The URL can be used to link to this page

317431 10/11/2017 U �,qwf CITY OF CARMEL, INDIANA VENDOR: 215000 D ONE CIVIC SQUARE NAPA AUTO PARTS INC CHECK AMOUNT: $**.....964.48" CARMEL, INDIANA 46032 5959 COLLECTION CENTER DRIVE CHECK NUMBER: 317431 CHICAGO IL 60693 CHECK DATE: 10/11/17 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 2201 4237000 8517995 915.48 REPAIR PARTS 2201 4357004 8517995 49.00 EXTERNAL INSTRUCT FEE a 2 < « ?_ > ID } \ \ \ 2 k 0 > 0 # > n n O / / ® m \ O e 0 % / 70 z K / E > o O 7 e c o ¥ $ / = o E m (D Q / / 0 ^ CD / \ OD _ < \ § § " § ƒ / ? k q ƒ [ / e / i ® M 2 < \ G 2 - > m ¥_ � 2 0 2 2 Q > - & \ - O | & @ $ / \ co E % _ #e I CD \\ k/ \/ m _ CL A § ° k & e $ \ Fn, CD R f \ E w 0. \ w 5 + - E - > 2 / ! E G Cl) co $ / 0 CDk = \ _ ƒ - • k / CD k } ƒ a) ° k 2 w & 0 { - m ƒ § « 3 3 ) \ ¢ -a %Z § § b § q CL e OL ° ° ` - 2 ' w a m \ \ U) 7 cy m % \ \ ) \ # j � § � 44 0 [ 0 CD a} § ° § ° § a _ m f C ) ( ® $ 6 �_ z 0> A } § § %k k k C/) # � & _0 Ln O e� = D }n ( \ / §/ e D� a= D \ \ / \ \ � 0 / g COD } j E / c r O E ¥_ « 2 \ ] i CD cr C (n CD cz f ® \ a § § m } r n § C 2 - � / § a D \ ] § \ ^ 7 C > \ ƒ § } k '69 0 CD C @ E OD E ® \ 51o, o� - " Aq-w, 3Jo - Tq,(5.g8 --- --------------- THIS INTENTIONLLY LEFT BLANK SECTION A -------------------------------------------------------------------- Visit our website for invoice copies and to make a payment. Page 2 of 3 41APAI , � www. NAPAaccount.com CUSTOMER NAME: CITY OF CARMEL-STREET DEPT ACCOUNT NO: TERMS TOTAL AMT DUE THIS MONTH $3,362.87 8517995 45 Day Pnc CLOSING DATE 09/30/2017 AGED ACCOUNT STATUS Current Total Past Due Amounts Due Future Months Total Open 3,215.87 147.00 915.48 4,278.35 Past Due 1 -30 Days Past Due 31-60 Days Past Due 61 -90 Days Past Due 90+Days 0.00 49.00 0.00 98.00 Type Inv Date Due Date Code Invoice# P.O.# Open Amount Explanation 03/01/17 04/20/17 INV 10000150993 49.00 05/16/17 06/20/17 INV 10000163106 49.00 07/14/17 08/20/17 INV 10000172626 Dealer Training 49.00 08/01/17 10/15/17 INV 104184 201.99 08/01/17 10/15/17 INV 977015 Truck 12 570.16 08/02/17 10/15/17 INV 977153 11.61 08/04/17 10/15/17 INV 104767 Street Sweeper 54.30 08/09/17 10/15/17 INV 105420 41.94 08/10/17 10/15/17 INV 978522 777.71 08/14/17 10/15/17 INV 106233 12.52 08/15/17 10/15/17 INV 979255 51.00 08/15/17 10/15/17 INV 979265 10.60 08/17/17 10/15/17 INV 979814 143.35 08/17/17 10/15/17 INV 979828 19.94 08/21/17 10/15/17 INV 980212 223.99 08/23/17 10/15/17 INV 107760 18.08 08/25/17 10/15/17 INV 981181 102.44 08/30/17 10/15/17 INV 981969 425.84 08/31/17 10/15/17 INV 982092 TRK 17 501.40 09/19/17 10/20/17 INV 10000182965 Dealer Trainina 49.00 Total Current Due 3,362.87 Future Due 09/01/17 11/15/17 INV 109290 9-1-17 45.78 