HomeMy WebLinkAbout184281 04/14/2010 CITY OF CARMEL, INDIANA VENDOR: 355214 Page 1 of 1
ONE CIVIC SQUARE GENUINE PARTS COMPANY-INDIANA Pp��
CARMEL, INDIANA 46032 5959 COLLECTIONS CENTER DRIVE Cl1ECK AMOUNT: $1,186.18
CHICAGO IL 60693 CHECK NUMBER: 184281
«ON O
CHECK DATE: 4114/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4237000 85- 017983 1,186.18 REPAIR PARTS
r
Account No TERMS
08517983 GOVT.45 DAYS NET
Closing Date Due Date Sequence No
03/31/10 04/14/10 15836005
'Previous Balance Payment(s) Received
3,495.91 2,309.73
New Charges /Credits Finance Charge New Balance
1,264.11 .00 2,450.29
Q, Total Past Due Current Future
x Agedy}\ 326.57- 1,512.75 1,264.11
Account Past Due Past Due Past Due
10 Days 40 Days 70 or More Days
kStatus
196.26- 130.31- .00
Page 1 of 2
AT 01 030509 76691H111 B *3DGT
II �I�I�I� 11 1���' �II�I�I��IIIII�I�1 'III�I'�I'�'�
CITY OF CARMEL POLICE DEPT
3 CIVIC SQ
CARMEL IN 46032 -7570
If you have QUESTIONS CALL: (877) 558-9287 Press 1 for invoice copies.
Visit our website for invoice copies at
www.NAPAaccount.com
Please Pay The Total Due
No Later Than 04/14/10
Thank You.
Your NAPA acco is on the nbl
www.NAPAaccount.com
Click on CUSTOMER LOGIN and
ACCOUNT ACTIVATION
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monthly statement and enter your email address.
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We appreciate your business!
WE PROVIDE MORE TIMELY AND ACCURATE INFORMATION TO THE BUSINESS COMMUNITY BY
SHARING OUR ACCOUNTS RECEIVABLE INFORMATION WITH D &B AND EQUIFAX.
ML
Customer Copy Retain for your Records
Acct No. 08517983 1 Page 2 of 2 Y
Customer I CITY OF CARMEL POLICE DEPT
e
Statement of Account with NAPA Auto Parts
Date Type' J Inv.No. AtnountDue Explanation
02/04 RI 752155 379.05
02/04 RM 752210 50.00-
02/10 RI 752637 70.08 TOCK
02/12 RI 752807 194.48
02J15 RI 752892 96.71
02/15 RI 752904 83.09
02J17 RI 753118 90.17
02/17 RM 753129 70.82-
02/22 RI 753432 97.52
T 's line intentionally left blank
02122 RI 753435 216.27
02/24 RI 753580 240.00
02/25 RI 753702 118.32
02/25 RI 753703 118.32
02!26 RM 753856 70.44
02J28 RU 747047 58.45 L PD CK #1819
02/28 RU 747855 71.86- UPL PD CK #1819
03/04 RI 754359 DT: 206.48
03/05 RI 754370 D 129.10
03/08 RU 748346 40.78- pd ck #18234
03108 RU 5978861 90.98- nid inv ck #182
03/09 RI 754712 DT: 5.44
03/10 RI 754814 DT: 297.66 E
stock order d
03/10 RI 754886' DT: 23.29
03/15 RI 755266 DT: 43.08 r
03/17 RI 755537 DT: 46.42 8-
03/17 RI 755564 DT: 36.16 E
03/18 RI 755686 DT: 8.00 a
m
03/18 RI 755708 DT: 22.29 E
03/22 RI 755964 DT: 65.65 m
v
This line intentionally left blank
0
in
03/23 RI 756055 101.75 00
m
03/24 RU 751553 64.50- upl pd ck 3182
03/25 RI 756302 DT: 203.91
03/30 RI 756761 DT: 47.76
03/31 RI 756923 DT: 27.12
co m
a
TOTAL DUE $1,186.18
m
TYPE CODES
a
RI Invoice RB Charge Back
RM Credit Memo RU Unapplied Payment
RF Finance Charge X# Miscellaneous Accounting Entry
I
�w Control N" 8827067
MM CARMEL NAPA
III g[DICRL DRIVE Y OCR Y REMIT:
CO LE
VER BY
I ah LI R.
