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225913 11/05/2013 CITY OF CARMEL, INDIANA VENDOR: 366089 Page 1 of 1 ONE CIVIC SQUARE NORTH CENTRAL CO-OP CHECK AMOUNT: $3,055.84 CARMEL, INDIANA 46032 PO Box 299 L.oM.�o WABASH IN 46992 CHECK NUMBER: 225913 CHECK DATE: 11/5/2013 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 2201 4232100 GT403953 81 . 55 GARAGE & MOTOR SUPPIE 2201 4232100 GT403963 616 . 00 GARAGE & MOTOR SUPPIE 2201 4231300 GT404009 685 . 30 DIESEL FUEL 1207 4231300 GT404013 757 . 39 DIESEL FUEL 1207 4231400 GT404013 915 . 60 GASOLINE HommWarsaw Wabash Peru Goshen Angola Fremont Logansport Plymouth Rochester CmcmmKokomo Huntington Auburn Constantine 574-753-3673 Star City Call: 800,720-0550 Call:800-234-0573 800-807-3673 Call: 574-224-2667 (C(D_GTI 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: GT GARY TEETERS Customer: 0060921720 Invoice #: GT 403963 CARMEL STREET DEPT Date: 10/24/2013 3400 W 131ST STREET Time: 09:36 CARMEL, IN 46074 Tres Terms Description Item # Description Legend Quantity Unit Price Item Total 02 NORMAL CHARGE TERMS 5574001 ADV PREM THE-DRUM * 55.0000 11.20000 616.00 Legend: Invoice Subtotal: 616.00 E=Metered, T=Taxable, *centered by Hand Indiana Sales Tax On: 0.00 ..... 0.00 Invoice Total: 616.00 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: 223 (OUSTOMER NORMWarsaw Wabash Peru Goshen Angola Fremont Logansport Plymouth Rochester (CM Kokomo Huntington Auburn Constantine 574-753-3673 Star City Call: 800-720-0550 Call: 800-234-0573 800-807-3673 Cal 174-224-2667 (CG_OTI 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: GT GARY TEETERS Customer: 0000921720 Invoice t#: GT 403953 CARMEL STREET DEPT Date:-10!2312013 3409 W 131ST STREET Time: 09:19 CARMEL, IN 46074 Tres Terms Description Item # Description Legend Quantity Unit Price Item Total 02 NORMAL CHARGE TERMS 5574402 CMC ATF MULTI—VEH SY 5.0000 16.31000 81.55 Legend: Invoice Subtotal: 81.55 E=Metered, T=Taxable, *=Entered by Hand Indiana Sales Tax On: 0.00 ..... 0.00 Invoice Total: 81.55 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 1-800-424-9300 WE APPRECIATE YOUR BUSINESS"' Customer Signature: CUSTOMER I HommWarsaw Wabash Peru Goshen ans ort Angola Fremont Lo Plymouth Rochester 9 Logansport Y (CNYMEL Kokomo Huntington Auburn Constantine 574-753-3673 Star City Call: 800-720-0550 Call: 800-234-0573 800-807-3673 Call: 574-224-2667 C�T) 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 317-77 0 WABASH,IN 4699231 9078 DATE 10/29/13 14:17:21 COUNT: START 0.0 END 195.8 GROSS DELIVERY 195.8 GALLONS 4040 SUPER DX-4 BIODIESDISTILLATI $ MULTIPLE DELIVERIES AT SITE CHARGE INVOICE Driver: GT GARY TEETERS Customer: 0000921720 Invoice #: GT 404009 CARMEL STREET DEPT Date: 10/29/2013 3400 W 131ST STREET Time: 13:53 CARMEL, IN 46074 Trms Terms Description Item # Description Legend Quantity Unit Price Item Total 02 NORMAL CHARGE TERMS 4040 SUPER-DX-4 BIODIESEL E 195.8000 3.50000 685.30 Legend: Invoice Subtotal: 685.30 E=Metered, T=Taxable, *=Entered by Hand Indiana Sales Tax On: 0.00 ..... 0.00 Invoice Total: 685.30 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: CUSTOMER VOUCHER NO. WARRANT NO. ALLOWED 20 North Central Co-op IN SUM OF $ P. O.. Box 299 Wabash, IN 46992 $1,382.85 ON ACCOUNT OF APPROPRIATION FOR Carmel Street Department PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members 2201 GT 403953 42-321.00 $81.55 1 hereby certify that the attached invoice(s), or 2201 GT 403963 42-321.00 $616.00 bill(s) is (are) true and correct and that the 2201 GT 404009 42-313.00 $685.30 materials or services itemized thereon for which charge is made were ordered and received except T Ps da ctober 31, 2013 ki�(IpT-V 1 Strew&& t { sl pner 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)) 10/23/13 GT 403953 $81.55 10/24/13 GT 403963 $616.00 10/29/13 GT 404009 $685.30 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 HommWarsaw Wabash Peru Goshen Angola Fremont Logansport Plymouth Rochester Cmqnkm Kokomo Huntington Auburn Constantine 574-753-3673 Star City Call: 800-720-0550 Call: 800-234-0573 800-807-3673 Call: 574-224-2667 CO-01) 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 317-773SPffO WABASH, IN 46992 4899 DATE 10/29/13 18:16:53 COUNT: START 0.0 END 305.2 GROSS DELIVERY 305.2 GALLONS 4011 87 E-10 PLUS GASOLINE i f* MULTIPLE DELIVERIES AT SITE SALE 9082 DATE 10/29/13 18:05:44 COUNT: START 0.0 END 200.7 GROSS DELIVERY 200.7 GALLONS 4040 SUPER DX-4 BIODIESDISTILLATI MULTIPLE DELIVERIES AT SITE CHARGE INVOICE Driver: GT GARY TEETERS Customer: 0000918936 Invoice #: GT 404013 BROOKSHIRE GOLF CLUB Date: 10/29/2013 CITY OF CARMEL Time: 17:46 12120 BROOKSHIRE PKWY CARMEL, IN 46033- Tres Terms Description Item # Description Legend Quantity Unit Price Item Total 02 NORMAL CHARGE TERNS 4011 87 E-10 PLUS E 305:2000 3.00000 915.60 State Road Tax 0.18000 54.94 02 NORMAL CHARM TERMS 4040 SUPER DX-4 BIODIESEL E 200.7000 3.50000 702.45 Legend: Invoice Subtotal: 1,672.99 E=Metered, T=Taxable, entered by Hand Indiana Sales Tax On: 0.00 ..... 0.00 Invoice Total: 1,672.99 WARNING - PETROLEUM PRODUCTS NOT TO BE USED FOR STARTING OR KINDLING FIRES. 6ASOLINES NOT SOLD FOR ILLUMINATING OR CLEANING PURPOSES. IN CASE OF EMERGENCY CONTACT CHEMTREC AT 1-800-424-9300 WE APPRECIATE YOUR BUSINESS!!! Customer Signature: i (OUSTOMErin-� VOUCHER NO. WARRANT NO. ALLOWED 20 North Central Co-op IN SUM OF $ P.O. Box 299 Wabash, IN 46992 $1,672.99 ON ACCOUNT OF APPROPRIATION FOR Brookshire Golf Club PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members 1207 I GT 40401' 42-314.00 $915.60 1 hereby certify that the attached invoice(s), or o?O` GT 4U-,U I 42-31,x.00 S757.39 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, October 31, 2013 Director, Brookshir olf 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)) 10/29/13 GT 404013 Fuel $915.60 10/29/13 GT 404013 Diesel $757.39 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