09/05/17 11/15/17 INV 982737 208.56 09/07/17 11/15/17 INV 109967 Truck 57 12.20 09/07/17 11/15/17 INV 983141 Stock 72.92 09/07/17 11/15/17 CR 983185 807478 -45.00 09/18/17 11/15/17 INV 111463 31.42 09/18/17 11/15/17 INV 984992 104.33 09/19/17 11/15/17 INV 111744 global 179.04 09/20/17 11/15/17 INV 985491 104.33 09/26/17 11/15/17 INV 986392 94.25 INV-Invoice CR-Credit Memo DED-Charge Back OA-On Account Payment OC-Finance Charge SPAIfiMP.ARTS Page 3 of 3 CUSTOMER NAME: CITY OF CARMEL-STREET DEPT ACCOUNT NO: TERMS TOTAL AMT DUE THIS MONTH $3,362.87 8517995 45 Day Prx CLOSING DATE 09/30/2017 Twe Inv Date Due Date Code Invoice# P.O.# Open Amount Explanation 09/26/17 11/15/17 INV 986394 65.01 09/27/17 11/15/17 INV 113021 23.98 09/27/17 11/15/17 INV 986657 15.60 09/28/17 11/15/17 INV 113178 3.06 Total Future Amount 915.48 INV-Invoice CR-Credit Memo DED-Charge Back OA-On Account Payment OC-Finance Charge 00 00 000000 229586 AIIIIIIIIIIIIIIII1111, Invoice No: 10000182965 INAPAk INVOICE Invoice Date: 9/19/17 +ill■Mir . Page: 1 of 1 Remit To: Customer No: 8517995 NAPA AUTO PARTS Payment Terms: 20th Prox 5959 Collections Center Dr. Due Date: 10/20/17 Chicago IL 60693 United States Bill To: AMOUNT DUE: 49.00 USD CITY OF CARMEL-STREET DEPT 3400 W 131 ST ST CARMEL IN 46074-8267 United States Amount Remitted For billing questions, please call Original Line Description Quantity UOM Unit Amt Net Amount 1 DEALER TRAINING 1.00 EA 49.00 49.00 Dealer Training Subtotal: 49.00 AMOUNT DUE: 49.00 USD Dealer Training - Remit to: (NAPA/ Genuine Parts Company, Inc. - 5959 Collections Center D ® Chicago, IL 60693 NAPA AUTO PARTS IND013 (IND) 4904 WEST 106TH STREET RECEIVED BY X MUST HAVE RECEIPT FOR RETURN 100006013986392 ACCT NO SOLD TO DATE JINVOICE1 STOR EMP SR 17995 CITY OF CARMEL-STREET DEPT .ACCT 7995 CARMEL IN (26) 460748267 INVOICE TYPE CHGE TY PART NUMBER LINE DESCRIPTION PRICE NET TOTAL CODE 5 . 00 715-1125 01 COUPLER . 0 . 00C 38 .50 . 00 00 . 0 C . 00 C . 00 1 . 00 715-1341 02 COUPLER . 0 . 00C 55 . 75 . 00 00 . 0 C 00 C . 00 3 . 00 03 . 0 . 00 . 00 T . 00 00 . 0 . 00 . 00 SUE 94 .25 MISC 00 . 000 TAX 00 TOT L 94 .25 CHGE 100006013 NAPA AUTO PARTS Time: 08:26 Invoice Number 0903-983141 NAPAAMR= , RETURNS IN ORIG BOX W RECEIPT up • REF BY VER BY Date: 09/07/2017 (III�III{Illlllllltll[IIIIIIIIIIIII�I�I 317-733-2180. IN 46077 `l (317) 733-2180 Page: 1/1 17995 Employee: 1 Keith • CITY OF CARMEL-STREET DEPT Sales Rep: 36 Ted Y Y 3400 W 131ST ST Accounting Day: 7 OCR CARMEL, IN 46074-8267 1000060139831418 Part Number Line Description Quantity Price Net Total 6522 FIL NAPAGOLD AIR FILTER () 2.00 55.94 13.9900 27.98 R 2321 FIL NAPAGOLD AIR FILTER (1 2.00 89.86 22.4700 44.94 R Anticipated Time: Our