RET B Y 959 r DIF
CAM11, IN Wr, 5 CH I CAGO L �B i� :J�;;
RECEIVED
1000060177538566 R x
BY
ALL GOODS R�,!U ED MUST Bt BY THIS INVOICE
1 10 AMMIJ6 1 "lul "#lul ul"a ul" luu'SOLD TO DATE ,J o STORE NO. EMP SR
8 5 1) 179 8 3 CITY OF CARMEL POLICE E) 21 G, 1 7 53, 8 55 8 1 7 1 :33 6 3v
3 CIVIC SO I o f I TIME PURCHASE ORDER NO. ATTENTION
CAI ME IN W- 2-14:13 t 3
2.3 1:, f2 i e INVOICE PE C r edit Memo
QUANTITY PART NUMBER LINE I DESCRIPTION PRICE NET TOTAL CODE
CAL Core Deposit 55.('0 55 `5. 0 CR D
.1 ('110 LE '5 19 0 B C) o C)
7 5 3 17 0 2 i:- 1 0 2' 5
--1. (-70 LE51.89B CAL Core Deposit 55. (")0 55. 00)c) L,551. (""C' C R Cr
15,3103 2- `010-02 c:
10. 31 7 LMP BULB 1.70 1. 0500 10. 50
;z C) o B P 1,:--'5 5 H 11. LMT' ftOGEN KU 2 `5L 14.5300 "-9.oG
SUB 7 0. 4 4 0. 0( 1 0 0 01 c'. o() 0. 44 CR
TOTAL TAX TOTAL 7
Control No.
L 6898
88
De CARMEL NAPA
tit KEDICIRL DRIVE y OCR y R E lyl I T e G P C I N D
REF BY VER BY I=
5959 GE)ILLECTION CTR. DR.
CAMR, IN 4032?- IL
i I RECEIVED
L
100006 CH I CAG 0171537022 BY x
A LL GOODS ETU ED MUST BE AQ BY THIS INVOICE
1 luu wvtlu I m luu 'SOLD TO DATE STORE NO. I EMP SIR
7
8 5 17 8 CII OF CARMEL POLICE D 1 53(02 1- 17 36
3 CIVIC SO I of 1. TIME PURCHASE ORDER NO. ATTENTION
CARMEL, IN 46013275 W
VOICE PE
ID e I i v e r Cha.) Sale!
QUA N TITY PART NUMBER LINE DESCRIPTION PRICE NET TOTAL CODE
1. 00 LE5190B CAL RM BRRKE CALI 1 .3.3. G 8 5 x 2 00 6,3. 32
1. -`-)0 LE5190B CAL Core Deposit 55.o() 55. 000C) 55. CK-) T)
20('-')'1 Chevt Impala 3.8 L 21 CID VG
TOTAL 1 1 s. 12 ml 00 7. 00 0 TOTAL 1 8 32
t.
S1111 I 0 1 TAX 01 1 —1
aw0 Control No. 8626899
CARMEL NAPA
T 'PC
III 01CRL DRUVE y OUR y RM
E1. ---Ir
C
REF BY VER BY
-r.. '-R
5959 LLE-.'1'1 .1 /(N DRI
CARM� 4603am CH G 1 CA ILL.
L I
RECEIVED x
1000060177537031 BY
ALL GOODS RE�UkNED MUST kE AC MPANIED BY THIS INVOICE
1 10 AMPMO! 11111 'Bull sulau 1111 SOLD TO DATE 0 0 o STORE NO. EMP SIR
F4 5 0 1 *79,9 3 CITY OF CARMEL POLICE D 2/25/2 (")10 "7 537() 3 G 0 1 7
3 civic so 1 of 1. TIME PURCHASE ORDER NO. ATTENTION
CARMEL., IN 46032-""75**/(-► W- 2-11:55 t1:10
22) Q e- I i v er INVOICE PE SaIc.
