206267 02/14/2012 CITY OF CARMEL, INDIANA VENDOR: 119835 Page 1 of 1
ONE CIVIC SQUARE HAMILTON COUNTY CO -OP INC
CHECK AMOUNT: $928.52
a �,a CARMEL, INDIANA 46032 PO BOX 1106
N .o. NOBLESVILLE IN 46061 CHECK NUMBER: 206267
CHECK DATE: 2/14/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2201 4237000 71825 89.66 REPAIR PARTS
2201 4231300 GT021055 838.86 DIESEL FUEL
DEPT. 7
MO. DAY YR. 7
H amilton.
A
C:U nty C N
c 0
T
T A
n M
FARM BUREAU COOPERATIVE e Y
ASSOCIATION, INC. o
P.O. Box 1106 e
16222 Allisonville Road
Noblesville, Indiana 46060 EMERGENCY CONTACT
CHEMTREC 1 -800-424-9300
SOLD BY CASH CHARGE ON ACCT MDSE. RET. TERMS
OTV. DESCRIPTION MIN. COMM. UNIT PRICE AMOUNT
C� T� 9,P3 7 1
r� T C-
SUB TOTAL F q
SALES TAX ON
Received B TOTAL
Additional finance charges may accrue at theiale aob per month (21% APRO)
if payment in full is not received by the 30th. Minimum $.50.
FERTILIZER/PETROLEUM GRAIN MERCHANDISING SHERIDAN HORTON ELEVATOR
776 -4143 773 -2685 758 -4181 758 -4463
VOUCHER NO. WARRANT NO.
ALLOWED 20
Hamilton Co. Co op
IN SUM OF
P. O. Box 1106
Noblesville, IN 46061
$89.66
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO# Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Members
2201 71825 42- 370.00 $89.66 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
I Wednesday,] ebruai�y�08, 2012
;Ly ir
n
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))
01/27/12 71825 $89.66
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
20
Clerk- Treasurer
SALE 5914 DATE 02110/12 15:12:46
COUNT: START 0.0 END 246.0
GROSS DELIVERY 246.0 GALLONS
4040 DIESELEX ULS UN DISTILLATI
+r MULTIPLE DELIVERIES AT SITE
HAMILTON COUNTY CO -OP
PO BOX 1105
NOBLESVILLE, IN 46061
CHARGE INVOICE
Driver: GT GARY TEETERS
Customers 0000031175 Invoice h GT 021055
CARMEL STREET DEPT Date: 2/10/2012
3400 W 131ST STREET Tice: 14:05
CARMEL, IN 45074
Trms Terms Description Itea 0 Description Legend Quantity Unit Price Item Total
01 NORMAL 154040 DIESELEX ULS UN 19 E 195.8000 3.36000 661.25
01 NORMAL 124029 HEATER OIL -UN 1993 E 49.'..'000 3.76000 184.99
01 NORMAL 194070 PETRO VOLUME DISCOUN 245.0000 0.03000 -7.36
Legend: Invoice Subtotal: 838.85
E= Metered, T= Taxable, Entered by Hand Indiana Sales Tax On: 0.00 0.00
Invoice Total: 838.85
WARNING PETROLEUM PRODUCTS NOT TO BE USED FOR STARTING OR KINDLING FIRES. GASOLINES NOT SOLD FOR
ILLU41NATING OR CLEANING PURPOSES. IN CASE OF EMERGENCY CONTACT CHEMTREC AT 1- 800 424-9300 WE
APPRECIATE YOUR BUSINESS
l
VOUCHER NO. WARRANT NO.
ALLOWED 20
Hamilton Co. Co -op
IN SUM OF
P. O. Box 1106
Noblesville, IN 46061
$838.86
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO# Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Members
2201 GT021055 42- 313.00 $838.86 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
o Friday /FebrfIary 10, 2012
Street Commissioner
Street LTitlemissioner
Cost distribution ledger classification it
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))
02/10/12 GT021055 $838.86
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
,20
Clerk- Treasurer