251977 12/02/15 CAA .
CITY OF CARMEL, INDIANA VENDOR: 355214
ONE CIVIC SQUARE GENUINE PARTS COMPANY-INDIANAPahfCK AMOUNT: $ '""121.15"
CARMEL, INDIANA 46032 5959 COLLECTIONS CENTER DRIVE CHECK NUMBER: 251977
CHICAGO IL 60693 CHECK DATE: 12/02/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2200 4237000 08518032 121.15 REPAIR PARTS
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100006017 — -'—' --__--- —'
CARMEL NAPA Time: 15:27 ! Invoice Number 008775;
AMPAW1441 S GUILFORD RD STE 140 I ILII)VIII VIII VIII VIII ILII IIII IIII°
WAPAICARMEL
� REF BY VER BY _ Date: 11/16/2015 €!
, IN 46032-2922 t
(317) 844-3973 Page: 1/1
18032 Employee: 26 Jared
® CITY OF CARMEL ENGINEERING Sales Rep: 10 Store
1 CIVIC SQ i Accounting Day: 16 OCR
® CARMEL, IN 46032-2584
0 i 1000060170087753
fr.`
'Part"`Number. L'irce' Descr.i on. _ uantit• .rPr-ice;">°i ; :"Ret>',
^....,�, �. .,.. .,.,t..,m.:........... _ ...'<...:.,,.z;_e _. . ,�.s.,':.:.a;L,L,•.e__»,:,,,,.�.....t.._.,.-o.;a.;:;.::i�.`::�ss."sE'.cz .m....,.... ,..�..a_._» ., :::. ..�....,..m. ...:,t� ....-._-M_,...... .__.<-,,:zt.. �.:_....,..<....-
2009 Ford Truck F150 1/2 Ton - Pic up
SS-7915-M SS� 'Brake Pads - Front, Premium (SS) 1.001 68.641 43.5900 M 43.59 fT
SS-7916-M ISS Brake Pads - Rear, Premium - (SS) 1.00 62.42( 39.6400' 39.64 sT
782-4001 1BK ;16FT 6G BSTR CBL-VALU (180) 1.00 36.29 29.9900` 29.99 'T
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Delivery: Subtotal 113.22
Attention: Indiana Sales Tax 7.0000% 7.93
Tax Exemp C
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0#: e3
ms:
Customer Signature 7 Charge Sale 121.15
ALLGOODS RETURNED MUST BE ACCOMPANIED BY THIS INVOICE 2- L OD L(23 I0C,0
REMIT:GPC-TND
5959 COLLECTION CTR.DR.
CHICAGO ILL. 60693
CUSTOMER COPY
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
GPC-IN Purchase Order No.
5959 Collections Center Drive Terms
Chicago, IL 60693 Date Due
Invoice Invoice Description
Date Number (or note attached invoice(s)or bill(s) Amount
11/16/2015 8775 Brake pads for E3 $ 121.15
Total $ 121.15
1 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
VOUCHER NO WARRANT NO.
GPC-IN ALLOWED 20
5959 Collections Center Drive IN SUM OF$
Chicago, IL 60693
$ 121.15
ON ACCOUNT OF APPROPRIATION FOR
Board Members
PO#or INVOICE NO. ACCT#/TITLE AMOUNT
DEPT# I hereby certify that the attached invoice(s), or
0 8775 2200-4237000 s 121.15 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
11/30/2015
Signature
City Engineer
Cost Distribution ledger classification if Title
claim paid motor vehicle highway fund
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