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Home My WebLink About320495 01/11/18 CITY OF CARMEL, INDIANA VENDOR: 215000 ONE CIVIC SQUARE NAPA AUTO PARTS INC CHECK AMOUNT: $*******677.28* x ,?q CARMEL, INDIANA 46032 5959'COCLLCTION CENTER DRIVE CHECK NUMBER: 320495 CHICAGO IL 60693 CHECK DATE: 01/11/18 �ITDN DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1110 4237000 8517983 677.28 REPAIR PARTS VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201(Rev.1995) Vendor# 215000 ALLOWED 20 ACCOUNTS PAYABLE VOUCHER NAPA AUTO PARTS INC IN SUM OF$ CITY OF CARMEL 5959 COLLECTION CENTER DRIVE 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. CHICAGO, IL 60693 Payee $677.28 ON ACCOUNT OF APPROPRIATION FOR Purchase Order# Carmel Police Terms Date Due PO# ACCT# DATE INVOICE# DESCRIPTION DEPT# INVOICE# Fund# AMOUNT Board Members DEPT# FUND# (or note attached invoice(s)or bill(s)) AMOUNT Dec statement 42-370.00 $677.28 1 hereby certify that the attached invoice(s),or 1/5/18 Dec statement repair parts $677.28 1110 101 1110 101 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 Monday,January 8,2018 A., Jim Barlow Chief 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 Cost distribution ledger classification if claim paid motor vehicle highway fund. Clerk-Treasurer View and Pay your NAPA Invoices Online. www aNAP.A.a.-ccountcom 7� Your account is now online at www.NAPAaccount.com Visit us today to view and pay your statements and invoices in minutes! You will haveaccess to: First Time Users: Copies-of statements and Invoices 0 Click on CUSTOMER LOGIN:and scroll • Receive monthly statement-via E-Mail down to"register,click-here"" • UP4"ate-account balance. 4 Enter.your Customer Number and • Last ePayment-and date received Statement'Number-cif 9732 • Link mUlOple accounts to-a sIngle user 0 Ybu"I.receive a-temporary password • Pay your account with NAPA.,e-Pay a Login' using-your email and taTripo.rary. password and create a new password I If you have questions call(877)558-9287,press I or email NS-A-Suppo.rt@ge.npt.com, We.provide.more timely and accurate.information to.the business community.bysharingouraccaunts . receivable.Information with varl o-uscredit reporting.agencies. PLEASE SEE BACK OF PAGE FOR YOUR ACCOUNT DETAILS NNNNNNNNN 00 00 000000 203469 - THIS SECTION INTENTIONALLY LEFT BLANK - - ------------------------------------------------ Visit our website for invoice copies and to make a payment. Page 2 of 2 41APAI AM WWW. NAPAaccount.com CUSTOMER NAME: CITY OF CARMEL POLICE DEPT ACCOUNT NO: TERMS TOTAL AMT DUE THIS MONTH $0.00 8517983 45 Day Prx CLOSING DATE 12/31/2017 AGED ACCOUNT STATUS Current Total Past Due Amounts Due Future Months Total Open 0.00 0.00 677.28 677.28 Past Due 1-30 Days Past Due 31-60 Days Past Due 61-90 Days Past Due 90+Days 0.00 0.00 0.00 0.00 Type Inv Date Due Date code Invoice# P.O.