HomeMy WebLinkAbout223588 08/27/2013 \,f CITY OF CARMEL, INDIANA VENDOR: 366089 Page 1 of 1
ONE CIVIC SQUARE NORTH CENTRAL CO-OP
s, io CARMEL, INDIANA 46032 PO BOX 299 CHECK AMOUNT: $597.66
•',� WABASH IN 46992 CHECK NUMBER: 223588
CHECK DATE: 8/27/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2201 4231300 GT403437 597 . 66 DIESEL FUEL
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517-278-4561 231-873-2158 765-67f38 8665 DATE 08/21/13 08:45:53
P.O. BOX 299 800-440-2667 317-77M
WABASH, IN 46992 TP START 0.0 END 176.3
GROSS DELIVERY 176.3 GALL
4040 SUPER DX-4 BIODIESDISTILLATi
�* MULTIPLE DELIVERIES AT SITE
CHARGE INVOICE
Driver: GT GARY TEETERS
Customer: 0000921720 Invoice #: GT 4033437
CARMEL STREET DEPT Date: 8/21/2013
3400 W 131ST STREET Time: 08:24
CARMEL, IN 46074
Trms Terms Description Item # Description Legend Quantity Unit Price Item Total
02 NORMAL CHARGE TERMS 4040 SUPER DX-4 BIODIESEL E 176.3000 3.39000 597.66
Legend: Invoice Subtotal: 597.66
E=Metered, T=Taxable, *=Entered by Nand Indiana Sales Tax On: 0.09 ..... 0.00
Invoice Total: 597.66
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 1-800-424-93300 WE
APPRECIATE YOUR BUSINESS!!!
Customer Signature: c o
CUSTOMER
VOUCHER NO. WARRANT NO.
ALLOWED 20
North Central Co-op
IN SUM OF $
P. O.. Box 299
Wabash, IN 46992
$597.66
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
2201 I GT 403437 I 42-313.001 $597.66 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
Fri Aug , 3, 2013
Streeftb%FmPA loner
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))
08/21/13 GT 403437 $597.66
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