Truck - 99-20:26 Subtotal 72.92 ;��,� Attention: Mike 1 INDIANA SALES TAX 7.00008 0.00 x Exemption: I PO#: tock Ter Total 72 .92 Customer Si ature Charge Sale 72.92 ALL G RETURNED PA OE ACCOMPANIED BY THIS INVOICE REMIT PAYMFNT TO 5959 COLLECTION CRT OR CHICAOD It, 60693 STORE COPY 100006013 ' NAPA AUTO PA S Time: 09:48 Invoice Number 0903-983185 N APA RETURNS 0 IG BOX W RECEIPT ! • REF BY VER BY Date: 09/07/2017 IIlfl�ll�l�ll�I�IIIIIIIIII�III��EIIIl��F 317-733-2180, IN 46077 (317) 733-2180 Page: 1/1 17995 Employee: 1 Keith • CITY OF CARMEL-STREET DEPT Sales Rep: 36 Ted Y Y 3400 W 131ST ST Accounting Day: 7 OCR • CARMEL, IN 46074-8267 10000601.39831.855 Part Number Line Description Quantity Price Net Total 8223 BAT Core Deposit (T34) -2.00 9.00 9.0000 18.00 CR D 7575 BAT Core Deposit (T34) -1.00 18.00 18.0000 18.00 CR 0 8227.NF ' BAT Core Deposit 1} -1.00 9.00 9.0000 9.00 CR D Anticipated Time: Subtotal 45.00ca t. Attention: INDIANA SALES TAX 7.00008 0.00 Tax Exemption: PO#: 807478 Terms: Total 45.000R Customer Signature Credit Memo 45.00 CR ALLGOOD$RETURNED MUST BE ACCOMPANIED BY THIS INVOICE REMIT PAYMENT TO S959 COLLECTION CRT DR CHICAGO IL 60693 STORE COPY 100006013 NAPA AUTO PARTS Time: 10:54 Invoice Number 0903-982737 Nw�w AMVER RETURNS IN OVER BOX W RECEIPT H H s REF BY BY Date: 09/05/2017 2180IIIIIIIIIIIIIIII�IIIIIII�IIIIIIIII�IIIII ® 317-733- , IN 46077 (317) 733-2180 Page: 1/1 17995 � CITY OF CARMEL-STREET DEPT Employee: 6 Tina Y Y 3400 W 131ST ST Sales Rep: 36 Ted � CARMEL, IN 46074-8267 Accounting Day: 5 OCR • _ 1000060139827370 Fart Number Line At :� (z� AteC' of 8822 NFD OIL DRY O D 24.00 15.40 8.6900 208.56 Delivery: Our Truck Subtotal 208.56 Attention: MIKE INDIANA SALES TAX 7.0000% 0.00 Tax Exemption: PO#: Terms: BY ENT Tdtal Customer Sig atur Charge Sale 208.56 ALL GOO S TURNED MUST BE ACCOMPA THIS INVOICE REMIT PAYMENT TO 595 9 COLLECTION CTR DR CHICAGO IL 50693 CUSTOMER COPY 100006017 CARMEL NAPA Time: 14:11 Invoice Number 4329-109290'+ 1441 S GUILFORD RD STE 140 IIIIIIIIIIIIIIII�I�II'IIIIII'IIIIIIIIIII NAPA • REF BY VER BY Date: 09/01/2017 CARMEL, IN 46032-2922 mmom (317) 844-3973 Page: 1/1 7995 Employee: 26 Heather Y Y CITY OF CARMEL-STREET DEPT Sales Rep: 36 Tige 1 3400 W 131ST ST - OCR CARMEL, IN 46074-8267 Accounting Day: 1 1000060171092905 4 52-7371 NBB =Core Deposit (CAL) -1 00- 61.11 61.1161.11CR-.D This item was purchased on invoice # 978522: 08/10/2017: 360-113 NSE 'NITRILE DISPOS GLOVE (430) 10.00: 30.44` 9.99 99.90 T R38TD CHT WARRANTY (C60) -1.00`. 41.04'• 22.94' 22.94 CR' This item was purchased on invoice # 989189: 07/06/2015 R38TD CHT '3 BIN DR RATCHET (C60) 1.00: 41.04; 22.941 22.94 615301 -NPT 'WARRANTY (C68,1) -1.00'. 