155192 01/10/2008 CITY OF CARMEL, INDIANA VENDOR: 00352242 Page 1 of 1
ONE CIVIC SQUARE AZ COMMERCIAL CHECK AMOUNT: $17.99
0 INDIANA 46032
CARMEL, 1445 S RANGELINE
CARMEL IN 46032 CHECK NUMBER: 155192
CHECK DATE: 1/10/2008
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 2622633255 17.99 OTHER EXPENSES
<M
Page 1 of 1 Customer ID: 618020
AutoZone, Inc.
P.O. Box 791409 Balance Forward Statement
Baltimore, Maryland 21279 -1409
Phone: (866) 208 -3385 Statement Date: 12/19/2007
Statement Number: 320
Bill To: CARMEL WASTEWATER
Statement Due Date: 01/0912008
ACCOUNTS PAYABLE
760 3RD AVE SW Balance Due on Last Statement $285.84
CARMEL, IN 46032 -2072 Less: Payments $285.84
Balance Forward $0.00
Current Month Transactions $17.99
Total Balance Due $17.99
CURRENT ACTIVITY
Date I Type nvoice 4 PO Amount
12/07/2007 PayOnAcct OA- R00214120707 285.84
12/1212007 Invoice 2622633255 17.99
We appreciate your business. If you have questions, please call Marvin Williams 866/208 -3385
To avoid suspension of your account, please pay any past due items upon receipt.
Notice: All disputes must be submitted in writing within 30 days of the statement date.
Please include the section below with your payment.
REMITTANCE
Customer Name: CARMEL WASTEWATER
Important: So that your payment can be posted promptly, Customer ID: 618020
please include your Customer Id on your check.
Statement Date: 12/19/2007
Amount Due $17.99
Remit To: Amount Enclosed:
AutoZone, Inc.
P.O. Box 791409
Baltimore, Maryland 21279- 1409 61802000003200000 017995
8,72D
Page: 1 of 1
1445 S RANGE LI
CARMEL, IN 46032
317 846 -1274
Customer Information Order Information
CARMEL WASTEWATER INVOICE NUMBER.. 2622633255 00
760 3RD AVE SW COMM SPECIALIST.SIMMERMAN, CHARLES
CARMEL, IN 46032- ORDER DATE...... 12 /12/2007 2:30p
PHONE...... 317 571 -2443 QUOTE DELIVERY.. 12 /12/2007 02:58p
PO NUMBER.
Items
Sugg.
Qty Sku Description List Cost Core Amount
1114496 24065 MANUAL CHEVY 35.98 17.99 0.00 17.99
NO VEHICLE GIVEN For The Above Items
I CERTIFY THAT I HAVE RECEIVED THAT PART(S) LISTED ABOVE ACTUAL DELIVERY TIME
BY:
o
o f
RECD
pEC 2 207
Thank you for your business! Payment Appry Amount
6180 201055 0 AWM5EJ 17.99
Subtotal 17.99
I Tax 0.00
IIII I I II Total 17.99
t III IIII �I I�I
2622633255121207C MSDS can be ordered upon request
VOI. ,CHER 076966 WARRANT ALLOWED
352242
IN SUM OF
r!,\Z COMMERCIAL (Auto Zone)
PO BOX 791409
Baltimore, MD 21279 -1409
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
2622633255 01- 7502 -06 $17.99 i
Voucher Total $17.99
distribution ledger classification if
claim paid under vehicle highway fund
Prescribed by State Board of Accounts City Form No. 201 (Rev 1995)
ACCOUNTS- PAY-ABLE VOUCHER
CITY OF CARMEL
An invoice or bill to be properly itemized must show, kind of service, where 1
performed, dates of service rendered, by whom, rates per day, number of units,
price per unit, etc.
Payee
352242
AZ COMMERCIAL (Auto Zone) Purchase Order No.
PO BOX 791409 Terms
Baltimore, MD 21279 -1409 Due Date 12/28/2007
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
12/28/2001 2622633255 $17.99
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