HomeMy WebLinkAbout212712 09/12/2012 CITY OF CARMEL, INDIANA VENDOR: 366089 Page 1 of 1
0 ` ONE CIVIC SQUARE NORTH CENTRAL CO-OP CHECK AMOUNT: $1,855.90
Po Box 299,
CARMEL INDIANA 46032
WABASH IN 46992 CHECK NUMBER: 212712
CHECK DATE: 9/12/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1207 4231400 GT400,904 1, 855 . 90 GASOLINE
NORMWarsaw 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 Noble 1 877-615-2667
6751 DATE 09/05/12 67:15:57
517-278-4561 231-873-2158 765-67 -
P.O. BOX 299 800-440-2667 317-77 - 0 START 0.0 END 336.6
WABASH, IN 46992 DELIVERY 336.6 GALLONS
4040 SUPER DX-4 BIODIESDISTILLATI
t* MULTIPLE DELIVERIES AT SITE
SALE 3437 DATE 09/05/12 07:23:50
COUNT: START 0.0 END 183.9
GROSS DELIVERY 183.9 GALLONS
4011 87 E-10 PLUS GASOLINE I.
MULTIPLE DELIVERIES AT SITE
CHARGE INVOICE
Driver: 6T GARY TEETERS
Customer: 0000918936 Invoice #: 6T 400904
BROOKSHIRE GOLF CLUB Date: 9/5/2012
CITY OF CAME Time: 07:06
12126 BROOKSHIRE PKWY
CARMEL, IN 46033-
Trms Terms Description Item # Description Legend Quantity Unit Price Item Total _
02 NORMAL CHARGE TERNS 4011 87 E-10 PLUS E 183.9000 3.29000 605.03
State Road Tax 0.18000 33.10
02 NORMAL CHARGE TERMS 4040 SUPER DX-4 BIODIESEL E 336.4000 3.62000 1217.77
Legend: Invoice Subtotal: 1,855.90
E--Metered, T=Taxable, *centered by Hand Indiana Sales Tax On: 0.00 ..... 0.00
Invoice Total: 1,855.90
WARNING - PETROLEUM PRODUCTS NOT TO BE USED FOR STARTING OR KINDLING FIBS. 6ASOLINES NOT S D FOR
ILLUMINATING OR CLEANING PURPOSES. IN CASE OF EMERGENCY CONTACT CHENTREC AT 1-800-424-9300
APPRECIATE YOUR BUSINESS!!!
/ r .
Customer Signature:
Date_2L-?
L-? Init. r�r�
Account# 3 $
Account# $
Account
Account# $
(OUSTOMEFI -�
VOUCHER NO. WARRANT NO.
ALLOWED 20
North Central Co-op
IN SUM OF $
P.O. Box 299
Wabash, IN 46992
$1,855.90
ON ACCOUNT OF APPROPRIATION FOR
Brookshire Golf Club
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1207 I GT 400904 I 42-314.00 I $1,855.90 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
Friday, September 07, 2012
Director, Brooks 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))
09/05/12 GT400904 Fuel $1,855.90
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