17.80 9.4900 9.49CR'T 615301 NPT 'REDUCER (C68,1) 1.00" 17.80: 9.4900'=: 9.49 T Delivery: Subtotal 38.79 Attention: Indiana Sales Tax 7.0000% 6.99 Tax Exemption: PO#: 9-1-17 Terms: -oil _,�,,. 4 ...//. is Custome S nature Charge Sale 45.78 AL GODS RETURNED MUST BE A OM NIED BY THIS INVOICE REMIT:GPC-IND 5959 COLLECTION CTR.DR. CHICAGO ILL. 60693 CUSTOMER COPY 100006017 CARMEL NAPA Time: 13:24 ? Invoice Number 4329-109967. 1441 S GUILFORD RD STE 140 NAPA - REF BY VER BY _ Date: 09/07/2017 IIIIIIIIIIIIIIIIIIIIilllllilllllllllllll CARMEL, IN 46032-2922 ' (317) 844-39731/1 a17995 ge: 1/1 Employee: 24 DAVE CITY OF CARMEL-STREET DEPT Y Y 3400 W 131ST ST Sales Rep: 36 Tige Accounting Day: 7 ; OCR CARMEL, IN 46074-8267 1000060171099677 „_ .,, r :'} ... . .'' " ,'r a� -r s.; ..:. 733-5408 BK U-BOLT O 2.00 3.10'' 1.6100': 3.22 733-5772 BK 'U-BOLT O 2.00; 8.64' 4.4900, 8.98 t Delivery: Subtotal 12.20 Attention: Nathon Morris Indiana Sales Tax 7.0000% 0.00 Tax Exemption: PO#: Truck 57 Terms: Customer Signature Charge Sale 12.20 ALL GOODS RETURNED MUST BE ACCOMPANIED BY THIS INVOICE REMIT:GPC-IND 5959 COLLECTION CTR.DR. CHICAGO ILL. 60693 CUSTOMER COPY 100006013 NAPA AUTO PARTS Time: 08:57 Invoice Number 0903-984648' RETURNS IN ORIG BOX W RECEIPT M REF BY VER BY Date: 09/15/2017 IIIIIIIIII�IIIIIIIIII�IIIIIIIIIIIIIIIIII 317-733-2180, IN 46077 (317) 733-2180 Page: 1/1 17995 Employee: 1 Keith CITY OF CARMEL-STREET DEPT Y Y Sales Rep: 36 Ted 3400 W 131ST ST OCR � CARMEL, IN 46074-8267 Accounting Day: 15 1000060139846484 Pert Junber Lit, ,.�, � 3��t offal AS11 FFP ''Fluid Film Lubricant 11.75 o (T32) 1.001 17.59': 0.0 0.00 Above Item on Sale Delivery: Our Truck INDIANA SALES TAX 7.0000% 0.00 Attention: Mike Tax Exemption: P #: 22-3 Te Customer Signatur Cash 0.00 ALL GOODS RETURNED MUST BE ACCOMPANIED BY THIS INVOICE REMIT PAYMENT TO 5959 COIA,ECTION CTR DR rHICAGO TL 50693 CUSTOMER COPY 100006017 CARMEL NAPA Time: 12:58 Invoice Number 4329-113021 1441 S GUILFORD RD E 140 III�IIIIIIIIIIIIIIIIII'lllllllllllllllll NAPA REF BY VER BY Date: 09/27/2017 CARMEL, IN 46032-2922 © (317) 844-3973 Page: 1/1 17995 Employee: 31 April CITY OF CARMEL-STREET DEPT Sales Rep: 36 Tige Y Y 3400 W 131ST ST OCR CARMEL, IN 46074-8267 Accoting Dy a : 27 __un . _ �... 1000060171130213 $ YtL1tt1",` a237,77;Fz. � F 360-173 NSE 'LATEX DISPOS GLOVE (430) 2.00 32.14; 11.9900, 23.98 Above Item on Sale Delivery: Subtotal 23.98 Attention: Indiana Sales Tax 7.0000% 0.00 Tax Exemption: PO#: Terms: a _. .. ski s Customer Signature Charge Sale 23.98 ALL GOODS RETURNED MUST BE ACCOMPANIED BY THIS INVOICE REMIT:GPC-IND 5959 COLLECTION CTR.DR. CHICAGO ILL. 60693 CUSTOMER COPY 100006017 ___. .. CARMEL NAPA Time: 09:28 Invoice Number 4329-111463' 1441 S