# Open Amount Explanation Future Due 12/07/17 02/15/18 INV 123381 Shop tools 8.82 i 12/14/17 02/15/18 INV 124456 7.76- 12/14/17 .76-12/14/17 02/15/18 INV 124476 12.36- 12/18/17 2.36-12/18/17 02/15/18 INV 124913 182.72 12/18/17 02/15/18 INV 124936 71.17- 12/20/17 1.17-12/20/17 02/15/18 INV 125353 178.98- 12/20/17 02/15/18 CR 125399 5180570 -126.00- 12/22/17 02/15/18 INV 125680 14.00 12/27/17 02/15/18 INV 126050 Car 145 18.97 12/27/17 02/15/18 INV 126106 Car145 5.56 12/28/17 02/15/18 INV 126231 255.14.- 12/28/17 02/15/18 CR 126368 -15.86 12/29/17 02/15/18 INV 126478 63.66 Total Future Amount 677.28 INV-Invoice CR-Credit Memo DED-Charge Back OA-On Account Payment OC-Finance Charge 100006017 w-----�--- - CARMEL NAPA Time: 10:04 Invoice Number 4329-123381 1441 S GUILFORD RD STE 140 IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII M " REF BYVER BY Date: 12/07/2017 CARMEL, IN 46032-2922 ' (317) 844-3973 Page: 1/1 17983 Employee: 26 Heather CITY OF CARMEL POLICE DEPT Y Y 3 CIVIC SQ � Sales Rep: 36 , Accounting Day: 7 OCR CARMEL, IN 46032-7570 1000060171233816 i 777-1041 WLD BRUSH SHOE HANDLE (617) 2.00 7:80 4.2900 8.58 T S38T30 CHT WARRANTY (C74) -1.00 11.04 5.1200 5.12 CR T This item was purchased on invoiCE # 912459 01/20/2014 S38T30 CHT 3 8DR T-30 ST BITSKT (C74) 1.00 11.04 5.1200 5.12 R Delivery:- Subtotal 8.58 Attention: yg Indiana Sales Tax 7.0000% 0.24 Tax Exemption: PO#: Shop tools Terms: Customer Signature Charge Sale 8.82 ALL GOODS RETURNED MUST BE ACCOMPANIED BY THIS INVOICE REMIT:GPC-IND 5959 COLLECTION CTR.DR. CHICAGO ILL. 60693 CUSTOMER COPY 2018-01-05 11 :28 NAPA Carvel 3178448194 >> P 1/1 L:AKKN1j NAVA Time: 14:b!) Invoice Number 4369-1L445b' 1441 S GUILFORD RD STE 140 I IIIIII VIII VIII VIII VIII VIII IIII IIII NAPAI • REF BY_ VER BY _ Date: 12/14/2017 CARMEL, IN 46032-2922 (317) 844-3973 Page: 1/1 17983 ('"-"' • Employee: 24 DAVE CITY OF CARMEL POLICE DEPT ~ Sales Rep: 36 Y Y 3 CIVIC SQ CARMEL, IN 46032-7570 Accounting Day: 14 OCR • �...�..... ,_,.,,....-._.�....�... _�_.._„.„.,.,� 1000060171244564 92-0445 ECH TPMS SENSOR VALVE () 4.00 3.88 1.9400 7.76 2016 Ford Explorer 3.7 L 227 CID 6 DOHC 241'Valve i{ s1 { Delivery: our Truck W- 2-12/14/2017 03:19 PM Subtotal 7.76 Attention: Indiana Sales Tax 7.0000% 0.00 Tax Exemption: PO#: Terms: 1 sii cua Customer Signature Charge Sale 7.76 ALL GOODS RETURNED MUST BE ACCOMPANIED BY THIS INVOICE RENIT:GPC-IND 5959 COLLECTION CTR.DR. CHICAGO ILL. 60693 Reprint l UUUUbU1/ ----^-^ CARMEL NAPA Time: 15:55 Invoice Number 4329-1244761 1441 S GUILFORD RD STE 140 I NAPA CARMEL, IN VER 46032.2922 Date: 12/14/2017 IIIIIIIIIIIIIIIIIII�IIIIIIIIIIIIIIIIIIII o (317) 844-3973 Page: 1/1 17983 Employee: 26 Heather w CITY OF CARMEL POLICE DEPT Sales Rep: 36 Y Y 3 CIVIC SQ Accounting Day: 14 OCR ® CARMEL, IN 46032-7570 4y [pL 1000060171244760 „ � Ps''T• a LII b ,,.w.,.a.,..