HomeMy WebLinkAbout228648 1/28/2014 CITY OF CARMEL, INDIANA VENDOR: 366089 Page 1 of 1
ONE CIVIC SQUARE NORTH CENTRAL CO-OP CHECK AMOUNT: $2,222.00
,?o CARMEL, INDIANA 46032 PO BOX 299
WABASH 1N 46992 CHECK NUMBER: 228648
CHECK DATE: 1/28/2014
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2201 4231300 GT404556 1, 078 . 00 DIESEL FUEL
2201 4231500 GT404556 1, 144 . 00 OIL
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P.O. BOX 299 800-440-2667 317-770 9505 DATE 01/17/14 09:44:24
WABASH, IN 46992 COUNT: START 0.0 END 440.0
GROSS DELIVERY 440.0 GALLONS
4040 SUPER DX-4 BIODIESDISTILLATI
MULTIPLE DELIVERIES AT SITE *
CHARGE INVOICE
Driver: GT GARY TEETERS
Customer: 0000921720 Invoice #: GT 404556
CARMEL STREET DEPT Date: 1/17/2014
3400 W 131ST STREET Time: 10:01
CARMEL, IN 46074
Tres Terms Description Item # Description Legend Quantity Unit Price Item Total
02 NORMAL CHARGE TERMS 4040 SUPER DX-4 BIODIESEL 308.0000 3.50000 1078.00
02 NORMAL CHARGE TERMS 4031 Heater Oil 132.0000 4.00000 528.00
02 NORMAL CHARGE TERMS 5574001 ADV PREM THF-DRUM * 55.0000 11.20000 616.00
Legend: Invoice Subtotal: 2,222.00
E=Metered, T=Taxable, *centered by Hand Indiana Sales Tax On: 0.00 ..... 0.00
Invoice Total: 2,222.00
WARNING - PETROLEUM PRODUCTS NOT TO BE USED FOR STARTING OR KINDLING FIRES. GASOLINES NOT SOLD FOR ILLUMINATING OR CLEANING PURPOSE
S. IN CASE OF EMERGENCY CONTACT CHEMTREC AT 1-800-424-9300 WE APPRECIATE YOUR BUSINESS!!! -
Customer Signature:
ZZ
CUSTOMER
VOUCHER NO. WARRANT NO.
ALLOWED 20
North Central Co-op
IN SUM OF $
P. O.. Box 299
Wabash, IN 46992
$2,222.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
2201 GT 404556 1 42-313.00 $1,078.00 I hereby certify that the attached invoice(s), or
2201 GT 404556 42-315.00 $1,144.00 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
W%n s P ,q2, 2014
V
Stre% rQFZ55Wroner
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))
01/17/14 GT 404556 $1,078.00
01/17/14 GT 404556 $1,144.00
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