239804 12/03/14 .F�q
CITY OF CARMEL, INDIANA VENDOR: 354275
js .I ONE CIVIC SQUARE T B A & OIL WAREHOUSE, INC CHECK AMOUNT: $********99.78*
x ?q CARMEL, INDIANA 46032 2425 E 30TH ST CHECK NUMBER: 239804
INDIANAPOLIS IN 46218-2724 CHECK DATE: 12/03/14
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4237000 03MS0575 99.78 REPAIR PARTS
TBA North Invoice
309 Gradle Dr. No. 03MS0575
Carmel, IN 46032
317-574-1957 FAX: 317-574-1982 II IIII III IIIIIIII IIII II I it II III I II
Page 1
13:59:27 Nov 24 2014
CUSTOMER NUMBER Invoice NUMBER Invoice DATE PACKING SLIP TERMS WHSE
318 03MS0575 11/24/14 03UN4810001 NET 10TH 030
BILL TO: SHIPPED TO:
CARMEL POLICE CITY GARAGE CARMEL POLICE CITY GARAGE
3 CIVIC SQUARE 3400 W 131ST `
CARMEL, IN 46032 CARMEL, IN 46074
Dept: 002 CARMEL POLICE CITY GARAGE Contact:JASON /Route: NORTH Direction:
YOUR P.O.NUMBER ORDER DATE CSR SHIPPED VIA CARTONS11/24/14, 13:59:26 000001 ONLINE ORDERS N NORTH A 1 ACX
"x* ACX Reference No: AU4915 **
UNIT ORDER BACK INV LIST CORE NET NET EXT
ITEM DESCRIPTION BIN QTY ORDERED QTY PRICE PRICE PRICE CORE PRICE
2009 CHEVROLET IMPALA
V6-3880cc 3.9L FLEX/FI
Vin M ID#39056
GYB 49003 GOODYEAR PULLY U EA 1 0 1 38.00 0.00 15.64 0.00 15.64
RAF ATD1159P AT POLICE PAD SET U EA 2 0 2 -94.88 0.00 42.07 0.00 84.14
TOTAL PURCHASE TOTAL LIST TOTAL MDSE TOTAL CORE FREIGHT TAX PCT TAX AMT
INVOICE TOTAL PAYMENTS BALANCE DUE
99.78 227.76 99.78 0.00 0.00 0.00 99.78 - ' 0.00 99.78
2.08% service charge on past due accounts(25% per annum). .._
Core returns must be in original box. All new returns must
be resalable. No return after 30 days without invoice.
--------------------------------------- — — -----
VOUCHER NO. WARRANT NO.
TBA N�b u
ALLOWED 20
IN SUM OF$
$99.78
ON ACCOUNT OF APPROPRIATION FOR
Carmel Police Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1110 I 03MS0575 I 42-370.00 ( $99.78 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
Wednesday, November 26, 2014
Chief of Police
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
j 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.
i
Payee
Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s)or bill(s))
11/24/14 03MS0575 repair parts $99.78
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 5-11710-1.6
20
Clerk-Treasurer