�...,.a,. `•,fir -.,.,....,_� DA1600 DC GL BLAC (522) 2.00 11.24 6.1800 12.36 Delivery: Our Truck W- 2-16:40 Subtotal 12.36 Attention: Indiana Sales Tax 7.0000% 0.00 Tax Exemption: PO#: Terms: I 7�Q�� Customer Signature Charge Sale 12.36 ALL GOODS RETURNED MUST BE ACCOMPANIED BY THIS INVOICE REMIT:GPC-IND 5959 COLLECTION CTR.DR. CHICAGO ILL. 60693 CUSTOMER COPY CARMEL NAPA Time: 12:53 Invoice Number 4329-124913 1441 S GUILFORD RD STE 140 NAPA AMREF BY VER BY _ Date: 12/18/2017 IIIIIIIIIIIIIIIIIIIII�IIIIIIIIIIIIIIIIII CARMEL, IN 46032-2922 (317) 844-3973 Page: 1/1 17983 Employee: 24 DAVE ® CITY OF CARMEL POLICE DEPT Sales Rep: 36 Y Y 3 CIVIC SQ OCR CARMEL, IN 46032-7570 Accounting Day: 18 1000060171249131 PBR930548K [PGB HUB BEARING KIT U 1.00 154.84 91.3600 91.36 2013 Chevrolet Impala 3.6 L 217 CID V6 DOHC 24 Valve VVT PBR930075 PGB HUB BEARING ASSEMBLY () 1.00 154.84 91.3600 91.36 2013 Chevrolet Impala 3.6 L 217 CI V6 DOHC 24 Valve VVT Delivery: Our Truck W- 3-13:53 Subtotal 182.72 Attention: Indiana Sales Tax 7.0000% 0.00 Tax Exemption: PO#: Terms: 7,11 Customer Signature Charge Sale 182.72 ALL GOODS RETURNED MUST BE ACCOMPANIED BY THIS INVOICE REMIT:GPC-IND 5959 COLLECTION CTR.DR. CHICAGO ILL. 60693 CUSTOMER COPY 1 0 0 0 U u U 1/ ""._'"."""' '.'""""""'."..". CARMEL NAPA Time: 14:34 Invoice Number 4329-124936} REFlBY GUI`VERRDBRD STE 140 Date: 12/18/2017 II'IIjIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII NAPACARMEL, IN 46032-2922 o (317) 844-3973 Page: 1/1 ��mm 17983 Employee: 24 CITY OF CARMEL POLICE DEPT DAVE Sales Re 36 E Y Y 3 CIVIC SQ P Accounting Day: 18 OCR ® CARMEL, IN 46032-7570 1000060171249364 90468 NTH GAUGE () 1.001 129.40 71.1700 71.17 1 J 1 Delivery: Our Truck W- 99-02:34 Subtotal 71.17 Attention: Indiana Sales Tax 7.0000% 0.00 Tax Exemption: j PO#: Terms: Customer Signature Charge Sale 71.17' ALL GOODS RETURNED MUST BE ACCOMPANIED BY THIS INVOICE REMIT:GPC-IND 5959 COLLECTION CTR.DR. CHICAGO ILL. 60693 CUSTOMER COPY CARMEL NAPA Time: 14:25 Invoice Number 4329-125353 ;' 1441 S GUILFORD RD STE 140 NAPA � rte° REF BY_ VER BY _ � Date. 12/20/2017 ) IIIIIIII�IIIIIIIIIIIIIIIIII�IIIIIIIIIIII CARMEL, IN 46032-2922 o (317) 844-3973 Page: 1/1 17983 CITY OF CARMEL POLICE DEPT Employee: 26 Heather 3 CIVIC SQ Sales Rep: 36 Y Y CARMEL, IN 46032-7570 i Accounting Day: 20 OCR 1000060171253535 t< �, .. __<._, ._�� ,•. Y _wPSYj�t�OI1 ✓.. . zrY3t s y � .: u2t,,.4 .. Od� _.. s.3 7565 BAT BATTERY (T34) WWs 1.00 172.25 104.3400 104.34_ (R 7565 (BAT gCore Deposit (T34) 1.00 18.00 18.0000 18.00 D 75520 jNOL NAPA' SYN 5W30 QT (518) ! 12.00!9 8.58 4.7200 56.64 Delivery: Our Truck W- 2-15:10 Subtotal 178.98 Attention: Indiana Sales Tax 7.0000% 0.00 1 Tax Exemption: PO#: � Terms: qgp e1go'011- -TS Customer Signature Charge Sale 178.98 ALL GOODS RETURNED MUST BE ACCOMPANIED BY THIS INVOICE REMIT:GPC-IND 5959 COLLECTION CTR.DR. CHICAGO ILL. 60693 CUSTOMER COPY lUUUUOUl/ ^` CARMEL NAPA Time: 17:39 Invoice Number 4329-125399 1441 S GUILFORD RD STE 140 NAPA REF BY_ VER BY _ Date: 12/20/2017 IIIII�IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII CARMEL, IN 46032-2922 o (317) 844-3973 Page: 1/2 Employee: 24 DAVE CITY OF CARMEL POLICE DEPT Y Y • Sales Rep: 36 , 3 CIVIC SQ Accounting Day: 20 OCR CARMEL, IN 46032-7570 1000060171253991 Paxt Number v Linea u.