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Home My WebLink About200877 08/30/2011 o CITY OF CARMEL, INDIANA VENDOR: 119835 Page 1 of 1 ONE CIVIC SQUARE HAMILTON COUNTY CO -OP INC CHECK AMOUNT: $1,945.21 CARMEL, INDIANA 46032 PO BOX 1106 NOBLESVILLE IN 46061 CHECK NUMBER: 200877 CHECK DATE: 8/30/2011 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 2201 4231500 106638 113.60 OIL 2201 4231300 GT 019980 657.82 DIESEL FUEL 1207 4231300 VP009666 1,173.79 DIESEL FUEL I Noblesville -Office Horton Feed Grain Gray Storage 773 -0870 758 -4463 776 -4155 t Hamilton C anty 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 o CARMEL STREET DEPT <CHARGE SALE) L 3400 `W 13 1 S'7REET D T CARMEL IN 46074 O ACCOUNT NO. I PURCHASE ORDER NO. SALES TAX LICENSE NUMBER SALESMAN TERMS: INVOICE NO. DATE PAGE PAYMENT DUE ON THE LAST DAY OF THE 3117 5 G 0' RE N ITE eS "U ST�BE MO AN IED BY 106638 0 8/ 2 5/ 11 1 PR ODUCT THIS INVOICE. LUKE OIL 194050 10.0000 GAL 11.3600 113.60 IS0100 All accounts subject to court REC DING ORDER AMOUNT PAID CASH DISCOUNT costs and attorney fees if legal action is necessary to collect CUSTOMER .00 113.60 said amount. SIGNATURE Emergency Contact: X 0 LATE CHARGE PER MONTH PER ANNUM Chemtrec 1- 800 -424 -9300 CUSTOMER COPY r e SALE 5031 DATE 08/23/11 14:17:51 COUNT: START 0.0 END 195.2 GROSS DELIVERY 195.2 GALLONS 4040 DIESELEX ULS UN DISTILLATI *4 MULTIPLE DELIVERIES AT SITE HAMILTON COUNTY CO -OP PO BOX 1106 NOBLESVILLE, IN 45061 CHARGE INVOICE Driver: GT GARY TEETERS Custoeer: 0000031175 Invoice D: GT 019980 CARMEL STREET DEPT Date: 8/23/2011 3400 N 131ST STREET y Tise: :14:13 CARMEL, IN 45074 Tres Terns Description Item Description Legend Quantity Unit Price Item Total 01 NORMAL 154040 DIESELEX ULS UN 19 E 195.2000 3.40000 663.68 01 NORMAL 194070 PETRO VOLUME DISCOUN 195.2000 0.03000 -5.86 Legend: Invoice Subtotal: 557.82 E=Metered, T =Taxable, Entered by Hand Indiana Sales Tax On: 0.@9 0.00 Invoice Total: 557.82 i 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!!! W h i VO NO. WARRANT NO. ALLOWED 20 Hamilton Co. Co -op IN SUM OF P. O. Box 1106 Noblesville, IN 46061 $771.42 ON ACCOUNT OF APPROPRIATION FOR Carmel Street Department PO# Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Members 2201 GT 019980 42- 313.00 $657.82 l hereby certify that the attached invoice(s), or 2201 106638 42- 315.00 $113.60 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 Frida Au us 26, 2011 r Street Commissioner,," 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)) 08/23/11 GT 019980 $657.82 08/25/11 106638 $113.60 I hereby certify that the attached invoice(s), or bill(s), is (are) true and correct and 1 have audited same in accordance with IC 5- 11- 10 -1.6 2a Clerk- Treasurer a HAMILTON COUNTY CO-VP P.O. BOX 1106 NOBLESVILLE, IN 46861 CHARGE INVOICE Driver: VP VERNON POOLE Custooer: 8888828761 Invoice: VP 889666 BROOKSHIRE GOLF CLUB Date: 8/1812811. CITY OF CARMEL Tine: 89:29 12120 BROOKSHIRE PKWY CARMEL, IN 46833 Tros Terns Description Item Description Legend Quantity Unit Price Item Total 01 NORMAL 184817 UNLEADED GAS 60VIT 226.8888 3.12@88 785.12 State Road Tax 0.18000 40.68 01 NORM. 154040 DIESELEX ULS UN 19 127.8880 3.37088 427.99 Legend: Invoice Subtotal: 1,173.79 E= Metered, T= Taxable, Entered by;Hand Indiana Sales Tax On: 0.08 0.00 Invoice Total: 1,173.79 HARMING 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! HAMILTON COUNTY I Phone (317) 773 -0870 P.O. BOX 13213 NOBLESVILLE, IN IN 46061 NO. PREVIOUS SALE NO. CODE GALLON READING -START 10THS 0 4 A U i d i .a J 2 2 7 YOUR SALE NO. GALLON READING- FINISH PATRON DATE, UNDYED FUEL FOR ON ROAD USE ONLY! DYED FUEL FOR OFF ROAD ui;L ONLY CASH C R POA BUDGET DEL'VD. BY Wa in Petroleum products not to be used fo starling or indling fires. Gasoline not sold for illuminating or clea Ing purp ses. FUELS GAL. CODE PRICE AMOUNT NINETY PLUS SeeNotice#4onRevorse 104012 PREM. UNLEADED See Not,. 