QUANTITY PART NUMBER LINE DESCRIPTION PRICE NET TOTAL CODE
2005 ChEvro'tc-t 1mf).i1a_
1.00 LE5189B CAL Caliper w/ Pads 9 3. 68 5 3 C2 Q E.3, 3
1. 00 LE51f3'-:)B CAL. Core Deposit. 55. 00 55. C) Q 55100 1
0C 7. Oo% 0. 0o TOTAL 11 2
TAX I
Control No 8826258
,0 CARMEL NAPA
III 010L DRIVE y OCR y REM I T GPC I ND
REF BY VER BY 595S) COLLECTION CTR. I-)RI. 4?
WE, IN 4603229'E2 C�jj.,�'RGO ILL. 1 f:- 0(Sr33
1000060177531180 BY x w ar
1 11 1 111 NIH 11 IN 111 IN IN ALL GOODS RETURNED MUST BE ACCOMPANIED BY THIS INVOICE
111WA131JON(DIIUUIIIUIIIUDIIIUUIIUIIIDUIS OLD TO DATE Myfg I STORE NO. EMP R
'17/201
7983 CITY OF' CARMEL POLIC*1"E D
3 CIVIC SO 1- of 1. TIME PURCHASE ORDER NO. ATTENTION
7 c 7
CARMEL, IN 40,*
6232 W- 2-14:33 1 2 42 INVOICE TY PE
QUANTITY PART NUMBER LINE I DESCRIPTION PRICE NET TOTAL CODE
1. 00 70095o BEL BHX 011TID1 WIR 46 06 23. 0300 2 0 3
F. 00 ZXEL 1. Z R X DEXC001. I 6AL 13.9-9 11. 1900 t: 7. 1
20C-13 Chevrolet I 3.8 L 231 CID VC,
TOTAL 90.171 wsc.� 1 0. cm.) 1 7. 00() TAX 01 f). 00 1 TOTAL 90. 1 7
2� Control No. 8825726
Up&
CARMEL NAPA
III REDICAL DRIVE y OCR y REMI1 \GP 'C--IND
REF BY YER BY 59t: tL�EECI (,IW u F
ILA L
CgR< iN 46009E C ullu-) G
1000060177526374 BY x
ALL GOODS RETUTED MUST Bp ACOMPANIED BY THIS INVOICE
10AWNWIJ51111 HOW 0119U 11111 INUI 19918OLD TO DATE 0 STORE NO. EMP SR
85-017982' CI'T'Y OF CAF"'MEL POL-ICE D
752637 (1) Fj Q 1.7 1 36" 36
1*3 civic so I of I TIME PURCHASE ORDER NO. ATTENTION
CIARIMEL, 1N 460327570 W 210:59 'i' 14
INVOICE TY PE
r-
QUANTITY PART NUMBER LINE DESCRIPTION PRICE NET TOTAL CODE
2'0. 00 2152'2 SF PRO SUET OIL F 4. 'A 1 2 1 's �j
Above It eri. on 1 3a I
12. 00 21o40 S I PRO SELECT OIL F 4. 11 2. 19 C-) 0 261. 28
Above It Em on Sale
T L 70, 08 0. 00 1 7. 000 TAX 00 1 TOTAL '7 0 0 L---J
d
a0® Control No. BE26770
CARMEL NAPA
III MEDICAL DRIVE y OCR y REM IT: BPC I ND
REF BY VER BY 9 59 C ILL L L E CT I &eYei R F)P.
CARKEL, M 460322922 fF 5 G X
C�U W.. J
1000060177535809
BY x
A LL GOODS R TOffD MUST BqX(�COMPANIED BY THIS INVOICE
I IIJAW"KJOIIIJU MU Hill 19 1 9111SOLD TO DATE 0 0 STORE NO. I EMP SR
1
85017983 CITY OF CARTIEL POLICE 00 D ('12/24/21 175"358C) 66017 1 -6 1 6
,3 civic 1 130 1 of 1. TIME PURCHASE ORDER NO. ATTENTION
CARMEL, IN 46C)327570 W 99-19:47 1*1 ia 1 i v p ir- I INVOICE PE I Ehavql
QUANTITY PART NUMBER LINE DESCRIPTION PRICE NET TOTAL CODE
4. 00 73()-47C6 BK LAMP 4. 4 0 GC). C)OC"')
00 o. 00 7. 0. c 00
I L 240 C) (�F� TAX 01 TOTAL 0
a C 7� Control No. 8825914
CARMEL NAPA
III OICAL DRI y OCR y REM I'F: GPC*,'--. IND
FEF BY VER BY 5959 CYLLEC' F I 'A/ T R. D R.
