186820 06/23/2010 CITY OF CARMEL, INDIANA VENDOR: 355214 Page 1 of 1
ONE CIVIC SQUARE GENUINE PARTS COMPANY-INDIANA P %CK AMOUNT: $40.58
CARMEL, INDIANA 46032 5959 COLLECTIONS CENTER DRIVE
CHICAGO IL 60693 CHECK NUMBER: 186820
CHECK DATE: 6/23/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1207 4350000 0851898 40.58 763659
Qt Control No.
RAW 7377584
0® CARMEL NAPA
III NEDIC& DRIVE y OCR y REM IT
REF BY VER 5959 COLLECTION CTR.DR.
CAME, IN %03M CHICAGO ILL. 60693
RECEIVED
1000060177636594 By x
ALL GOODS RETURNED MUST BE ACCOMPANIED BY THIS INVOICE
ACCT NO. SOLD TO DATE 0 Cho STORE NO. I EMP SR
85-001898 CII'Y OF' CARMEL/BROOKSHI 06/10/2010 1763659 C.16017 1 19 110
A civic SO 1 of I TIME I PURCHASE ORDER NO. ATTENTION
CARMEL, IN 460322584 NE- 314-19 .3: 1
INVOICEi YPE
:109) Pel iver I 6 11 Charge Sale
QUANTITY PART NUMBER LINE DESCRIPTION PRICE NET TOTAL CODE
q
20. 00 710 1
-1149 BK TIRE REP PATCH 1 1.74 6900 33. 80 1
2.00 75--210 NOL NWA GEAR W90 4.24 3. 3900 6.78 1
NO. WARRANT NO.
ALLOWED 20
IGPC -IND
IN SUM OF
5959 Collection Ctr. Drive
Chicago, IL 60693
$40.58
ON ACCOUNT OF APPROPRIATION FOR
Brookshire Golf Club
PO# Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Members
1207 763659 43- 500.00 $40.58 1 hereby certify that the attached invoice(s), or
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
Thursday, June 17, 2010
71 -1 L—
Director, Brooi shire Golf Club
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
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
Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
06/10/10 763659 Repair Parts $40.58
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
2t)
Clerk- Treasurer