__..... _ Descg3ta oi7. QuaxGity PrNet ,� Total W E i 7565 BAT Core Deposit (T34) -2.00# 18.00 18.00 36.00CRD ¢ u.1 This item was purchased on invoice # 122261411/29/2017 i 7565 BAT Core Deposit (T34) -1.00 18.00 18.00 18.000RiD This item was purchased on invoice # 125353 12/20/2017 7565 BAT Core Deposit (T34) -1.00 18.00 18.00 18.000RID This item was purchased on invoice # 121095 11/20/2017 7534 BAT Core Deposit (T34) -2.00 18.00 18.00 36.00 CR D This item was purchased on invoic # 122261111/29/2017 + Attention: RETURNS Tax Exemption: PO#: 5180570 Terms: LL CONTINUED 1 Customer Signature ALL GOODS RETURNED MUST BE ACCOMPANIED BY THIS INVOICE REMIT:GPC-IND 5959 COLLECTION CTR_DR. y' CHICAGO ILL. 60693 . } CUSTOMER COPY CARMEL NAPA Time: 17:39 Invoice Number 4329-125399 1441 S GUILFORD RD STE 140 R179833 REF BY VER BY _ Date: 12/20/2017 IIIIIIIIIIIIIIIIIIIIIIIIIILIIIIIIIIIIIII CARMEL, IN 46032-2922 (317) 844-3973 Page: 2/2 J Employee: 24 DAVE ® CIT ^-ARMEL POLICE DEPT } Y Safes Rep: 36 � Y 3 CIS_ p'Q Accounting Day: 20 OCR CARMEL, IN 46032-7570 10000601712 5 3 9 91 7534 AT Core Deposit (T34) -1.00 18.00 18.00 18.00CRD This item was purchased on invoic # 121095 11/20/2017 gg E I i .._.....�__.�__._..,.�,.___ Delivery: Subtotal 126.00CR Attention: RETURNS Indiana Sales Tax 7.0000% 0.00 Tax Exemption: PO#: 5180570 Terms: Customer Signature Credit Memo 0 ALL GOODS RETURNED MUST BE ACCOMPANIED BY THIS INVOICE REMIT:GPC-IND 5959 COLLECTION CTR.DR. CHICAGO ILL. 60693 CUSTOMER COPY 100006017 •----•----------------------------------------------------------------- ARMEL NAPA Time: 11:04 :: Invoice Number 4329-125680. NAPA 441 S GUILFORD RD STE 140 ' i 1 tttI 111 1111t 1 EF BY_ VER BY Date: 12/22/2017 I}IIII1'IIIIIIIIII�IIIIIIIFI#IIII'llllllll o IN 46032-2922317) 844-3973 Page: 1/1 --------------------------------------------.................................. 17983 ............................. ...........•......................... Employee: 29 , JAEDYN CITY OF CARMEL POLICE DEPT Sales Rep: 36 3 CIVIC SQ OCR Accounting Day: 22 CARMEL, IN 46032-7570 t 1000060171256809 ------------ :::.:'.:3TC:::>::::>:::::: :::>=><::::=:<: 3:," '-=:=z:=:>:::<:::>:::<::<:::<::::::<:: Y . ... :....= r <=>=::>:::>:>:<::..i a :. ......:...... ------------------------- • .. ................... ....-................................ ............ ....... ......... ::::::::: = .......... :........... ...:.... :......:.:-...................................... ........................................................... .... ::::::14::::: .............. :::14.00.:::: .. ..... ............... :: . . 7-2749 SIPS :PRESSURE HOSE U 1.00: 8.00: .0000.: QOH=O 2000 Dodge Ram 1500 1/2 Ton :- Wagon van 5.2 L. 318 f 3 ................ Delivery: Our Truck W- 99-23:04 Subtotal 14.00 Attention: Indiana Sales Tax 7.0000 0.00 Tax Exemption: PO#: } Terms: --:. ...............•----...-------•------------'--•--•--...-----... - - - - --- : ::::: �'.Cs;iii.