HomeMy WebLinkAbout166586 12/10/2008 CITY OF CARMEL, INDIANA VENDOR: 354290 Page 1 of 1
s ONE CIVIC SQUARE BOONE COUNTY AUTOMOTIVE, INC
INDIANA 46032 1212 W MAIN ST CHECK AMOUNT: $135.27
CARMEL
LEBANON IN 46052 -2324
CHECK NUMBER: 166586
CHECK DATE: 12/10/2008
DEPARTMEN AC COUNT P O NUMBE INVOICE NUMBER AMOUNT DESCRIPTION
1120 4237000 7996 135.27 REPAIR PARTS
HH Automotive Supply NAPA Auto Parts of Westfield
Le 2 Main Street AND (3173896 818206 Fax anaw Le ban on IN 46052 2324
NAPA Auto Parts of Noblesville
10 (317) 773 -3180
(765) 482 -1180 Remit to (317) 774 -0932 Fax
(800) 924 6831 Boone County Automotive, Inc. NAPA Auto Parts Carmel
(317 844 -3973
(765) 482 -7398 Fax 1212 W. Wa in S tree t, Lebanon, IN 46052.2324 (317)_8
BILL TO T
CITY OF CARMEL -FIRE DEPT
2 CIVIC SQUARE
CARMEL, IN A :,C T# PA E
7996 43 1
46032
>DATE TYPE REF..ERENCE.:,, •i AMOUNT P.OJGHEGK11 .;z.r,';
10/28/08 Inv 713132 3 9.02 BOB
10/29/08 Inv 713195 19.55 BOB
10/29/08 Inv 713253 6.29
10/29/08 Inv 713264 3.50
10/30/08 Inv 713392 9.98
10/31/08 Inv 713451 19.48
10/31/08 Inv 713515 21.42
11/17/08 Inv 714772 10.99
11/17/08 Inv 714802 35.04
Summary as of 11/26/2008
Previous Balance 347.34
Payments 347, 34Cr
Purchases 135.21
Current Balance 135.27
Future Dated 0.00
CURRENT 4 '.PAST DUE.30:DAYS. PAST. DUE 60 DAYS =.F .PAST.DUE 90 >DAY.S',
135.27 0.00 0.00 0.00
3
DATE 11/26/2008 T o a` 1;> O w e d 135.27
TERMS No svc due 10th
o,
STORE 100006128 -0004 L TE,o a I Due 135.27
IVAP 4 'Auto Parts of '.C:armel
111,''iNedical Drive' Carmel,'Indiana 844 -3973 •.�Fax:.317= 844 =6220
Please Remit To: H &.RAutomotive Supply: 1212 W. Main St •Lebanon, IN 46052
AGRICULTURAL EXEMPTION: CERTIFICATE agricultural use
NAPA INDIANA DEPARTMENT.OF REVENUE -SALES TAX DIVISION LIMITED WARRANTY PLEASE READ
I hereby cerlify under the penalties of perjury that the personal property purchased by the use of ihisexemplion certificate will be
diiectly used in9he direct pioduction'of agricultural products forresale.
Please examine these parts at once. Errors should be report ed befo7e using or installing. Returns' The factory warranty constitutes all of the warranties with respect to the sale of this itemfitems. The seller herebyexpressly,. r
O must bemade. within TEN DAYS and must be accompanied by this INVOICE NUMBER. This disclaims all warianties, either express or implied;;including any implietl warranty of merchantability or fitness for aparticular
.property is sold to you with''he definite understandingg'that it is purchased for resale; unless tax purpose and the seller neither assumes nor authorizes any other person to assume for it any liability in connection with
has been added to the-price: ALL RETURNS SUBJECT 10 RESTOCKING CHARGE. sale of this itenVitems., i• the
NO RETURN ON ELECTRICAL PARTS:.
