244808 4 /29/2015 0`iy..c�g4 CITY OF CARMEL, INDIANA VENDOR: -354275
j; ® ONE CIVIC SQUARE T B A & OIL WAREHOUSE, INC CHECK AMOUNT: $"•""'33,72'
�9 IQ CARMEL, INDIANA 46032 2425 E 30TH ST CHECK NUMBER: 244808
M�i6N INDIANAPOLIS IN 46218-2724 CHECK DATE: 04/29/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
601 5023990 03NA9997 33.72 OTHER EXPENSES
TBA North Invoice
309 Gracile Dr. No. 03NA9997
Carmel, IN 46032
317-574-1957 FAX: 317-574-1982 II IIIIIIIIIIIIIIIIIII IIIIIIIIIIilllll I III
Page 1
11:09:41 Apr 16 2015
CUSTOMER NUMBER Invoice NUMBER Invoice DATE PACKING SLIP TERMS WHSE
314 03NA9997 04/16/15 03UX9368001 NET 10TH 030
BILL TO: SHIPPED TO:
CITY OF CARMEL WATER CITY OF CARMEL WATER
3450 W. 131ST ST. 3450 W. 131ST ST
CARMEL, IN 46074 CARMEL, IN 46074
Dept: 002 CITY OF CARMEL WATER Contact: /317-733-2853 Route: NORTH Direction:
YOUR P.O.NUMBER ORDER DATE CSR SHIPPED VIA CARTONS OPER
04/16/15, 11:09:40 200003 MATT SEGERSON N NORTH A 1 202
UNIT ORDER BACK INV LIST CORE NET NET EXT
ITEM DESCRIPTION BIN QTY ORDERED QTY PRICE PRICE PRICE CORE PRICE
HAS LF613F HASTINGS OIL FILTER U EA 6 0 6 7.72 0.00 2.52 0.00 15.12
HAS LF11OF HASTINGS OIL FILTER U EA 6 0 6 5.99 0.00 1.55 0.00 9.30
HAS LF487F HASTINGS OIL FILTER U EA 6 0 6 6.43 0.00 1.55 0.00 9.30
TOTAL PURCHASE TOTAL LIST TOTAL MDSE TOTAL CORE FREIGHT TAX PCT TAX AMT INVOICE TOTAL PAYMENTS BALANCE DUE
33.72 120.84 33.72 0.00 0.00 0.00 33.72 0.00 33.72
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# 151589 WARRANT# ALLOWED
354275 IN SUM OF $
TBA WAREHOUSE-INDY
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2425 E 30TH STREET ;{
INDIANAPOLIS, IN 46218
Carmel Water Utility
ON ACCOUNT OF APPROPRIATION FOR j
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Board members
PO# INV# ACCT# AMOUNT j Audit Trail Code
03NA9997 01-6500-04 $33.72 II
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Voucher Total $33.72
Cost distribution ledger classification if
claim paid under vehicle highway fund
x
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 of service rendered, by whom, rates per day, number of units,
price per unit, etc.
Payee
354275
TBA WAREHOUSE-INDY Purchase Order No.
i
2425 E 30TH STREET Terms
INDIANAPOLIS, IN 46218 Due Date 4/21/2015
i
i
Invoice Invoice Description
Date Number (or note attached ,invoice(s) or bill(s)) Amount
4/21/2015 03NA9997 $33.72
1
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
Date Officer