�8';:_:`::;-.: ';'?';:=:=: ? ' - < : Customer Signature Charge Sale :14.00::::....... ............... ALL GOODS RETURNED MUST BE ACCOMPANIED BY THIS INVOICE REMIT:GPC-IND 5959 COLLECTION CTR.DR. CHICAGO ILL. 60693 CUSTOMER COPY 100006017 •--•--........--•....................................................... NAPA Time: 08:57 ; Invoice Number 4329-126050NAPA AM41 S GUILFORD RD STE 140F BY_ VER BY Date: 12/27/2017oRMEL, IN 46032-2922 17) 844-3973 Page. 1/1 •--------------------•------------------------------------•-------............ 17983 ----•-...........-....•--• . . . . •------•-------- , Employee: 29 JAEDYN CITY OF CARMEL POLICE DEPT Sales Rep: 36 Y Y 3 CIVIC SQ OCR Accounting Day: 26 CARMEL, IN 46032-7570 :....................................................... s 1000060171260509 ------------------ -e :. EYf1. ........=?s:>== 3F ::::: > 5 :':' fl25:«:f=::`:::::>::>::>::::<:::><:::;::>::::= 6-021-1 _WIP 21IN EXACTFITBLADE (T12) 2.00: 16.36' 5.9900:; 11.98 Above Item on Sale 2009 Jeep Grand Cherokee 5.7 L 345: CID V8 HI mi 6-014-C .W IP =14IN EXACTFIT-REAR () 1.00; 17.08= 6.9900;: 6.99 Above Item on Sale 2009 Jeep Grand Cherokee 5.7 L 345 CID V8 Hemi ......................................................................................................................................••.........•-- Delivery: Subtotal 18.97 Attention: Indiana Sales Tax 7.0000% 0.00 Tax Exemption: PO#: Car 145 Terms: ............................... ..:................::'::$$:::: :L:- r}: =:i::-ii`rr - ::1: :L::':-::.'. J:::::::i::: �.i........:........ 1 ......................................................................................................................................... ........................................................................................ ................................................ Customer Signature Charge Sale 18.97 ALL GOODS RETURNED MUST BE ACCOMPANIED BY THIS INVOICE - REMIT:GPC-IND 5959 COLLECTION CTR.DR. - CHICAGO ILL. 60693 - -. CUSTOMER COPY 1000060:17 :...............•----------------------••............................... APA Time: 11:20 3Invoice Number 4329-126106' NAPA " UILFORD RD STE 140 VER BY Date: 12/27/2017pIN 46032-2922 4-3973 Page: 1/1 17983 :............................ ............•-------..... . Employee: 29 , JAEDYN CITY OF CARMEL POLICE DEPT Sales Rep: 36 Y Y 3 CIVIC SQ OCR Accounting Day: 26 CARMEL, IN,46032-7570 ............................ - 1000060171261063 Yi<:: . ............................. k::::::k:::::: :::::::'.: ' .........:::::::= �3 :2==':.............. ::'� i3Y��-'.�:: ::t 2...... ��cf� :?:= =.... .... ::::::=:t::::=:..............}'E5 3�:2::ut:::: >=:?==? =' .......... ... ......................... •. ... ................ _........ ................... ....................... ................................................:::: ........... ::::::5.56 :::::::R_:::..... ::.2329 FIL -NAPAGOLD AIR FILTER (300) .00 27.82' 5.5600: 2009 Jeep Grand Cherokee 4.7 L 287: CID V8 SJHC 16 Valve t i c ............................................................................................................................................................. Delivery: Subtotal 5.56 Attention: Indiana Sales Tax 7.0000% 0.00 Tax Exemption: PO#: Car145 Terms: Customer Signature ::............... ChargeSale::::. 