184493 04/14/2010 CITY OF CARMEL, INDIANA VENDOR: 354275 Page 1 of 1
ONE CIVIC SQUARE T B A OIL WAREHOUSE, INC CHECK AMOUNT: $361.96
CARMEL, INDIANA 46032 2425 E 30TH ST
INDIANAPOLIS IN 46218 -2724 CHECK NUMBER: 184493
CHECK DATE: 4/14/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4237000 011Z3432 361.96 REPAIR PARTS
s
TBA Warehouse Invoice 7
2425 E 30th Street N 0'I IZ3432 L
Indianapolis, IN 46218
317 -923 -2222 PAX: 317 -923 -2233
Page 1
14:05:01 Mar 18 2010
'CUSTOMER NUMBER Invoice NUMBER Invoice DATE PACKING SLIP TERMS WHSE
318 01IZ3432 03/18/10 OIQG8973001 NET 10TH 010
BILL TO: SHIPPED TO:
CARMEL POLICE CITY GARAGE CARMEL POLICE CITY GARAGE
3 CIVIC SQUARE B 3400 W 131ST
SHIP TO 3400 W 131ST WSTF CARMEL, IN 46074
CARMEL, IN 46032
IIIIIIIIIfIII 1111 III111IlIIIIIlII111III11IIEIIIIFIII
Dept: 002 CARMEL POLICE CITY GARAGE Contact: /317- 733 -4600
YOUR P.O. NUMBER ORDER DATE CSR SHIPPED VIA CARTONS OPER
stk 03/18/10, 14:05:00 200003 MATT SEGERSON 3 CARMEL /WESTFII LD A 202
ITEM DESCRIPTION BIN UNIT ORDER BACK INV LIST CORE NET NET EXT
QTY ORDERED QTY PRICE PRICE PRICE CORE PRICE
D60 18A2322 19169879 KEEP 4 CARMEL U EA 4 0 4 95.86 0.00 50.27 0.00 201.08
RAF ATD1159P AT POLICE PAD SET U EA 4 0 4 103.36 0.00 40.22 0.00 160.88
TOMS C-9 SIM-8 6.961
TOTAL PURCHASE FREIGHT TAX PCT TAX AMT INVOICE TOTAL PAYMENTS BALANCE DUE
361.96 0.00 0.00 361.96 0.00 361.96
1.5% service charge on past due accounts(18 %a per annum).
Core returns must be in original box. All new returns must
be resaleable. No return after 30 days without invoice.
Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No. 201 (Rev. 1995)
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
TBA Warehouse Purchase Order No.
2425 E 30th St
Terms
Indpls, IN 46218
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
3/18/10 011Z3432 payment for auto repair parts 361.96
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
T$A Warehouse
2425 E 30th St IN SUM OF
Indpls, IN 46218
361.96
ON ACCOUNT OF APPROPRIATION FOR
police general fund
Board Members
PO# or INVOICE NO. ACCT #!TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
1110 01123432 370 361.96 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 7, 20 10
Sign of PO ice
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund