193103 12/22/2010 a CITY OF CARMEL, INDIANA VENDOR: 355214 Page 1 of 1
t- ONE CIVIC SQUARE GENUINE PARTS COMPANY-INDIANA PpLI�
CARMEL, INDIANA 46032 5959 COLLECTIONS CENTER DRIVE CHECK AMOUNT: $63.29
CHICAGO IL 60693 CHECK NUMBER: 193103
CHECK DATE: 12/22/2010
DEPARTMENT ACCOUNT PO N UMBER INVOICE NUMBER AMOUNT DESCRIPTION
1207 4238900 0851898 63.29 780749
Control No.
RAW 7582359
CARMEL NAPA
III MEDICAL DRIVE y
I OCR REM 1 f o GPC-- I ND
REF BY VER BY 5959 COLLECTION C-� R. DR.
cAffla, R1 40322 C XC7 I WL. F,- 3 RECEIVED 1000001.7707490 B
ALL GOODS RETURNED MUST BE ACCOMPANIED BY THIS INVOICE
ACCT NO. SOLD TO DATE I w0 M I STORE NO.. EMP SR
85•0018.38 C *TY OF CARMEL/BROOKSHI 1 1 5 :`0 1 C 1 7 8 07 49 1 601 7 10 1
I civic SO 1. of 1, TIME PURCHASE ORDER NO. I ATTENTION
6 3--1511?) t-4.- 19 �(.ISSELL
CARMEL, Il'i 4
(14) coau Ina V 2- 1 041 Deliverl INVOICE PE Ch---irge Sale
QUANTITY PART NUM R LINE DESCRIPTION PRICE NET TOTAL CODE
NICE WILE PKR CAR 3 5. ('-),c 21.990 21. 9
Above Item on Sale
1. OC 7 E', 0 1.:a67 ELK DirlUXE WNR Bfill 7. 49
1. 0 760-1363 B K DELUXE FENDER Bf 8.8E 7. 290c 7. 2 9
2. oi_ Ni"'76 NCB UNISH CAR PGI 8,, 4 16 9
6. Zi. 3 1. CH Spark Pilig Cop 1. 5 O 1 9. 54
r. SUB 01 6,� 7.0000% 0 C TOTAL G, 3.
T?TAL 1 0 1 1 TAX 1
VOUCHER NO. WARRANT NO.
ALLOWED 20
GPC -IND
IN SUM OF
5959 Collection Ctr. Drive
Chicago, IL 60693
$63.29
ON ACCOUNT OF APPROPRIATION FOR
Brookshire Golf Club
PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members
1207 780749 42- 389.00 $63.29 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
Friday, December 17, 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))
12/15/10 780749 Repair Parts $63.29
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
1 20
Clerk- Treasurer