GUILFORD RD STE 140 Nf�111 low • REF BY VER BY Date: 09/18/2017 VIII'IIIIIIIII�III�I��IIIIIIII�IIIIII�I ��RMH CARMEL, IN 46032-2922 n (317) 844-3973 Page: 1/1 17995 ,. Employee: 26 Heather * CITY OF CARMEL-STREET DEPT Sales Rep: 36 Tige Y Y 3400' W 131ST ST OCR � CARMEL, IN 46074-8267 Accounting Day: 18 1000060171114632 Part Number' 'Line 7-3432 NPS PRESSURE HOSE O 1.00 56.901 31.4200 31.42 `;A Delivery: I Subtotal 31.42 Attention: Kevin Indiana Sales Tax 7.0000% 0.00 Tax Exemption: PO#: Terms: ustome ur Charge Sale 31.42 ALL GOODS RETURNED MUST BE ACCOMPANIED BY THIS INVOICE RF'ITIT:GPC-IND. 5959 COLLECTION CTR.DR. CHICAGO ILI,. 60693 CUSTOMER COPY Y`f 100006017 CARMEL NAPA Time: 14:26 Invoice Number 4329-111744€ 1441 S GUILFORD RD STE 140 NAPA AM = REF BY VER BY Date: 09/19/2017 < (I'III�IIIIIII'IIIIIIIII�IIII�IIII�IIIII a CARMEL, IN 46032-2922 ' (317) 844-3973 Page: 1/1 17995 Employee: 26 Heather CITY OF CARMEL-STREET DEPT Sales Rep: 36 Tige Y Y 3400 W 131ST ST Accounting Day: 19 OCR CARMEL, IN 46074-8267 ' 1000060171117443 77, 97811 LIT 'WEST COAST MIRROR O 2.00', 34.62: 22.79001 45.58 97609 LIT 'SMALL FLAT GLASS MIRR O 2.00[ 87.6856.0500' 112.10 97802 LIT '5 ROUND MIRROR O 2.00 16.88 10.6800' 21.36 Delivery: Subtotal 179.04 Attention: Indiana Sales Tax 7.0000% 0.00 Tax Exemption: O#: global e mS: Ya s _kma I 1 Customer S igfWe Charge Sale 179.04 ALL GOODS RETURNED MUST BE ACCOMPAY41ED BY THIS INVOICE t . REMIT:GPC-IND f 5959 COLLECTION CTR.DR. _ CHICAGO ILL. 60693 . CUSTOMER COPY 100006017 CARMEL NAPA Time: 10:55 Invoice Number 4329-113178'' 1441 S GUILFORD RD STE 140 NAPA AMREF BY VER BY Date: 09/28/2017 IIIIII�IIIIIIIIIIIIIIII�IIII�IIIIIII�III CARMEL, IN 46032-2922 ' (317) 844-3973 Page: 1/1 17995 Employee: 33 Kohlstaedt CITY OF CARMEL-STREET DEPT Y Y Sales Rep: 36 Tige 3400 W 131ST ST OCR CARMEL, IN 46074-8267 Accounting Day: 28 � 1000060171131784 1816 LMP 'BULB O 2.00 2.44- 1.5300 3.06 Delivery: Subtotal 3.06 Attention: Indiana Sales Tax 7.0000% 0.00 Tax Exemption: PO#: Terms: k ,def- �.,., Cu omer ignatur Charge Sale 3.06 ALL GOODS RETURN MUST BE ACCOMPANIED BY THIS INVOICE REMIT:GPC-IND 5959 COLLECTION CTR.DR. CHICAGO ILL_ 60693 CUSTOMER COPY • 100006013 NAPA AUTO PARTS Time: 11:53 Invoice Number 0903-986657 RETURNS IN ORIG BOX W RECEIPT NAPA "PAS REF BY VER BY Date: 09/27/2017 IIIIIIIIIIIIIIIII'IIIIIIIII'IIIII�IIIIII 317-733-2180, IN 46077 ® (317) 733-2180 Page: 1/1 17995 _ Employee: 1 Keith CITY OF CARMEL-STREET DEPT Sales Rep: 36 Ted Y Y 3400 W 131ST ST OCR � CARMEL, IN 46074-8267 Accounting Day: 27 1000060139866577 Part Number Liffe D0_ ti°on Q jint ty Net Total 2015 Ford F250 Super Duty 3/4 Ton - Pickup 92-0445 ECH sTire Pressure Monitoring System O 8.00 3.88 