221633 07/02/2013 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: $4,304.42
'+ WABASH IN 46992 CHECK NUMBER: 221633
CHECK DATE: 7/2/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2201 4231300 EB302792 1, 810 . 26 DIESEL FUEL
1207 4231300 GT403014 1, 027 . 51 DIESEL FUEL
1207 4231400 GT403014 723 . 87 GASOLINE
2201 4232100 GT403042 742 . 78 GARAGE & MOTOR SUPPIE
HORMWarsaw Wabash Peru Goshen Angola Fremont Logansport Plymouth Rochester
p Kokomo Huntington Auburn Constantine 574-753-3673 Star City
Call: 800-720-0550 Call: 1100-234-0573 800-807-3673 Ca 574-224-2667
877-615-2667
P.O. Branch Co. MI Hart MI � Noblesville
517-278-4561 231-873-2158 765-67SA53814208 DATE 06/13/13 10:54:44
WABASH, IN 466 992
P.O.BOX 2 800-440-2667 317-77MWi3 START 0.0 END 518.7
GROSS DELIVERY 518.7 GALLONS
NDIS DISTILLATE DISTILLATI
* MULTIPLE DELIVERIES AT SITE
CHARM INVOICE
Driver: EB ERIC BAKER
Customer: 0000921720 Invoice #: EB 302792
CARMEL STREET DEPT Date: 6/13/2013
3400 W 131ST STREET Time: 10:39
CARMEL, IN 46074
Trms Terms Description Item # Description Legend Quantity Unit Price Item Total
02 NORMAL CHARGE TERMS 4040 SUPER D%-4 BIODIESEL 518.7000 3.49000 1810.26
Legend: Invoice Subtotal: 1,810.26
E=Metered, T=Taxable, *centered by Hand Indiana Sales Tax On: 0.00 ..... 0.00
Invoice Total: 1,810.26
Customer Signature: C
�I
(CUSTOMER
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))
06/13/13 EB 302792 $1,810.26
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
$1,810.26
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
2201 I EB 302792 1 42-313.001 $1,810.26 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
rs 013
§W;tCr
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
�OL\S S JS JS Warsaw Wabash Peru Goshen Angola Fremont Logansport Plymouth Rochester
p A Kokomo Huntington Auburn Constantine 574-753-3673 Star City
Call: 800-720-0550 Call: 800-234-0573 800-807-3673 Call: 574-224-2667
V Branch Co. MI Hart MI Noblesville 877'615-2667
517-278-4561 231-873-2158 765-67'.SA10- 8 8361 DATE 06/26/13 15:06:05
P.O. BOX 2 6 800-440-2667 317-77;M'i; START 0.0 END 303.2
WABASH. IN asss2 GROSS DELIVERY 303.2 GALLONS
4040 SUPER DX-4 BIODIESDISTILLATI
** MULTIPLE DELIVERIES AT SITE
SALE 4389 DATE 06/26/13 15:16:22
COUNT: START 0.0 END 214.8
GROSS DELIVERY 214.8 GALLONS
4011 87 E-10 PLUS GASOLINE 1
MULTIPLE DELIVERIES AT SITE
I
CHARGE INVOICE
Driver: GT GARY TEETERS
Customer: 0000918936 Invoice #: GT 4014
BROOKSHIRE GOLF CLUB Date: 6/26/2013
CITY OF CARMEL Time: 14:50
1212® 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 214.8M 3.19000 685.21
State Road Tax 0.18000 38.66
I
02 NORMAL CHARGE TERMS 4040 SUPER DX-4 BIODIESEL E 303.IM 3.39M 1027.51
Legend: Invoice Subtotal: 1,751.38
E=Ietered, T=Taxable, *=Entered by Hand Indiana Sales Tax On: 0.00 ..... 0.00
Invoice Total: 1,751.38
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:
CUSTOMIEFID-,�
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))
06/26/13 GT 403014 Diesel $1,027.51
06/26/13 GT 403014 Fuel $723.87
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
$1,751.38
ON ACCOUNT OF APPROPRIATION FOR
Brookshire Golf Club
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1207 GT 403014 42-313.00 [:$1,027.51 1 hereby certify that the attached invoice(s), or
1207 GT 403014 __42-314,00 $723.87 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, June 28, 2013
Director, Brookshir Golf Club
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
�O Warsaw Wabash Peru Goshen Angola Fremont Logansport PI mouth Rochester
9 Y
Q Kokomo Huntington Auburn Constantine 574-753-3673 Star City
Call: 800-720-0550 Call: 800-'234-0573 800-807-3673 Call: 574-224-2667
Q Branch Co. MI Hart MI Noblesville 877-615-2667
517-278-4561 231-873-2158 765-67:,SAftE38 8382 DATE 06/28/13 15:42:31
WABASHH,, I N 46992
P.O. 299 800-440-2667 317-77;C011Mfi: START 0.0 END 182.1
GROSS DELIVERY 182.1 GALLONS
4040 SUPER DX-4 BIODIESDISTILLATI
MULTIPLE DELIVERIES AT SITE
I
CHARGE INVOICE
Driver: GT GARY TEETERS
Customer: 0000921720 Invoice R: GT 40V42
CARMEL STREET DEPT Date: 6/28/2013
3400 W 131ST STREET Time: 15:22
CAR R, IN 46074
Trms Terms Description Item # Description Legend Quantity Unit Price Item Total
02 NORMAL CHARGE TERMS 4040 SUPER DX-4 BIODIESEL E 182.1000 3.37M 613.68
02 NORMAL CHARGE TERMS 05573704 ADV AW 46 - PAIL * 10.0000 12.91000 129.10
Legend: Invoice Subtotal: 742.78
E=Metered, T=Taxable, *centered by Hand Indiana Sales Tax On: 0.00 ..... 0.00
Invoice Total: 742.78
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 1-8 -424-9300 WE
APPRECIATE YOUR BUSINESS!!!
Customer Signature:
i
I
CUSTOMER
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))
06/28/13 GT 403042 $742.78
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
VOUCHER NO. WARRANT NO.
ALLOWED 20
North Central Co-op
IN SUM OF $
P. O.. Box 299
Wabash, IN 46992
$742.78
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO#/Dept. INVOICE NO. I ACCT#/TITLE AMOUNT Board Members
2201 I GT 403042 I 42-321.001 $742.78 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
Monday, July 01, 2013
V et Co ssi v
r
Title G
Street CoMmlonioMw
Cost distribution ledger classification if
claim paid motor vehicle highway fund