IN 46030E ly
4�1
1 1000060177528078 -Y x l :LL.
ALL GOODS AE COMPANIED BY THIS INVOICE
I�t\
01111 J1UU1 10111 U0111 1991 1111SOLD TO DAtE ['M6@MM'j STORE NO. EMP SR
V/
85-01 79 833 CITY OF CAF FICILICE D 02'/12/2(. 17528( 66,017 1
F�NEDMUS BE C
3 C IVIC S Q 1 of .1. TIME PURCHASE ORDER NO. ATTENTION
M�
L, IN 46032757C.) W- 2-15:57 1 INVOICE T YPE
Z
FT 1i A ri in !:`a
QUANTITY PART NUMBER LINE DESCRIPTION PRICE NET TOTAL 4 CODE
t-- 00 6 ().-022-1 WIP BLADE 18. 3: 5 8. 4900 16 `1. 8
2005 Ch olet Impala 3.8 L 2131 CID VE,
`o0 D o g e Tr u c k 1) u a n g o
2 6 I W I P Riper Blade U 32.17 16. 1900 1 6. 1 9
6 121-3. W I F" Wiper Blade Ex 16. 1. GO 8. 4900 8. 4
ME SUB
TOTAL 194. 48 Q: C)0 7. o0o TAX 0
I TOTAL 194.4R-
QaapaD Control No. 88OLO-012
CARMEL NAPA
o®
III MEDICAL DRIVE y O'C" R y REM 17 GPC-- I Nf.)
REF BY VER BY 5959 COLLECT :I ON CTR. EIR.
CRIB, N 4603229E CH L.. 60693
RIVED IL
1000060177522109 Eiy x
1101 ALL GOODS RETURNED MUST BE ACCOMPANIED BY THIS INVOICE
I IUA(W"N&IIU 11011111 111111 BUII MOSOLD TO DATE I M,96gM.M.1 STORE NO. EMP SIR
85-0 CITY OF' CARMEL POLICE D (12/04/2( 601.7 1 8(:)1:36
3 civic so I of D TIME PURCHASE ORDER NO. ATTENTION
04) CARMEL, IN 46C)327570 INVOICE TYPE Cr Mc-mo
QUANTITY PART NUMBER LINE DESCRIPTION PRICE NET TOTAL CODE
—1. '7534 BAT Care, Deposit 10. 00 10. 00(-)c) 10. 0 C. R E)
752155 2610-02-0
—1.00 7565 BAT Core Deposit IC). G0 10. Woo I t i, i ii i C R 1 1
750265 2010 -01 1 2
-1 00 7527F BAT Core Deposit tip, 00 W 00(10 10. Oo CFA D
,0 1 o 0 I (DZj
OTAL misc. TAX TOTAL Ccnt 1 nuud
I 1 01 1 1
Control No. ��rl��l1�
CARMEL NAPA
III L91U&009 Y OCR Y REMIT:GPC- IND
REF 8Y__N� 8 Y__ 5959 COLLECTION CTR.DR.
0NE^DN�O��2 CHICAGO ILL. 60693
1000060177522109
IN 1111, ALL GOODS RETURNED MUST BE ACCOMPANIED BY THIS INVOICE
13 CIVIC SO 2 f 2 TIME PUF DER NO. ATTENTION
C 11\1 460327570 1,3:48
104) INVOICE PE Credit Mema
-QUANTITY PART NUMBER LINE DESCRIPTION PRICE NET TOTAL CODE
750265 20100112
TOTAL 01 SC.* 0 1 TAX I TOTAL
0 7 AN Control No. 8826003
CARMEL NAPA
III KEDICAL DRIVE y OCR y REM1
REF BY VER BY 5959 COLLECTION CTR., M*x".
