HomeMy WebLinkAbout207177 03/13/2012 CITY OF CARMEL, INDIANA VENDOR: 366089 Page 1 of 1
ONE CIVIC SQUARE NORTH CENTRAL CO -OP
CHECK AMOUNT: $3,155.78
CARMEL, INDIANA 46032 Po BOX 299
WABASH IN 46992 CHECK NUMBER: 207177
CHECK DATE: 3/13/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1207 4231300 GT400039 3,155.78 DIESEL FUEL
(CM Warsaw Wabash Peru Goshen Angola Fremont Logansport Plymouth Rochester
Kokomo Huntington Auburn Constantine 574- 753 -3673 Star City
Call: 800 -720 -0550 Call: 800 -234 -0573 800- 807 -3673 Call: 574-224-2667
co ON Branch Co. MI Hart Ml Noblesville 877-615 -2667
P.Q. BOX 299 517- 278 -4561 231- 873 -2158 765-679 2959 DATE 83/67/12 15 :57:56
WABASH, IN 46992 800- 440 -2667 317 -7770 START 8.8 END 588.2
GROSS DELIVERY 588.2 GALLONS
2287 SET UNLEAD GAS 6ASMINE 1
MULTIPLE DELIVERIES AT SITE
SALE 6836 DATE 63/87/12 15 :51:24
COUNT. START 6.8 END 344.9
GROSS DELIVERY 344.9 GALLONS
4646 SURER DX-4 DIESEL DISTILLATI
MULTIPLE DELIVERIES AT SITE
CHARGE INVOICE
Driver: GT GARY TEETERS
Custooer: 6688918936 Invoice UT 4639
BROOKSHIRE 601-F CLUB Date: 3/7/2812
CITY OF CARM L Tine: 14:49
12128 BROOKSHIRE PKWY
CARMEL, IN 46633
Trns Terns Description Iteo Description Legend Quantity Unit Price Iteo Total
82 NORMAL CHARGE TERMS 4646 SUPER DX -4 DIESEL E 344.9668 3. SM 1217.58
62 NORMAL CHARGE TERMS 4811 87 E -16 PLUS 568.2088 3.459 8 1753.29
Federal Road Tax 8.18408 93.51
State Road Tax 6.18608 91.48
Legend: Invoice Subtotal: 3,155.78
E=Metered, T =Taxable, +=Entered by Hand Indiana Sales Tax On: 8.08 6.66
Invoice Total: 3,155.78
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 -SW424 -9308 WE
APPRECIATE YOUR BUSINESS!!!
Custooer Signature:
CUSTOME.R
VOUCHER NO. WARRANT NO.
ALLOWED 20
North Central Co -op
IN SUM OF
P.O. Box 299
Wabash, IN 46992
$3,155.78
ON ACCOUNT OF APPROPRIATION FOR
Brookshire Golf Club
PO# Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Members
1207 I GT 400039 42- 31100 I $3,155.78 1 hereby certify that the attached invoice(s), or
I 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, March 12, 2012
G
Director, Brookshi 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. 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))
03107/12 GT 400039 Fuel $3,155.78
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