r ACCT SOLD TO g .DATE ::TIME 4; STORE EMP
0 �59E C -T -,.G CARMEL F'1�31Er I1-PT /t�dli3E1 L 1 <')7 llrsX3t}61
$R 2 C-1 V I L SQUAiRE PURCHASE" ORDER?# ATTENTION
CH'1R�IEL, IN I�C1I� NDR
4. 4Ct� ,r� TAX EXEMPTION:
AD TERMS o VC
y 6 .1► loth CHA kGE SALE'
DELIVERY:. TRUCK:
PARTAUMBER LN; DESCRIPTION QUANTITY PRICE `NET f; TOTAL
.ut. a
r �ia'3 E' 1 R' _F* ILTER Id OQ 3 4'e .37b.
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STQt "FEE'
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N9 46052 t
X
SIGNATURE TC1Tf1L' C4�ARGE SALE; r3, ti;; 1
ALL GOODS RETURNED MUST BE ACCOMPANIED BY THIS INVOICE
-NAPA Auto Parts of Carmel
t1`11 Medical Drive Carmel,`Indiana 46032 •317- 8443973 *Fax: 317- 844 6220
Please :Remit To: H H Automotive Supply 1212 VU: Main Stl •Lebanon, IN 46052 14 :`f�
AGRICULTURAL EXEMPTION CERTIFICATE al L .�7 agricultural use:,
i 3A r INDIANA DEPARTMENT OF REVENUE -SALES TAX DIVISION t3u1II LIMITED WARRANTY PLEASE READ. r I hereby certify,under the penalties of perjury that thperson' property purchased by the'use of this exemption ce will be d in the.direct production of agricultural' zpers s for resale. r Please:ezamine these parts'at once. Errors should be reported before usingorinstalling. Returns 'The factory warranty coristdutesall oLihe warranties with respect to the sale of this se�tems. The seller herby expressly,
mfisCbe made within.TEN DAYS and must be accompanied by this INVOICE NUMBER. This "disclaims all warranties, eilher,express or implied, including any Implied warranty_of merchantability or biness fora particular'
:property is sold to you.w
ilh the definite understanding that it is purchased for resale, unless tax purpose and the seller nettherassumes nor suthorizes any other person to assume for it any liability'in connection with the.
'Tfias. been added to'.the
N price. A @L RETURNS SUBJECT TO 10% "RESTOCKING CHARGE. sale of this itemfitems i r J.
NO RETURN O ELECTRICAL PARTS
ACCT 't $OLD -TO z a DATE TIME STORE` EMP:, f
ra'9 C:IT'l .C31` t�Fzt��Cl� F r'FtE' [J.EF'T c�; �'/c38. r7 :�.�t'ar7t:! ,3
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SCUI�RE PURCHASE ORDER i ATTENTION
SR,# G�tF l I•P't ilOt? g AOB
A 40f, TAX EXEMPTION: 1
4 k� 2AD h ,a, rte, TERMS
t>I�a Svc 1. 3 t�# h HARG,E %4.E x tip
DELIVERY:'
PART:NUMBER LN DESCRIPTION QUANTITY,, I PRICE NET TOTAL!' a
is ��n t� iievr .l t ucic: SdIv ad `-50(j :a T:art 411 ter Ip
148? F I): NA'ArCJL.D n F- I:LTER r�t;> awev -7`� R
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SIGNATURE TOTAL CMARUE:: S F�L:E' J ai
,ALL GOODS RETURNED MUST BE ACCOMPANIED BY THIS INVOICE
yx�
NAPA Auto Partst.of Carmel
t ,11.1 Medlcal.Drlve Carmel, Indiana 46032 317= 844- 3973.•`Fax :317- 844 6220 'b
P1 Remlt,To: H H Automotive SuppI 1212'W. Ma1n -St. •Lebanon;lN 46052 a
AGRICULTURAL EXEMPTION CERTIFICATE
agricultural.usa
AP INDIANA DEPARTMENT OF REVENUE; SALES TAX DIVISION`
.i. .LIMITED WARRANTY PLEASE RE
I hereby certifyunder the penalties of pepury,that,the persohal property purchased by the use of this exemption�certiticate will be.
directly used in the direct production of agricultural products for resale:
r The factory warren constitutes of the warranties aal
with respect to the'e.of this itemditems. The seller hereby expressy� I
e.Please examine these parts at once. Errors should be reported before using or installing Returns 4`.
