193649 01/19/2011 CITY OF CARMEL, INDIANA VENDOR: 00350350 Page 1 of 1
0 ONE CIVIC SQUARE AUTOZONE INC CHECK AMOUNT: $35.98
CARMEL, INDIANA 46032 PO BOX 116067
ATLANTA GA 30368 -6067 CHECK NUMBER: 193649
CHECK DATE: 1/19/2011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
601 5023990 2622757950 35.98 OTHER EXPENSES
FA 0 500//i
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Page 1 of 1 Customer ID: 359080
AutoZone, Inc.
P.O. Box 116067
Atlanta, GA 30368 -6067
Phone: (866) 208 -3385
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Open Item Statement
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Bill to: 5286 1 MB 0.382 Statement Date: 01/04/2011
CARMEL WATER DISTRIBUTION 231 5286
Ste 110 Statement 747
760 3rd Ave SW Amount Due $35.98
Carmel IN 46032 -2070
If you have questions about your account, please call Accounts Receivable Specialist 8661208 -3385
If you are not paying the full amount of your statement, place an "X" in the "Remit Advice", column for the items you are
paying and return a copy of your statement with your payment.
Date Type Remit Invoice PO Number Due Date Document Invoice Amount Due
Advice Amount
Account: CARMEL WATEF DISTRIBUTION 359080 760 3RD AVE. SW STE 1Y0 CARMEL IN 46032
12/22/2010 Invoice 2622757950 01/21/2011 35.98 35.98
Total for CARMEL WATER DISTRIBUTION 35.98
Current and Future Items PAST DUE ITEMS
Future Current 1 -30 31-60 61-90 91-120 121 180 Over 180
$0.00 $35.98 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00
To avoid suspension of your account, please pay any past due items upon receipt.
Reminder: Please include your Customer Id and statement number on your check.
Notice: All disputes must be submitted in writing within 30 days of the statement date.
Page: 1 of 1
1445 S RANGE LI
CARMEL, IN 46032
317 846 -1274
Customer Information Order Information
CARMEL WATER DISTRIBUTION INVOICE NUMBER.. 2622757950 09
3450 W 131ST STREET COMM SPECIALIST.LEATHERWOOD, KEVIN
WESTFIELD, IN 46074- ORDER DATE...... 12 /22/2010 8:58a
PHONE...... 317 733 -2855 QUOTE DELIVERY.. 12 /22/2010 09:27a
PO NUMBER..
Items
Sugg.
Qty Sku Description List Cost Core Amount
1 369511 10020 FUEL TREATMENT 5. 11.98 5.99 0.00 5.99
Lucas Complete Fuel Treatment
1 899712 10013 LUCAS FUEL TREATME 59.98 29.99 0.00 29.99
Lucas Complete Fuel Treatment
NO VEHICLE GIVEN For The Above Items
NO VEHICLE GIVEN For The Above Items
Payment Appry Amount
3590 801057 0 AG4ASU 35.98
26227579501222100
Subtotal 35.98
Tax 0.00
Total 35.98
MSDS can be ordered upon request
*The signature above acknowledges customer's agreement to be bound by all terms outlined in the AutoZone Commercial Customer Charge Account
Agreement, as amended from time to time.
VOUCHER 103789 WARRANT ALLOWED
352242 IN SUM OF
AUTOZONE WAIM
PO BOX 116067 O
PO BOX 6717
ATLANTA, GA 30368 -6067
Carmel Water Utility
ON ACCOUNT OF APPRO ATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
2622757950 01- 6500 -05 $35.98
Voucher Total $35.98
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
352242
AUTOZONE Purchase Order No.
PO BOX 116067 Terms
PO BOX 6717 Due Date 12/30/2010
ATLANTA, GA 30368 -6067
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
12/30/201( 2622757950 $35.98
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
Date Officer