190272 09/29/2010 CITY OF CARMEL, INDIANA VENDOR: 355214 Page 1 of 1
0 ONE CIVIC SQUARE GENUINE PARTS COMPANY- INDIANAP% CHEC
CARMEL, INDIANA 46032 5959 COLLECTIONS CENTER DRIVE K AMOUNT: $121.16
CHICAGO IL 60693
CHECK NUMBER: 190272
CHECK DATE: 9/2912010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1207 4350000 0851898 121.16 0851898
Control No. 7763561
RAW CAIRMEL NAPA
III REDICK DRIVE y OCR y REMI
U BY VER BY 5953 COLLEUTION CTR.DR.
CA, IF! 46 10000601777 4
0329E CH I CAGO
�o LL 6fp!9
RECEIVED
2288 BY x 1 1 Jj C c P
ALL GOODS R11WRNW%hT BE ACCOMPANIED BY THIS INVOICE
ACCT. NO. SOLD TO DATE o c STORE NO. EMP SIR
85•001898 ci"ry OF CARMEL/BROOKSHI 09/10/201(j 772i:R'84 06017 3- 1(
I civic so L 0 f 2 TIME PURCHASE ORDER NO. ATTENTION
CARMEL, IN 460322584 NE-314-49 13:49 INVOICE TYP
-ge Sale
09) Deliver Cha�
QUANTITY PART NUMBER LINE DESCRIPTION PRICE NET TOTAL CODE
90-100-1 0.76 0. 6900 17. 25
1.0C SLIME 10011 NCC
B SLIWE TIRE Mi 12. 4*5 9. 9900 9.99
UB 0 c i
444 T mi T '7. 000 TA X 0 TOTAL 121.
Control No.
aW0® 9 7 7 6 3 3 0
CARMEL NAPA
III MEDICAL DRIVE y OCR y REMIT:GPC-IND
REF BY VER BY 5959 COLLEq CTR.DR.
Wa7N ,I W 10006017722848
3&9E CHICA IL Q E RECEIVED
BY x
07 C
ALL GOODS, IL
I 4ST ACCOMPANIED BY THIS INVOICE
ACCT NO. SOLD TO DATE 00 STORE NO. I EMP SR
85--001896 CITY OF CARMEL/BROOKSHI 09/10/2oll 772284 106017 1 30 1(
civic so I of L TIME PURCHASE ORDER NO. ATTENTION
CA IN 460322584 E- 1 0-14:49 13.49
(09) Deliverl INVOICE PE I Charge Sale
QUANTITY PART NUMBER LINE DESCRIPTION PRICE NET TOTAL CODE,
2. OC TG7000W ECH SW ITCH 1 :3. 94 6. 13.38
I.00 E91 BP4 BK ENR W AR-4 BA 1 El. Gc 5.2900 5.29
1.0C E9213P4 BK ENR MX W4 N 15.15c 5. 2900 5. 29
1.0C 85905 NHF PREH AU 32 HYD F 54.8- 39. 9900 39. 99
2.00 BP 1235/H3 LM r_ HLOO BULB 10.3 7. 9 9 0(_' 15.98
1 0 765 BK1 UNIVERK CEKW 20.4 13. 9901 13.99
TOTAL MISC. TAX u TOTAL Contine
I I A I
CARMEL NAPA
CD M
111 S03CAL DRIVE
REF BY VER BY
CARMEL, 13 460322422
w printa
C7
Q
ACCT BOLD TO DATE TIME STORE P ff" 0 Xmmic
1898 CITY OF CARKRr. /BROOKSKIRE GOLF 09/10/2010 13:49 100006017 36 772284
1 CIVIC 80 PURCHASE ORDER 0 ATTENTION
SR ACCT 1898
y 10 CA'RMEL, IN 460322584 TAX EKHMPT REPRINT
AD TER36Ss No src due 10th Charge sale
g DBLIVRRYs Our Truck NE 3 02:1
PART WVbMRR LN DESCRIPTION QDA"ITX PRICE NET TOTAL
Q 13.36
2.00 9.94 6.8900
ECH
z E91BP4 BK HNR NAI AA -4 BATTERY 1.00 6.60 5.2900 5.29
8928P4 BR EM MAX AAA -4 BATT 1.00 6.60 5.2900 5.29
w 65 -905 N8F PRW6 AN 32 HYD FL 50 1.00 54.83 39.9900 39.99
Q SPL235/03 IXP HALOGEN BULB 2.00 1D.39 7.9900 15.98
U 7651198 RK UNIVERSAL CZK3N7 1.00 2D.46 1,3.9900 13.99
901001 39TH VAL CORE 25.00 D.70 0.6900 17.25
SLIME 10011 HC8 SLIME TIRE SEALANT 1.00 12.49 9.9900 9.99
RMK17 :OPC -INn subtotal 121.16
m 5959 COLLRCTTON CTB.DR. Indiana Bales Tax 7.000% 0.00
CHICAGO ILL. 60693 0.00
N rOrAL 121.16 M •6
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4
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SIGHATQRE
m III goods returned must be accompanied by this invoice
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VOUCHER NO. WARRANT NO.
ALLOWED 20
GPC -IND
IN SUM OF
5959 Collection Ctr. Drive
Chicago, IL 60693
$121.16
ON ACCOUNT OF APPROPRIATION FOR
Brookshire Golf Club
t
PO# Dept. INVOICE NO. ACCT #ITITLE AMOUNT Board Members
1207 772284 43- 500.00 $121.16 I hereby certify that the attached invoice(s), or
G f 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
i
Thursday, September 23, 2010
Director, Brookshir 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))
09110/10 772284 Repair Parts $121.16
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