187389 07/07/2010 CITY OF CARMEL, INDIANA VENDOR: 00352498 Page 1 of 1
ONE CIVIC SQUARE NAPA OF WESTFIELD CHECK AMOUNT: $89.50
CARMEL, INDIANA 46032 PO Box 245
WESTFIELD IN 46074 CHECK NUMBER: 187389
CHECK DATE: 717/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
601 5023990 380550 89.50 TRANSPORTATION EXPENS
'S
s
Westfield Automotive Supply, Inc.
700 East Main Street P.O. Box 245 U O W PT
Westfield, Indiana 46074 N
Phone (317) 896 -5615 EAST MAIN STREET
Fax (317) 896 -1820 WESTFIELD, IN 46074
PLEASE SEND PAYMENT TO PO BOX 245 WESTFIELD
BILLTO CITY OF CARMEL -WATER
3450 W 131 ST STATEMENT
WESTFIELD, IN 46074
AGGT# -?'GSM #max `'PAGE
8039 0 1
a� jDE1 i _tom >.r ..f_TYFt k r ,RtFE("tENC ..,Ib.,`.:. AIV1C?UNTT 7 7 "'s c 7 tP C3 (,CHEGlUJ E` r,:
s_..
06/1612010 INV 380550 89.50
°�x a 'C.URREN7 �.kp vu «PAST)DU.E'30 .'kPAST D.U'E.60. m .;PAST DUE 90'x.,
89.50 0.00 1 0.00 0.00
DATE 06/25/2010 �T`otal "O wetl F
d a ;'�tL�' a 9.50
TERMS No SVC dUe 10th �T °Ot�a l Da t Ijn g� 0.00
STORE 100006273 �����ToFt 89.50
NAPA Auto Parts of Westfield
700 E. Main Street is Po Box 245 is Westfield, In 46074.317- 896 -5615
I hereby certify under the lease Remit To: H H Automotive Supply 1212 W. Main St. Lebanon, IN 46052
1 A N AGRICULTURAL EXEMPTION CERTIFICATE LIMITED WARRANTY PLEASE
INDIANA DEPARTMENT OF REVENUE -SALES TAX DIVISION
penalties of perjury that the personal property purchased by the use of this exemption certificate will be
directly used in the direct production of agricultural products for resale.
'The fact censtitules all of the warranties with respect to the sale of this itemlitems, The seller hereby expressly
Please examine these parts at once. Errors should be reported before using or installing. Returns factory warren tY
C must be made within TEN DAYS and must be accompanied by this INVOICE NUMBER. This disclaims all warranties, either express or implied, including any implied wananty of merchantability or fitness for part icular
property is sold to you with the definite understanding that it is purchased for resale, unless tax purpose and the seller neither assumes nor authorizes any other person to assume for it any liability in connection with the
has been added to the price. ALL RETURNS SUBJECT TO 10% RESTOCKING CHARGE. sale of this itemfitems.
NO RETURN ON ELECTRICAL PARTS.
ACCT SOLD TO DATE TIME STORE EMP No Le
8039 CITY OF CARMEL —WATER 06/16/1 12:41 1 10000627 2c 380550
SR 3450 W 131 ST PURCHASE ORDER ATTENTION
WESTFIELD, IN 46074
41 TAX EXEMPTION:
AD TERMS: No svc due 10th Charge Sale
14 DELIVERY: 1 of 1
PART NUMBER LN DESCRIPTION QUANTITY PRICE NET TOTAL
ROTOR LAII LATHE 2 Oc 0.0 15-OOOC 30.00
2006 Ford Truck F250 Super Duty 3/4 Ion Pic"
U P— 7 9 7 4— M UP Brake Pads Front, Ultra Premium OE 1.00 107.53 59 5 0 0 .5 9. 5 0 R
4L
1 89.50
25 %I"RESTOCKING FEE Indiana Sale 7.000% 0.00
REMIT TO: 1212 W MAIN ST 0.00
LE86NON, IN 46052 -2324
TOTAL Charge Sale 89.50
SIG�IpjYURE
ALL GOODS 1 11 ACCOMPANIED BYTH/S INVOICE
VOUCHER 102061 WARRANT ALLOWED
354290 IN SUM OF
NAPA BOONE COUNTY AUTO- Q NC
1 24- �nainy„M,,�-ST- R& Et -4
c2 B 7 0c P1►.L CAI .��nc7 L, 5
Carmel Water Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
380550 01- 6500 -05 $89.50
Voucher Total $89.50
Cost distribution ledger classification if
claim paid under 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 of service rendered, by whom, rates per day, number of units,
price per unit, etc.
Payee.
354290
NAPA BOONE COUNTY AUTO -DO NOT USE Purchase Order No.
1212 W MAIN STREET Terms
LEBANON, IN 46052 Due Date 6/29/2010
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
6/29/2010 380550 $89.50
hereby certify that the attached invoice(s), or bill(s) is (are) true and
correct and I have audited same in accordance with IC 11- 10 -1.6
Date Officer