248275 08/12/15 ♦d.C�H9J
qY CITY OF CARMEL, INDIANA VENDOR: 353686
® ONE CIVIC SQUARE CIRCLE CITY AUTO PARTS INC CHECK AMOUNT: S""""77 84'
CARMEL, INDIANA 46032 9700 LAKESHORE DRIVE EAST CHECK NUMBER: 248275
+M r INDIANAPOLIS IN 46280 CHECK DATE: 08/12/15
ETON�
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2201 4237000 651001 77.84 REPAIR PARTS
ALL GOO C#S RETURNED MUST BE ACCOMPANIED BY THIS INVOICE
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CIFZCL_E CITY Af iTo PARTS e
9700 L_AKESHORLE I7 r( FAST
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AUTO PARTS INC.,
A1999 INDIANAPOLIS I N 46*280 ,A
Auto Plus
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2001 P(7„MIKE DATE. 07!i28/1.5
CARMEL. STREET DEPARTMENT _ INv.biCEe 631061
WE,S- F . 1 C 1ST STREET v
WESTFIEI_D IN 46074
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Picked By: www.circlecityautoparts.com Checked By:
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C:I-iF1RGE INVOICE
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RECEIVED BY
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INVOICES NOT PAID BY THE"10TH OF THE MONTH ARE SUBJECT TO A SERVICE CHARGE AND COLLECTION COSTS. -
VOUCHER NO. WARRANT NO.
Circle City Auto Parts ALLOWED 20
IN SUM OF$
9700 Lakeshore Drive East
Indianapolis, IN 46280
$77.84
i
i
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO#/Dept. INVOICE NO. ACCT#!TITLE AMOUNT OUNT Board Members I
2201 j 651001 42-370.00 $77.84 1 hereby certify that the attached invoice(s), or
I
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
[F � I
iday ust 7, 015
VVA/L9 LEV
Sf�� R4)i�l§I;;IR®ter
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))
07/28/15 651001 $77.84
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