209283 05/22/2012 CITY OF CARMEL, INDIANA VENDOR: 366089 Page 1 of 1
ONE CIVIC SQUARE NORTH CENTRAL CO -OP CHECK AMOUNT: $4,872.01
t CARMEL, INDIANA 46032 PO BOX 299
WABASH IN 46992 CHECK NUMBER: 209283
CHECK DATE: 5/22/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1207 4231300 GT 400264 831.28 DIESEL FUEL
1207 4231400 GT 400264 1,570.17 GASOLINE
2201 4231300 GT 400330 1,037.67 DIESEL FUEL
1207 4231300 GT 400370 479.36 DIESEL FUEL
1207 4231400 GT 400370 953.53 GASOLINE
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 -67 38
P.O. BOX 299 800- 440 -2667 317 -77 p� DATE 05/08/12 15:18:22
WABASH, IN 46992 START 0.0 END 292.3
GROSS DELIVERY 292.3 GALLONS
4640 SUPER DX -4 BIODIESDISTILLATI
MULTIPLE DELIVERIES AT SITE H
CHARGE INVOICE
Driver: GT GARY TEETERS
Customer: 0000921720 Invoice GT 400330
CARMEL STREET DEPT Date: 5/8/2012
3400 W 131ST STREET Time: 15:18
CARMEL, IN.46074
Tros Terms Description Item Description Legend Quantity Unit Price Item Total
02 NORMAL CHARGE TERMS 4040 SUPER DX -4 B10DIESEL E 292.3M 3.55000 1637.67
Legend: Invoice Subtotal: 1,037.67
E=Metered, T= Taxable, Entered by Hand Indiana Sales Tax On: 0.00 0.00
Invoice Total: 1,037.67
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 CHEMTREC AT 1- 800 424 -9300 WE
APPRECIATE YOUR BUSINESS!!!
v
Customer Signature
C U ST M E.Irm.
VOUCHER NO. WARRANT NO.
ALLOWED 20
North Central Co -op
IN SUM OF
P. O.. Box 299
Wabash, IN 46992
$1,037.67
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO# Dept. INVOICE NO. I ACCT /TITLE AMOUNT Board Members
2201 I GT400330 I 42- 313.001 $1,037.67 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
Thursday, Maay 17, 2012
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))
05/08/12 GT400330 $1,037.67
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
Warsaw Wabash Peru Goshen Angola Fremont Logansport Plymouth Rochester
MAI 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 -67 38
P.O. BOX 2ss e 800- 440 -2667 317 77 Z 6326 DATE 05/16/12 14:57:24
WABASH, IN 46992 i s START 0.0 END 268.7
GROSS DELIVERY 268.7 GALLONS
4040 SUPER DX -4 BIODIESDISTILLATI
MULTIPLE DELIVERIES AT SITE
SALE 3158 DATE 05/16/12 15:04:25
COUNT: START 0.0 END 13333.9
GROSS DELIVERY 133. GALLONS
4011 87 E -10 PLUS GASOLINE 1
MULTIPLE DELIVERIES AT SITE
CHARGE INVOICE
Driver: GT GARY TEETERS
Customer: 0000918936 Invoice GT 400370
BROOKSHIRE GOLF CLUB Date: 5116/2012
CITY OF CARMEL Time: 14 :53
12120 BROOKSHIRE PKWY
CARMEL, IN 46033
Tres Terms Description Item Description Legend Quantity Unit Price Item Total
02 NORMAL CHARGE TERMS 4011 87 E -10 PLUS E 133.9000 3.40000 455.26
=State Road Tax- 0.- 18000 24:10
02 NORMAL CHARGE TERMS 4040 SUPER DX -4 BIODIESEL E 268.6000 3.55000 953.53
Legend: Invoice Subtotal: 1,432.89
E= Metered, T= Taxable, by Hand Indiana Sales Tax On: 0.00 0.00
Invoice Total: 1,432.89
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!!!
I ot. Customer Sign ature:
Account u a 1 r
Account 4 17
Account*
Account*
(OUST
VOUCHER NO. WARRANT NO.
ALLOWED 20
North Central Co -op
IN SUM OF
P.O. Box 299
Wabash, IN 46992
$1,432.89
ON ACCOUNT OF APPROPRIATION FOR
Brookshire Golf Club
PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members
1207 GT 400370 42 313.00 $479.36 I hereby certify that the attached invoice(s) or
1207 GT 400370 42 31�! )0 $953.53 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, May 21, 2012
Director, Brookshir 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))
05116/12 GT 400370 Fuel $479.36
05/16/12 GT 400370 Diesel $953.53
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
Warsaw Wabash Peru Goshen Angola Fremont Logansport PI mouth Rochester
9 Y
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 -6738 6230 DATE 04/26/12 15:15:06
P.O. BOX 299 800- 440 -2667 317 -77 TD START 0.0 END 442.4
WABASH, IN 46992 GROSS DELIVERY 442.4 GALLONS
4040 SUPER DX -4 BIODIESDISTILLATI
MULTIPLE DELIVERIES AT SITE
SALE 3088 DATE 04/226/12 15:22:00
COUNT: START 0.0 END 232.2
GROSS DELIVERY 232.2 GALLONS
4011 87 E -10 PLUS GASOLINE 1
MULTIPLE DELIVERIES AT SITE
CHARGE INVOICE
Driver: GT GARY TEETERS
Customer: OW18936 Invoice GT 400264
BROOKSHIRE 601-F CLUB Date: 4/26/2012
CITY OF CARMEL Time: 15:09
12120 BROOKSHIRE PKWY
CAME, IN 46033
Trms Terms Description Item Description Legend Quantity Unit Price, Item Total
02 NORMAL CHARGE TERMS 4011 87 E -10 PLUS E 232.2000 140000 789.48
State Road Tax 0.18000 41.80
02 NORMAL CHARGE TERMS 4040 SUPER DX -4 BIODIESEL E 442.3000 3.55000 1570.17
Legend: Invoice Subtotal: 2,401.45
E=Metered, T= Taxable, *centered by Hand Indiana Sales Tax On: 0.00 0.00
Invoice Total: 2,401.45
WARNING PETROLEUM PRODUCTS NOT TO BE USED FOR STARTING OR KINDLING FIRES. 89SOLINES NOT SOLD FOR
ILLUMINATING OR CLEANING PURPOSES. IN CASE OF EMERGENCY CONTACT CHENTREC AT I- 800-424 -9300 WE
APPRECIATE YOUR BUSINESS'.!!
Customer Signature:
Date Init.
Account
Account# �la3t" t�
Account 4 t
e 16
CUST
VOUCHER NO. WARRANT NO.
ALLOWED 20
North Central Co -op
IN SUM OF
P.O. Box 299
Wabash, IN 46992
$2,401.45
ON ACCOUNT OF APPROPRIATION FOR
Brookshire Golf Club
PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members
1207 GT 400264 42- 313.00 $831.28 1 hereby certify that the attached invoice(s), or
1207 GT 400264 42 -31y. $1,570.17 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
Wednesday, May 09, 2012
Director, Brookshir 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))
04/26/12 GT 400264 Fuel $831.28
04/26/12 GT400264 Fuel $1,570.17
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