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207979 04/10/2012 CITY OF CARMEL, INDIANA VENDOR: 366089 Page 1 of 1 ONE CIVIC SQUARE NORTH CENTRAL CO -OP CHECK AMOUNT: $2,872.52 CARMEL, INDIANA 46032 PO BOX 299 WABASH IN 46992 CHECK NUMBER: 207979 CHECK DATE: 4/10/2012 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 2201 4231500 GT400105 2,072.95 OIL 2201 4231300 GT400116 799.57 DIESEL FUEL NORM 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 Branch Co. MI Hart MI Noblesville 877 615 -2667 517- 278 -4561 231 873 -2158 765- 675 -2538 P.O. BOX 299 800- 440 -2667 317 773 -0870 WABASH, IN 46992 CHARGE INVOICE Driver:, GT GARY TEETERS Customer: 0000921720 Invoice 0: GT 400105 CARMEL STREET DEPT Date: 3/23/2012 3400 W 131ST STREET Time: 14:12 CAR R, IN 46074 Tres Terms Description Item D Description Legend Quantity Unit Price Ite■ Total 62 NORMAL CHARGE TERMS 557430E ADVANTAGE HD DEO "15W 110: 0 12.930 02 NORMAL CHAD TERNS 5574313 ADVANTAGE GEO ISM 55. M 11.83000 650.65 Legend: Invoice Subtotal: 2,072.95 E=Metered, T= Taxable, *centered by Hand Indiana Sales Tax On: 0.00 0.00 Invoice Total: 2,072.95 WARNING PETROLEUM PRODUCTS NOT TO BE USED FOR STARTING OR KINDLING FIBS. GASOLINES NOT SOLD FOR ILLUMINATING OR CLEANING PURPOSES. IN CASE OF EMERGENCY CONTACT CHEMTIEC AT 1 -80- 424 -9300 WE APPRECIATE YOUR BUSINESS!!! Customer Signature:. CUST C Warsaw Wabash Peru Goshen Angola Fremont Logansport Plymouth Rochester Kokomo Huntington Auburn Constantine 574 753 -3673 Star City Call: 800-720-0550 Call: 1100"234-0573 800- 807 -3673 Cal': 574- 224 -2667 Branch Co. MI Hart MI Noblesville 877- 615 -2667 517- 278 -4561 231- 873 -2158 765 675 -2538 P.O. BOX 299 800- 440 -2667 317- 773 -0870 WABASH, IN 46992 RE- PRINT CHARGE INVOICE Driver: GT GARY TEETERS Customer: 8000921720 Invoice B: 6T 4116 CAMEL STREET DEPT Date: 3/27/2012 3400 W 131ST STREET Time: 15:08 CARTEL, IN 46074 Trms Terms Description Item t Description Legend Quantity Unit Price Item Total 02 NORMAL CHARGE TERMS 4040 SUPER DX -4 BIODIESEL E 216. IM 3.70000 799.57 Legend: Invoice Subtotal: 799.57 E=Metered, T= Taxable, *=Entered by Hand Indiana Sales Tax On: 0.10 0.06 Invoice Total: 799.57 YARNING PETROLEUM PRODUCTS NOT TO BE USED FOR STARTING OR KINDLING FIRES. GASGEINES NOT SOLD FOR ILLUMINATING OR CLEANING PURPOSES. IN CASE OF EMERGENCY CONTACT CHENTREC AT 1- 800 424 -9300 WE APPRECIATE YOUR BUSINESS!!! Customer Signature: 4 CUST 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)) 03/23/12 GT 400105 $2,072.95 03/27/12 GT 400116 $799.57 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 VOU CHER NO. WARRANT NO. ALLOWED 20 North Central Co -op IN SUM OF P. O.. Box 299 Wabash, IN 46992 $2,872.52 ON ACCOUNT OF APPROPRIATION FOR Carmel Street Department PO# Dept. INVOICE NO. ACCT /TITLE I AMOUNT Board Members 2201 GT 400105 42- 315.00 j $2,072.95 1 hereby certify that the attached invoice(s), or 2201 GT 400116 1 42- 313.00 $799.57 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 Thursday, April'05, 2012 ;i Street Commissioner Title Cost distribution ledger classification if claim paid motor vehicle highway fund