227062 12/11/2013 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: $2,431.87
WABASH IN 46992
CHECK NUMBER: 227062
CHECK DATE: 12/1112013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2201 4231500 002325 1, 982 . 25 OIL
2201 4231300 EB304200 449 . 62 DIESEL FUEL
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
Branch Co. MI Hart MI Noble,,villa Cal-a;- 877615-2667
517-278-4561 231-873-2158 765-6755-2-53515508 DATE 12/03/13 15:36:34
P.O. BOX 299 800-440-2667 317-779-OuTj J START 0.0 END 129.2
WABASH. IN 46992 GROSS DELIVERY 129.2 GALLONS
NDIS DISTILLATE DISTILLATI
*# MULTIPLE DELIVERIES AT SITE
CHARGE INVOICE
Driver: EB ERIC BAKER
Customer: 0000921720 Invoice #: EB 304200
CARNEL STREET DEPT Date: 12/3/2013
3400 W 131ST STREET, Time: 15:40
CARMEL, IN 46074
Tres Terms Description Item # Description Legend Quantity Unit Price Item Total
02 NORMAL CHARGE TERNS 4040. SUPER DX-4 BIODIESEL 129.22000 3.48000 449.62
Legend: Invoice Subtotal: 449.62
E=Metered, T=Taxable, *centered by Hand Indiana Sales Tax On: 0.00 ..... 0.00
Invoice Total: 449.62
Customer Signature:
C U TO M E
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Hamilton Petroleum INVOICE INVOICE NO' 002325
16222 AlI1oonvilla ORDER DATE 12/05/13
Noblesville IN 45060 ACCOUNT NV . 0000921720
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~ BATCH 404 CLD
CARMEL STREET DEPT
&V 3400 W 131ST STREET
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CARMEL IN 46074 `
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Z< P O # SHIP DATE TERMS SLS L0C
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�`. __-________-______-___________--________--_--_____-_____-______-____�______-____
12/05/13 DUE 01 /20/2014 CLD 256
PACKAGES SOLD DESCRIPTION UNITS SOLD UNIT PRICE EXTENDED
__-_____________________--___-__-___-_____-__________-_____--______-__--_-______
6574001 ADV PREM THF-DRUM 110 GAL 1� 2000 1232 @0
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` 5574313 ADV GEO 10W30 SYN BLD-DRUM 55 GAL 12 ' 1300 667 '15 \
1274311 ADV GEO 5W20 SYN OLD-QTS 6 GAL 13 .8500 83 , 10
TOTAL DUE $$ 19O2 25 ` -
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( RECEIVED BY .
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VOUCHER NO. WARRANT NO.
ALLOWED 20
North Central Co-op
IN SUM OF $
P. O.. Box 299
Wabash, IN 46992
$2,431.87
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO#/Dept. INVOICE NO, ACCT#/TITLE AMOUNT~ Board Members
2201 EB 304200 j 42-313.00 j $449.62 1 hereby certify that the attached invoice(s), or
2201 002325 42-315.00 $1,982.25 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
o Frid y De ber 0 , 2 13
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
Prescribed by State Board of Accounts City Form Flo.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))
12/03113 EB 304200 $449.62
12/05/13 002325 $1,982.25
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