Date: 10/9/2008
CITY OF CARNEL Time: 17:40
12120 BROOKSHIRE PKWY
CARMEL, IN 46033
Tres Ter ®s Description Itea Description Legend Quantity Unit Price Item Total
01 NORMAL 104817 UNLEADED GAS GOV'T E 526.8000 2.89000 1522.45
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' 94.82
01 NORMAL 154040 DIESELEX ULS E 207.2000 3.31040 685.83
01 NORMAL 194070 PETRO VOLUME DISCOUN 734.0000 0.03000 -22.02
Legend: Invoice Subtotal: 2,281.08
E--Metered, T= Taxable, *=Entered by Hand Indiana Sales Tax On: 0.00 0.00
Invoice Total: 2,281.08
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'''
Pres�bed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No. 207 (Rev. 1995)
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))
/V v i 6>13Y &S °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
ll� /lam
ON ACCOUNT OF APPROPRIATION FOR
Board Members
PO# or INVOICE NO. ACCT #/TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
150 e7 -23 10 �-�f3 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
Cost distribution ledger classification if Title Director of Golf
claim paid motor vehicle highway fund