187742 07/21/2010 CITY OF CARMEL, INDIANA VENDOR: 00352688 Page 1 of 1
ONE CIVIC SQUARE CARQUEST AUTO PARTS STORES
CARMEL, INDIANA 46032 PO BOX 503601 CHECK AMOUNT: $442.62
ST LOUIS MO 63150 -3601
CHECK NUMBER: 187742
CHECK DATE: 7/21/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2201 4236400 260174052 442.62 PAINT
CARQUEST AUTO PARTS STORES REMIT TO:
PO BOX 503589 CARQUEST CARQUEST AUTO PARTS STORES
ST LOUIS MO 63 -3589 15". STATEMENT PO BOX 503589
UNITED S ;rA'fES ST LOUIS MID 63150 -3589
(888) 340 -5043 AUTO PARTS UNITED STATES
(888) 340 -5043
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P15MLN007010781004309
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CITY OF CARMEL STREET DEPARTMENT
3400 W 131ST ST
WESTFIELD IN 46074
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CUSTOMER NO
PAY THIS AMOUNT IND 860097
CUSTOMER NO INTERNAL CUST STATEMENT DATE PAGE 442.62 INTERNAL CUST STATEMENT DATE PAGE
CHECK
IND 860097 1141889 30- Jun -10 1 Of 1 1141889 30- Jun -10 1 of 1 ITEMS
NOT
INVOICE DATE INVOICE NUMBER PO NUMBER DUE DATE INVOICE AMOUNT AMOUNT PAID AMOUNT DUE INVOICE REFERENCE AMOUNT DUE PAID
03- JUN -10 2601 -ID -74052 31- JUL -10 442.62 442.62 2601 -ID -74052 442.62
IND Noblesville 10 442.62 IND Noblesville IN 442.62
TOTAL 442.62 PAY THIS AMOUNT
442.62
PAYMENT SUMMARY
DATE CHECK PAYMENT
PAID PREVIOUS PAID CURRENT UNAPPLIED SUBTOTAL PAID FUTURE TOTAL PMTS
0.00 0.00 0.00 0.00 0.00 0.00
30 DAYS PAST 60 DAYS PAST 90 DAYS PAST 120 DAYS TOTAL PAST DUE
0.00 0.00 0.00 0.00 0.00
PREV. TOTAL DUE FINANCE CHG CURRENT -PAYMENTS TOTAL DUE FUTURE TOTAL OWING
0.00 0.00 442.62 0.00 442.62 0.00 442.62
A FINANCE CHARGE OF 1.50 PERCENT PER MONTH (18.00 PERCENT PER YEAR)
WILL BE ADDED TO ACCOUNTS OVER 30 DAYS PAST DUE (0.50 MINIMUM)
L
15MLN_007 E01078- 1004309 0011002
®e PROUDLY SERVING A WORLD IN MOTIONS"
CARQUEST. CQ OF NOBLESVILLE IN 9186 PAGE 1 OF 2
1.64 N 10TH ST REF# 113947
NOBLESVILLE, IN 46060
317- 773 -4274
AUTO PARTS GREAT PEOPLE!
I III II I II I I I IIII II III I IIII II II IIIII I I II III 16III I I I I GREAT PRODUCTS!
GREAT PRICES!
21201006030260100000740520000113947741
ANY PRODUCT RETURNED FOR CREDIT MUST BE ACCOMPANIED BY THIS RECEIPT. SEE CARQUEST STORE FOR DETAILS OF THE COAST TO COAST GUARANTEE.
BCITY OF CARMEL STREET DEPARTMENT L OF CARMEL STREET DEPARTMENT
X3400 w 131ST ST P3400 W 131ST ST
TWESTFIELD, IN 46074 TWESTFIELD, IN 46074
0 0
CUSTOMER SALES TEAMMATE
INVOICE NO. NO DATE CUST. P.O. NO. ID ID FORM OF PYMT.
2601 860097 ln�;/ni/i I K1710 CHARGE
G. PART NUMBER ORDERED SHIPPED LIST PRICE NET NET CORE EXT. AMOUNT I TAX
1 DPC K -4 1 1 116.06 93.79 0.00 93.79 kIN
2 DPC KM -8 1 1 112.00 90.50 0.00 90.50 NIN
3 DPC K -4 1 1 116.06 93.79 0.00 93.79 N IN
0
a
4 DPC 71605 -01 1 1 93.13 75.25 0.00 75.25 NIN
a
U EMAKER
5 DPC 390OS -01 1 1 53.44 43.18 0.00 43.18 NIN
WARRANTY DISCLAIMER: "The factory warranty constitutes all of the warranties with respect to the sale of all items. The seller hereby expressly disclaims all warranties, either expressed or implied, including any
implied warranty of merchantability or fitness for a particular purpose, and the seller neither assumes nor authorizes any other person to assume for it any liability in connection with the sale of all items."
SHIP VIA DELV. TIME DELV. ID FREIGHT TAXABLE AMT. SALES TAX TOTAL CORE PREV. DEPOSIT
RECEIVED PAY THIS
03:55 PM BY X CUSTOMER COPY AMOUNT CONTINUED
PROUDLY SERVING A WORLD IN MOTIONS'"
ORQUES T CQ OF NOBLESVILLE IN 9186 PAGE 2 OF 2
164 N 10TH ST REF# 113947
NOBLESVILLE, IN 46060
317- 773 -4274
AUTO PARTS GREAT PEOPLE!
IIIIIIIIIIi IIII iII 1 1111111 111 lII I II II III I I II II ICI I [I I GREAT PRODUCTS!
GREAT PRICES!
21201006030260100000740520000113947741
ANY PRODUCT RETURNED FOR CREDIT MUST BE ACCOMPANIED BY THIS RECEIPT. SEE CARQUEST STORE FOR DETAILS OF THE COAST TO COAST GUARANTEE.
BCITY OF CARMEL STREET DEPARTMENT HCITY OF CARMEL STREET DEPARTMENT
X3400 W 131ST ST P3400 W 131ST ST
TWESTFIELD, IN 46074 TWESTFIELD, IN 46074
0 0
CUSTOMER SALES TEAMMATE
INVOICE NO. NO DATE CUST. P.O. NO. ID ID FORM OF PYMT.
MFG. PART NUMBER ORDERED SHIPPED LIST PRICE NET NET CORE EXT. AMOUNT TAX
6 DPC 39015 -01 1 1 57.06 46.11 0.00 46.11 /N
0
X x
W
O
U
WARRANTY DISCLAIMER! "The factory warranty constitutes all of the warranties with respect to the sale of all items. The seller hereby expressly disclaims all warranties, either expressed or implied, including any
implied warranty of merchantability or fitness for a particular purpose, and the seller neither assumes nor authorizes any other person to assume for it any liability in connection with the sale of all items."
SHIP VIA DELV. TIME DELV. ID FREIGHT TAXABLE AMT. SALES TAX TOTAL CORE PREV. DEPOSIT
RECEIVED PAY THIS
03:55 PM BY X CUSTOMER COPY AMOUNT 442.62
VOUCHER NO. WARRANT NO.
ALLOWED 20
Carquest Auto Parts Stores
IN SUM OF
P. O. Box 503589
St. Louis, MO 63150 -3589
$442.62
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO# Dept. INVOICE NO. ACCT /TiTLE AMOUNT Board Members
2201 2601 -74052 42- 364.00 $442.62 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, 115, 2010
Street Commission14/
S."Fee Ge "i oivi i
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))
06/03/10 2601 -74052 $442.62
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
20
Clerk- Treasurer