1.9500'; 15.60 Delivery: Our Truck Subtotal 15.60 Attention: Kevin INDIANA SALES TAX 7.0000% 0.00 Tax Exemption: kat :Total 1� 6{�Charge Sale 15.60 ALL GOODS RETURNED MUST BE ACCOMPANIED BY THIS INVOICE REMIT PAYMENT To 5959 COLLECTION CTR DR CHTCAGO IL 60693 CUSTOMER COPY 100006013 NAPA AUTO PARTS Time: 09:32 Invoice Number 0903-986394 RETURNS IN ORIG BOX W RECEIPT IIIIII�IIIIIIIIIIIIIIIIIII�I'IIII�II�III M REF BYVER BY Date: 09/26/2017 317-733-2180, IN 46077 (317) 733-2180 Page: 1/1 17995 Employee: 3 Chad * CITY OF CARMEL-STREET DEPT Sales Rep: 36 Ted Y ) Y 3400 W 131ST ST OCR � CARMEL, IN 46074-8267 Accounting Day: 26 1000060139863945 Part Number Line Description Quantity Price Net Total 75213 NOL NAPA GEAR 8OW-90 5GAL O 1.00 120.18 65.0100 65.Oi Delivery: Subtotal 65.01 .r. " Attention: Dave INDIANA SALES TAX 7.0000% 0.00 Tax Exemption: PO#: Terms: Total 65 .01 Omer Signature Charge Sale 65.01 /I- ODS RETURNED MUST BE ACCOMPANIED BY THIS INVOICE REMIT PAYMENT TO 5959 COLLECTION CTR DR CHICAGO IL 60693 CUSTOMER COPY 1-3-7. 00006013 APA AUTO PARTS Time: 11:49 Invoice Number 0903-985491 ETURNS IN VER BOX W RECEIPT II'IIIII�IIIIIIIIIIIII'llllllllll�Illlll M � EF BYVER BY Date: 09/20/2017 -733-2180, IN 46077 (317) 733-2180 Page: 1/1 995 Employee: 3 Chad CITY OF CARMEL-STREET DEPT y y Sales Rep: 36 Ted 3400 W 131ST ST OCR . CARMEL, IN 46074-8267 Accounting Day: 20 1000060139854919 Part Number Line Description Quantity Price Net Total 81-9290F NSP REMAN PS PUMP O 1.00 115.52 58.3300 58.33 81-9290F NSP Core Deposit () 1.00 46.00 46.0000 46.00 D Delivery: Our Truck Subtotal 104.33 Attention: KEVIN INDIANA SALES TAX 7.0000% 0.00 - Tax Exemption: PO#: TA� 3 Total 104 .33 Customer Sig7na-t7uW Charge Sale 104.33 ALL GOODS RETURNED MUST BE ACCOMPANIED BY THIS INVOICE REMIT PAYMENT TO 5959 COLLECTION CTR DR CHICAGO IL 60693 CUSTOMER COPY 100006013 NAPA AUTO PARTS Time: 09:30 Invoice Number 0903-984992 RETURNS IN ORIG BOX W RECEIPT 'IIIIIII�IIIIIIII'I'I'IIII'I'IIIIIIIIIII M AWPAZ � REF BY VER BY Date: 09/18/2017 . 317-733-2180, IN 46077 (317) 733-2180 Page: 1/1 17995 Employee: 1 Keith CITY OF CARMEL-STREET DEPT Sales Rep: 36 Ted Y Y 3400 W 131ST ST OCR � CARMEL, IN 46074-8267 Accounting Day: 18 1000060139849926 Part Number iaxari fat , , ' cta ; 2004 GMC Truck Sierra 250OHD 3/4 Ton - Pickup 81-9290F NSP 'Power Steering Pump w/ Reservoi O 1.00 115.52 58.3300 58.33 81-929OF NSP Core Deposit O 1.00; 46.00 46.0000 46.00 D Delivery: Our Truck Subtotal 104.33 Attention: Kevin INDIANA SALES TAX 7.0000% 0.00 Tax Exemption: Ts TOOZ-3 Oma . Customer S gna e Charge Sale 104.33 ALL GOODS RETURNED MUST BE ACCOMPANIED BY THIS INVOICE REMIT PAYMENT TO 5959 COLLECTION CTR DR CHICAGO II. 60693 CUSTOMER COPY