196245 04/13/2011 ^Qy, CITY OF CARMEL, INDIANA VENDOR: 00350350 Page 1 of 1
ONE CIVIC SQUARE AUTOZONE INC CHECK AMOUNT: $203.98
i s CARMEL, INDIANA 46032 Po Box 116067
ATLANTA GA 30368 -6067 CHECK NUMBER: 196245
CHECK DATE: 4/1312011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4239011 2622830323 203.98 SPECIAL DEPT SUPPLIES
Page: 1 of 1
1445 S RANGE LI
CARMEL, IN 46032
317 846 -1274
Customer Information Order Information
CARMEL FIRE INVOICE NUMBER.. 2622830323 08
2 CIVIC SQUARE COMM SPECIALIST.LEATHERWOOD, KEVIN
CARMEL, IN 46032- ORDER DATE...... 3/05/2011 11:58a
PHONE...... 317 571 -2600 QUOTE DELIVERY.. 03 /05/2011 12:27p
PO NUMBER..
Items
Sugg.
Qty Sku Description List Cost Core Amount
2 690875 7133 OIL ABS 448 FULLER 11.98 5.99 0.00 11.98
Moltan Oil Absorbent
48 690875 7133 OIL ABS 448 FULLER 11.98 5.99 0.00 287.52
Moltan Oil Absorbent
NO VEHICLE GIVEN For The Above Items
Deal 020708 $4ea. when you buy 3. 95.52
NO VEHICLE GIVEN For The Above Items
Payment Appry Amount
1034 061057 0 AA3K4D 203.98
2622830323030511C
Subtotal 203.98
Tax 0.00
Total 203.98
MSDS can be ordered upon request
"The signature above acknowledges customer's agreement to be bound by all terms outlined in the AutoZone Commercial Customer Charge Account
Agreement. as amended from time to time.
VOUCHER NO. WARRANT NO.
ALLOWED 20
Auto Zone
IN SUM OF$
1 RaftgehiTe Road
Car�rtel�FN
$203.98
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT
Board Members
1120 I 2622830323 I 42- 390.11 I $203.98 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
APR 2011
�7
Fire Chief
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))
2622830323 $203.98
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
20
Clerk- Treasurer