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218962 04/09/2013 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: $786.39 WABASH IN 46992 CHECK NUMBER: 218962 CHECK DATE: 4/9/2013 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 2201 4231300 GT402310 715 . 64 DIESEL FUEL 2201 4232100 GT402356 70 . 75 GARAGE & MOTOR SUPPIE HOMEWarsaw Wabash Peru Goshen Angola Fremont Logansport Plymouth Rochester ��p o Kokomo Huntington Auburn Constantine 574-753-3673 Star City Call: 800-720-0550 Call: 800-234-0573 800-807-3673 Call: 574-224-2667 Cc-ap 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 317-772 ^P 0 WABASH, IN 46992 5ALE7 7860 DATE 03/26/13 14:37:07 COUNT: START 0.0 END 199.9 GROSS DELIVERY 199.9 GALLONS 4040 SUPER DX-4 BIODIESDISTILLATI f* MULTIPLE DELIVERIES AT SITE CHARGE INVOICE Driver: GT GARY TEETERS Customer: 00M1720 Invoice #: GT 402310 CARME- STREET DEPT Date: 3126/20i3 3400 W 131ST STREET Time: 14:18 CARMEL, IN 46074 Trms Terms Description Item # Description Legend Quantity Unit Price Item Total 02 NORMAL CHARGE TERMS 4040 SUPER DX-4 BIODIESEL E 199.9000 3.58000 715.64 Legend: Invoice Subtotal: 715.64 E=Metered,'T=Taxable, *=Entered by Hand Indiana Sales Tax On: 0.00 ..... 0.00 Invoice Total: 715.64 WARNING — PETROLEUM PRODUCTS NOT TO BE USED FOR STARTING OR KINDLING FIRES. GAMINES NOT SOLD FOR ILLUMINATING OR CLEANING PURPOSES. IN CASE OF EMERGENCY CONTACT CHENTREC AT 1-800-424-9300 WE APPRECIATE YOUR BUSINESS"' Customer Signature: 2ti- CUSTOMER VOUCHER NO. WARRANT NO. ALLOWED 20 North Central Co-op IN SUM OF $ P. O.. Box 299 Wabash, IN 46992 $715.64 ON ACCOUNT OF APPROPRIATION FOR Carmel Street Department PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members 2201 I GT402310 I 42-313.001 $715.64 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 17 J Wedn `day 13 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)) 03/26/13 GT402310 $715.64 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 He= Warsaw Wabash Peru Goshen Angola Fremont Logansport Plymouth Rochester CHMWUKokomo Huntington Auburn Constantine 574-753-3673 Star City Call: 800-720-0550 Call: 800-234-0573 800-807-3673 Call: 574-224-2667 co-w 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: 6T GARY TEETERS Customer: 0000921720 Invoice #: 6T 402356 CARMEL STREET DEPT Date: 4/2/2013 3400 W 131ST STEM Time: 15:00 CARMEL, IN 46074 Tres Terms Description Item # Description Legend Quantity Unit Price Item Total 02 NORMAL CHARGE TERMS 0573711 ADV MV 46 — PAIL * 5.0000 14.15000 70.75 Legend: Invoice Subtotal: 70.75 E=Metered, T=Taxable, *--Entered by Hand Indiana Sales Tax On: 0.00 ..... 0.00 Invoice Total: 70.75 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 I-80-424-9360 WE APPRECIATE YOUR BUSINESS"' Customer Signature: CUSTOMER VOUCHER NO. WARRANT NO. ALLOWED 20 North Central Co-op IN SUM OF $ P. O.. Box 299 Wabash, IN 46992 $70.75 ON ACCOUNT OF APPROPRIATION FOR Carmel Street Department PO#/Dept. INVOICE NO. I ACCT#/TITLE AMOUNT Board Members 2201 I GT 402356 I 42-321.001 $70.75 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 )/b . a All Y" ,iWoulm M 12013 U(AJVW A­t�M StrctEWG6*ffiMf6ner 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)) 04/02/13 GT 402356 $70.75 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