CARM, IN 460KBE CHICAGCW-L. 6(')6'93
RE
10000601775289 RECEIVED
BY x
IN ALL GOODS RETURNED MUST BE ACCOMPANIED BY THIS INVOICE
I INAM"N(NIM ffUU 10119 IUIIU 1101 IUMSOLD TO DATE km9mmm, I STORE NO. EMP SR
J) 6 C) 1 7
1 36
8 5 0 179 8 CITY OF- CARMEL POLICE D 15 /2 10 1. 7 5 2 9- 9 2 t
TIME PURCHASE ORDER NO. ATTENTION
1 ci ic S G! 1 of I
CARMEL, IN 4 6(:)32 75 C W 2--09-.06
INVOICE PE
QUANTITY PART NUMBER LINE DESCRIPTION PRICE NET TOTAL CODE
2008 Docge Tr u c k D u r at n g o
1.. 00 N i :EJ Owi Wiper Made IM 12. 6 8. 7 4 0 8. 7
-1. 0
1.00 NB• OW 1 Wiper t'a NA C) 4. 880 4, F38
1 3 Q
1.00 7565 BAT Battery M L 134. 9 0
1. ()0 750 5 BAT Core Deposit 10. 00 0000 1 C), oc)
SUB
TOTAL 96. 71 KescV- 0. f) 1 7. !0. 00 9-s. 1
1� TAX TOTAL 0
Control No. 88260-1.5
QaapaD CAMEL NAPA
III KEDICRL DRIVE y OCR Y R. LAM. 1T. G P C I N
Rff BY VER BY 5� COLLECTION UTR,,Qf�-
CARM71N 4603OF 44 T W G
r IO ILL. GC)693
:cr
1000060177529040 BY
ALL GOODS RETURNED MUST BE ACCONrPANIED BY TH19I
I NAW"W011M 1IUIU 19111 UIIIIII DIIII IU0SOLD TO DATE o o STORE NO. EMP SR
8 15 01'7 "_813 CITY OF' CARMEL POLICE D r 2 15/ 2 C) 1 7 5 c"9 0 4 4) 6 7 3 6 13 6
13 civic Z I of
TIME PURCHASE ORDER NO. ATTENTION
1.
C A. R M E L I IN 46o3i:: 45 INVOICE T YPE
QUANTITY PART NUMBER LINE DESCRIPTION PRICE NET TOTAL CODE
1. 00 '7565 B B AT TE R Y 134.31 73.09oO .o9 j
1. 00 736 BAT core Deposit 1 r:). 0 10. r,-)
X) 1.0. 0
SUB 0 8 3 Q 1- 3
TOTAL 0 9 NUSC O 7. 00() TAX C) C) C) TOTAL
Control No.
CAN 6825607
,�e CARREL NAPA
III OICAL DRIVE y OCR. y REMIT G"FIC.-IN
RIT BY VER BY 5959' A"TEC"I" i DR
0"
MINE, IN 4603229iF Cq&CAGO L
BY ED x
1000060177534356 )v
IN OED MUST B AC iOMPANIED BY THIS INVOICE
I 1111101990 11161 U TO DATE� o STORE NO. EMP SR
5 0 17 1 9 8 3' CITY OF:" CARMEL POLICE D f t i 1 7 E�( 1 6
W J
3 civic H). 1. 0 f 1. TIME PURCHASE ORDER NO. ATTENTION
_5
CAF)MEL, IN 46-013- INVOICE TY
QUANTITY PART NUMBER LINE DESCRIPTION PRICE NET' TOTAL CODE.
3. o0 7534 BA BATTERY 115. 07 62� 0900 1 a61. 'c1 r? f)
2 00 753z4 BAT luare Depo.,it 1 C). 00 10. 0(
3 0. O0 1
SUB TX 216. 2 7
T 2 1 F) 2` 7 I ry S640 1 0. (10 1 7. 00 A
00 TOTAL
Control No.
8 8 2 6
AR A P F
III 01PAL DRIVE y OCR y FREM IT: GPC I ND
R9 BY14YEP BY Z 59''J9 C 0 L L E C11 0 N C_ 7* R. D R.