104015 UNLEADED GASOLINE SeeNotice#4 104017 on Reverse LP GAS Product temperature Corrected To 60T 134020 HEATER OIL See #2 on Reverse 124029 FURNACE OIL Se Notice #2 on Reverse 124030 KEROSENE �Notic e#2onRevene 124034 DIESELEX -4 See edFuel #z onRevense 4040 PREM. DIESEL -R SSeeeeNticee#3onRover" 154540 OTHER PETROLEUM OIL 194050 GREASE 194060 ANTI FREEZE 194080 VOLUME DISCOUNT 194070 CASH DISCOUNT 194071 SUB -TOTAL SALES TAX ON ABOVE LINE 2221 FEDERAL EXCISE TAX STATE FUEL USE TAX GOODS RECEIVED BY TOTAL AMOUNT Additional finance charges may accrue at the rate of 1 314% per month (21% APRO) if payment in full is not received by the 30th. Minimum'.50. EMERGENCY CONTACT Chemtrec 1.800 -424 -9300 o NOTICE #11 This fuel qualifies for blending with Cauntryrhark on- higbway Premium Diesel -R in compliance with 4b CFR P art 80. TMSI DIE- SEL FUEL DOES NOT CONTAIN VISIBLE EVIDENCE 00 DYE. NOTICE #2 This distillate product does not comply with on highway requiremen.¢s of the 1890 Clean Air Act, 40 CFR Part 80 and is for off highway use only. Dyed. diesel fuel; non- taxable use only; penalty for taxable use. NOTICE #3 Compdes �"1 40 CI `;'art 80 for use as an on- highwayiaet. Contains 2% soy methyl ester. NOTICE 4�4 ��JR \RK00.6�2 C 0 K ViF_M710 N AL GASOLN4 LOW RV? GrS.S'OUII!�- Con- forms requirements for a 7.8 p s.+. °LU&LRVP" gasoline during the months of May 1 s€ Sep- tember 15th. THIS F ODUCT DOES MOT MEET T HE REQWREWJL.NTS FOR MEFO R_ 9, 1006. TOMS P ovv"CT �tc,*L- TAIX8. PRE SCH9RED LEVELS OF VALVE DE- TERGENT (I.V.D.) AD ®iirNE. HAMILTON COUNTY'' Y Phone•(317) 773 -0870 P.O. BOX 1 IN 13 213 9 NOBLESVILLE, IN 46061 NQ, �l PREVIOUS SALE NO. CODE GALLON READING -START 10THS 4 YOUR SALE NO. GALLON READING FINISH yy PATRON `s �a IJ TE: V i f 6#,Q g UNDYED FUEL FOR ON ROAD USE ONLY! CASH CHARGE PDA BUDGET DEL"' BY Warning_ Petroleum products not to used for sta ing r kindling fires. ,Gasoline not so ld f or il or cleaning rposes. ''FUELS' GAL. CODE PRICE AMOUNT NINETY PLUS SeeNodce#4onReverse 104012 PREM. UNLEADED SeeNotice#4 04015 on Reverse UNLEADED GASOLINE SeeNotice#4 104017 on Reverse LP GAS Product temperature Corrected To 134020 HEATER OIL S #2 on Reverse 124029 FURNACE OIL Se Notice#2onReverse 124030 KEROSENE. �Notice#2on Reverse 124034 DIESELEX-4 See Notice #2 on Reveres 154040 PREM. DIESEL -R See�Notice#3onReveres 154540 OTHER PETROLEUM OIL 194050 GREASE 194060 ANTI FREEZE 194080 VOLU DISCO 194070 CASH DISCOUNT 194071 SUB -TOTAL SALES TAX ON ABOVE LINE 2221 FEDERAL EXCISE TAX STATE FUEL USE TAX GOODS RECEIVED BY TOTAL 3 AMOUNT Additional finance charges may accrue at the rate of 1 3/4% per month (21 APRO) if payment in full is not received by the 30th. Minimum .50. EMERGENCY CONTACT Chemtrec 1- 800 -424 -9300 NOTICE #1 This fuel qualifies for blending with Cor_rntrymark on- highway Premium Diesel -R in -con ;fiance with 40 CFR'Part 80.-THIS DIE- SEL EVIDENCE OF DYE. NOTICE #2 This distillate product does not comply with on-highway_ requirements _of the 1 Clean Air Act, 40 `CFR Far 80 and is' for off highway use `gnly .Qyed diesel. fuel; non- taxable use only; penalty for taxable. use. N®` MEM #3 Compl with 40 CFR Part 80 for use as an on- highway fuel. Contains 2% soy methyl ester. G N SOU ME LOW GASOUMr� Con- forms requirements for a 7.8- p .s.i. "LOW -RVP" gasoline during the months of May 1st S .ep- terriber 1 nth. THM FRODUCT DOES HOT MERT u HE 19 REmEMTS F(D REF(OR- _0" 1, tqg�. Tms PRO)�DMCT Cam rqE C LEVELS OF I�IT KE VAV /F tZ)E- TEnGaENT (IM U.) ADDMVE. VOUCHER NO, WARRANT NO. ALLOWED 20 Hamilton County CO -OP IN SUM OF P.O. Box 1106 Noblesville, IN 46061 $1,173.79 ON ACCOUNT OF APPROPRIATION FOR Brookshire Golf Club PO# 1 Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Members 1207 VP 009666 42- 313.00 $1,173.79 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 Monday, August 22, 2011 Director, Brook ire 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)) 08/18/11 VP 009666 Fuel $1,173.7 1 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 2a Clerk- Treasurer