211885 08/14/2012 CITY OF CARMEL, INDIANA VENDOR: 366089 Page 1 of 1
ONE CIVIC SQUARE NORTH CENTRAL CO-OP
CARMEL, INDIANA 46032 Po Box 299 CHECK AMOUNT: $2,834.45
WABASH IN 46992 CHECK NUMBER: 211885
«o
CHECK DATE: 8/1412012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2201 4231500 000549 727 . 65 OIL
2201 4231300 GT400775 497 .28 DIESEL FUEL
1207 4231300 GT400799 917 . 66 DIESEL FUEL
1207 4231400 GT400799 691 . 86 GASOLINE
GENTR7
ti o North CentraR Co-op PATRON
P.O. Box 299, Wabash, Indiana 46992
260-563-8381 800-992-3495 Fax 260-563-3021
Hamilton Petroleum ---______-= PAGE 1
16222 Allisonville Road INVOICE INVOICE NO . 000549
Noblesville IN 46060 --- ---- ORDER DATE 07 /31/12
ACCOUNT NO . 0000921720
BATCH 402 NJN
CARMEL STREET DEPT
3400 " W 131ST STREET
CARMEL IN 46074
P . O . # SHIP DATE TERMS SLS LOC
---------------------------------------I-----------------------------------------
07/31/12 Due 08/20/2012 NJN 256
PACKAGES SOLD DESCRIPTION UNITS SOLD UNIT PRICE EXTENDED
--------------------------------------------------------------------------------
5574301 ADV HD DEO 15W40—DRUM 55 GAL 13 . 2300 727 . 65
TOTAL DUE $$ 727 . 65
- r IVFf]RV
�® Warsaw Wabash Peru Goshen Angola Fremont Logansport Plymouth Rochester
i Kokomo Huntington Auburn Constantine 574-753-3673 Star City
Call: 800-720-0550 Call: 800-234-0573 800-807-3673 Call: 574-224-2667
1 877-615-2667
Branch Co. MI Hart MI Noble§ Ip&e 6629 DATE 08/97/12 13:45:26
517-278-4561 231-873-2158 765-6718 START 0.0 END 148.0
P.O. BOX 299 800-440-2667 31 7-77
WABASH, IN 46992 %fdgODELIVERY 148.0 GALLONS
4040 SUPER DX-4 BIODIESDISTILLATI
MULTIPLE DELIVERIES AT SITE
CHARGE INVOICE
Driver: GT GARY TEETERS
Customer: 0000921720 Invoice #: GT 400775
CARMEL STREET DEPT Date: 8/7/2012
3400 W 131ST STREET Time: 13:32
CAME, IN 46074
Trms Terns Description Item # Description Legend Quantity Unit Price Item Total
02 NORMAL CHARGE TERMS 4040 SUPER DX-4 BIODIESEL E 148.0000 3.36M 497.28
Legend: Invoice Subtotal: 497.28
E=Metered, T=Taxable, *centered by Hand Indiana Sales Tax On: 0.00 ..... 0.00
Invoice Total: 497.28
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 1-8I424-9300 WE -
APPRECIATE YOUR BUSINESS!!!
Customer Signature:
CUSTQM -Er�
VOUCHER NO. WARRANT NO.
ALLOWED 20
North Central Co-op
IN SUM OF $
P. O.. Box 299
Wabash, IN 46992
$1,224.93
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO#/Dept. INVOICE NO. I ACCT#/TITLE AMOUNT Board Members
2201 000549 42-315.00 j $727.65 1 hereby certify that the attached invoice(s), or
2201 GT 400775 42-313.00 $49728 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 Thu`rscday,;:August 09, 2012
v
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))
07/31/12 000549 $727.65
08/07/12 GT 400775 $497.28
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
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 Nobles Le 3381 DATE 08/10/12 99:19:10
517-278-4561 231-873-2158 765-678 START 0.0 END 193.8
P.O. BOX 299 800-440-2667 317-77
WABASH, IN 46992 %RWDELIVERY 193.8 GALLONS
4011 87 E-10 PLUS GASOLINE 1
** MULTIPLE DELIVERIES AT SITE to
SALE 6654 DATE 08/10/12 69:10:47
COUNT: START 0.0 END 260.7
GROSS DELIVERY 260.7 GALLONS
4040 SUPER DX-4 BIODIESDISTILLATI
MULTIPLE DELIVERIES AT SITE f*
CHARGE INVOICE
Driver: ST GARY TEETERS
Customer: 0000918936 Invoice #: ST 400799
BROOKSHIRE GOLF CLUB Date: 8/10/2012
CITY OF CAME Time: 68:59
12120 BROOKSHIRE PKWY
CARREL, IN 46033-
Trms Terms Description Item # Description Legend Quantity Unit Price Item Total
02 NORMAL CHARGE TERMS 4011 87 E-10 PLUS E 193.8000 3.39000 656.98
State Road Tax 0.IBM 34.88
62 NORMAL CHARGE TERMS 4040 SUPER DX-4 BIODIESEL E 260.7M 3.52M 917.66
Legend: Invoice Subtotal: 1,609.52
E=Metered, T=Taxable, *=Entered by Hand Indiana Sales Tax On: 0.00 ..... 0.00
Invoice Total: 1,609.52
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!!!
'Customer Signature:
CUSTOM -ER
VOUCHER NO. WARRANT NO.
ALLOWED 20
North Central Co-op
IN SUM OF $
P.O. Box 299
Wabash, IN 46992
$1,609.52
ON ACCOUNT OF APPROPRIATION FOR
Brookshire Golf Club
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1207 GT 400799 42-313.00 $917.66 1 hereby certify that the attached invoice(s), or
1207 GT 400799 42-31i/ $691.86 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
Friday, August 10, 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))
08/10/12 GT 400799 Fuel $917.66
08/10/12 GT 400799 Fuel $691.86
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