DM IkWW122 CHICAGO ILL. 6(
RECEIVED
1000060177531297 By x
I
11 MH 10 IN ALL GOODS RETURNED MUST BE ACCOMPANIED BY THIS INVOICE
I 1 flAtW"W(§!IHU 1101 11 HlU 11019 101 NUIISOLD TO DATE I STORE NO. EMP SR
ci OF* CARMEL POLICE D 02/17/2010175 6017 j. 8 3.6
JA
3 CIVIC SO 1 of 1. TIME PURCHASE ORDER NO. ATTENTION
CARMEL, IN 4(So.'.'-'2757o 1 4 0
INVOICE T YPE
1. 0 11 C -redit Memo
QUANTITY PART NUMBER LINE DESCRIPTION PRICE NET TOTAL CODE
--1. 00 21398 EXH MUFFLER 158.08 7C). 8200
70.82 CR
,7 4 i i 10 1 0 09 9 8
J. 0 0 1 7 TOTA C R
SUB 17 0. K .00(') 0.0o 8
TOTA .LTs0uT:'-:L::� T;10-
Control No.
4w 8826604
CARMEL NAPA
III MEDICAL DRIVE y OCR y REMIT 30PC-IND
REF BY VER BY 5959 CQLLECTI �l DR.
CA&R, IN 460ym C H I CA G I I LL. E-1
RECEIVED
1000060177534329 BY X
ALL GOODS RETUNNED MUST BEdIrCNIMPANIED BY THIS INVOICE
1 lUAW"NO!'" 111 U'UUU 111 "Ul lMSOLD TO DAT o o STORE NO. EMP SR
85-0179C�3 CITY OF CARMEL D POLICE 1 e Cj 1 ;r 1 80 136
3 C I V 1 C SO I Of 1. TIME PURCHASE ORDER NO. ATTENTION
CAPMEL, IN 1-6 0- 2-12:19 1 1. .3 4
INVOICE TYPE I
9") 1) c I i v r I Cha i c ?3 1 e
QUANTITY PART NUMBER LINE DESCRIPTION PRICE NET TOTAL CODE
1. 0(") HL'7051 ECH SWITCH 1 *7 9. -.20 97. 5 i:: 0 0 T. 5 2. f
ChEvrolet Impala 3.8 L 2-"-:;1 CID VG
SUB 00c
TOTAL 97. 552, 1 0. OOT7. TAX C), OC' I TOTAL 97. 52
Control No.
88.01949
CARMEL NAPA
III 01CAL DRIVE y OCR y R 11. 1"1" GID f. Nb'—
REF BY VER BY D R.
CARKL, III 4032
VED
C 0
C H I CAG
RECEr
y x
1000060177521556
ALL GOODS RETU NED MUST �E AC OMPANIED BY THIS INVOICE
'VAW"K1(9llU 1101111 Ul" 100 OLD TO DATE- O Ultib, STORE NO. EMP SR
85... CI TY CARMEL POLICE D 1752155
1
3 1'-", V I C SO I f I TIME PURC HASE ORDER NO. ATTENTION
4
CAi.\.'.IEL IN -4603;27570 2-09:39
9 T)r V INVOICE PE a rc I
04) Cl
QUANTITY PART NUMBER LINE DESCRIPTION PRICE NET TOTAL CODE
3. 00 753 AV BAT BA 11. 5. 0 E 09 18E.. 2'e"
3. 0C '75 '"E 4 BAT Core Deposit 1. C )c i I(), C)Ool) 0. oo
2. 00 t3 34 7 8
BATTERY I 3, '2" 3 71.390o 1 4 7 6 W
c. 00 8434/• BAT Core Deposit 0. 00 10. 000c) 20. CA. 1)
TOTAL )0o 0
7 9.
379. 5 rmvo 01. 00 1 7.(- TAX TOTAL
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
Genuine Parts Company Indianapolis Purchase Order No.
5 959 Collections Center Drive Terms
Chicago, IL 60693 Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
4/12/10 payment for repair parts 1,186.18
Total
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
VOUCHER NO. WARRANT NO.
ALLOWED 20
G enuine Parts Company Indianapolis, IN IN SUM OF
5959 Collections Center Drive
Chicago, IL 60693
1,186.18
ON ACCOUNT OF APPROPRIATION FOR
police generAla£nd
Q5� D I
9:3 Board Members
PO# or INVOICE NO. ACCT #!TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
1110 370 1,186.18 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
April 12 20 10
Signature
Chief of Police
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund