HomeMy WebLinkAbout214381 11/07/2012 CITY OF CARMEL, INDIANA VENDOR: 366089 Page 1 of 1
` ONE CIVIC SQUARE NORTH CENTRAL CO-OP CHECK AMOUNT: $585.72
o CARMEL, INDIANA 46032 PO BOX 299
4 Via? WABASH IN 46992 CHECK NUMBER: 214381
CHECK DATE: 11/7/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2201 4231300 GT401248 585 . 72 DIESEL FUEL
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517-278-4561 231-873-2158 765-678 7037 DATE 10130/12 14:26:24
WABASH, IN 466 992
P.O.Box 2 800-440-2667 317-77bW9 START 0.0 END 161.8
GROSS DELIVERY 161.8 GALLONS
4040 SUPER DX-4 BIODIESDISTILLATI
MULTIPLE DELIVERIES AT SITE
CHARGE INVOICE
Driver: ST GARY TEETERS
Customer: 800921720 Invoice #: 6T 401248
CARMEL STREET DEPT Date: 1013012012
3400 W 131ST STREET Time: 14:09
CARMEL, IN 46074
Tres Terms Description Item # Description Legend Quantity Unit Price Item Total
02 NORMAL CHARGE TERMS 4040 SUPER DX-4 BIODIESEL E 161.8000 3.62M 585.72
Legend: Invoice Subtotal: 585.72
E=Netered, T=Taxable, *centered by Hand Indiana Sales Tax On: 0.00 ..... 0.00
Invoice Total: 585.72
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: ON
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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))
10/30/12 GT401248 $585.72
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
VOUCHER NO. WARRANT NO.
ALLOWED 20
North Central Co-op
IN SUM OF $
P. O.. Box 299
Wabash, IN 46992
$585.72
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO#/Dept. INVOICE NO. I ACCT#/TITLE AMOUNT Board Members
2201 I GT401248 I 42-313.001 $585.72 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, November 01, 2012
y Street Commissioner
� u
Street CornrTitle.icrer
Cost distribution ledger classification if
claim paid motor vehicle highway fund