5_.5:fi ........ :::.::.:.. ALL GOODS RETURNED MUST BE ACCOMPANIED BYTHIS INVOICE REN.IT:GPC—IND 5959 COLLECTION CTR.DR. CHICAGO ILL. 60693 CUSTOMER COPY CARMEL NAPA Time: 08:11 Invoice Number 4329-126231 1441 S GUILFORD RD STE 140 NAPA � • REF BY_ VER BY _ Date: 12/28/2017 IIIIIIIIIIIIIIIIIIIII�IIIIIIIIIIIIIIIIII PAW CARMEL, IN 46032-2922 o (317) 844-3973 Page: 1/1 17983 Employee: 3 Keith • CITY OF CARMEL POLICE DEPT � Y Y Sales Rep: 36 , 3 CIVIC SQ Accounting Day: 27 OCR • CARMEL, IN 46032-7570 1000060121262311 • 4 q -.: ,,P '��V11I{1k12Y ..,•ti�..�,-��-L,lil� �.�a''� ;�xT3e$C��.pt�.012'" .syr? ':�'�llall�li�'y ,.,?„P,LiCG�,�,' a NBt�i .�.'�., `POtd� -;�� - �'x:� 6935 FIL NAPAGOLD AIR FILTER (300) 2.00 26.16 5.2300 10.46 R 7565 BAT BATTERY (T34) 2.00 172.25 104.3400 208.68 IR 7565 BAT Core Deposit (T34) 2.00 18.00 18.0000 36.00 D Delivery: Subtotal 255.14 Attention: Indiana Sales Tax 7.0000% 0.00 Tax Exemption: PO#: i Terms: Customer Signature Charge Sale 255.14 ALL GOODS RETURNED MUST BE ACCOMPANIED BY THIS INVOICE REMIT:GPC-IND - 5959 COLLECTION CTR.DR. CHICAGO ILL. 60693 CUSTOMER COPY 1 0 0 0 U O U 1/ l 1 CARMEL NAPA ',, Time: 14:41 Invoice Number 4329-126368 m 1441 S GUILFORD RD STE 140 II'IIIIIIIIIIIIIIIIIIIIIIII�IIIIIIIIIIII ¢ M AMREF BYVER BY Date: 12/28/2017 CARMEL, IN 46032-2:22 (317) 844-3973 �� Page: 1/1 17983 _ Employee: 4 Chris ® CITY OF CARMEL POLICE DEPT Y Y 3 CIVIC SQ Sales Rep: 36 , Accounting Day- 27 OCR CARMEL, IN 46032-7570 1000060171263686 • Pxt Number r Lin ` Descxz tz6n; 4 ��an, tic Y� 7-2749 NPS WARRANTY O -1.00 28.00 15.86 15.86 CR This item was purchased on invoice # 117356 10/25/2017 9 9 Deliver Y: - Subtotal 15.86CR Attention: Indiana Sales Tax 7.0000% 0.00 Tax Exemption: ( PO#: Terms: Customer Signature Cr clef emo 15 86 CR ALL GOODS RETURNED MUST BE ACCOMPANIED BY THIS INVOICE REMIT:GPC-IND 5959 COLLECTION CTR.DR. CHICAGO ILL. 60693 CUSTOMER COPY -' 1 0 0 0 U b U 1-/ --------w•--w--�- CARMEL NAPA Time: 10:06 Invoice Number 4329-126 8 lY VER B GUILFORD RD STE,' 140 REFBDate: 12/29/2017 MR=AM > CARMEL, IN 46032-2922 ( IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII (317) 844-3973 Page: 1/1 17983 : CITY OF CARMEL POLICE DEPT Employee33 Kohlstaedt Sales Rep: 36 3 CIVIC SQ AccountingDay: 28 OCR RM ® CAEL, IN 46032-7570 Y...._ � �....,�,. 1000060171264783 Pt Numbex I zzeiTae a G a an 9005 AVB CAPSULE O 6.00 4.62 2.3100 13.86 1255HIl AVB CAPSULE O 6.00 16.60 8.3000 49.80 z 35e-livery-:-�_��_..._._...____. .._,", ._..._._ �_..__ �....____�_.._._,� Subtotal 63.66 Attention: Indiana Sales Tax 7.0000% 0.00 } Tax Exemption: PO#: Terms: AIRr Customer Signature Charge Sale 63.66 ALL GOODS RETURNED MUST BE ACCOMPANIED BY THIS INVOICE REMIT:GPC-IND 5959 COLLECTION CTR.DR. CHICAGO ILL. 60693 CUSTOMER COPY