C must be made.within TEN'DAYS and .must be accompanied;oy this INVOICE NUMBER. This tlisclaims all warranties; either express or including any impliedwarranty of merchantability or fitness for a particular
,'vopertyis sold tc you withcthe definite understanding that it is purchas6d,for resale, unless tax th
Purpose and e seller neither assumes nor authorizes any other person to assume for it any liability in connection with the'
as been addedao the'price.�ALLAETURNS SUBJECT TO f6 /'RESTOCKING CHARGE.'. sale of this pemfitems
t rN0 RETURN ONELECTRICAC PARTS.` f T7.
SOLD TO DATE {TIME STORE e
rte 3' !`1F t F�1Mt~Ix f I (�E UE'rT c ..9 /a r 3 i 3, U��),cCJ 1 i3 t ;tea
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°SR ;C'T °J, C SGI A ':PURCHASE ORDER`# 07.ENTI0 N I
?G�FttYlf= I« T Cif r x� i
TAX EXEMPTION.
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AD r` TERMS�at►. 6
Q t3� CI1f1FtC� Ski E �t
Gt7 Wil D L.1.`TI?!:1 R
t,aa�I
DELIVERY:
pART'NUMBE_ R DESCRIPTION' (�UA'NT,ITY; r PRICE.,,; NET'# _TOTAL. .a
Y Er E3ii l�I�lfait�t
v.
r ,�i� 1¢ o`e 5�� En 1
78 '11 t 5�`4`
r i I w� t J1 I I
.'i {�Ec"rtCf�.l =E ftau'ui�t-
R Iii Ihl�iT N Tax" 7� GfX T}'tL
y a 1t W4
Ask;
A7 SIGNATURE 7f�T4�L
CHARGE :.SAL
ALL GOO S.RETURNEO MUST,BE-ACCOMPANIED BY THIS INVOICE
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NAPA Auto Parts of Cannel
.1:11 Medical'Drive Carmel, Indiana 46032 317 =8,44 3973 eTax 317 -844 6220: *J,
Please Remlt Tor' H H •Automotive Supply •.1212 W Main $t Lebanon; IN 46052 ,y
AGRICULTURAL EXEMPTION CERTIFICATE ti 3 'agricultural:use
S
JNDIANA DEPARTMENT OF REVENUE'-' TAX DIVISION 1:d 1 1LIMITED WARRANTY PLEASE READ
J APA 1 L I hereby certify m under thepenalties of perjury that tie personal property purchased by th use of this exemption certficate will be
directly. used the direct production of,agricultural products for resale. I
.Please'examine these artsat once: Errors should be re orted Before usin or installing. Returns "The factory warranty constitutes all of the warrantieswith respect to the sale of this item /items. The seller expressly l
%must fie matle withinTEN.DAVS Arid must be acoompenied by,this INVOICE NUMBER. This disclaims alfwarrantias,`either,express or implietl, including anyimplied warranty of merchantability or fitness fora particular. ::4
property is sold to. you with the definite understanding that it is purchased ior.resale, unlesstax Purpose and the seller neither assumes nor authorizes any ;other person to,assume for h any liability in connection with jhe
has been added tot he pnce ALL RETURNS SUBJECT 70 70/ RESTOCKING CHARGE sale of this itemltems
NO RETURN ON ELECTRICAL PARTS
SOLD DATE i ,x TIME STORE EMP# o e
r
4�C" G€1 L: —4 RE t)EP, tjl�?'�I�?8_,'11 ea n`� c�trtrt;'Et '71
CIt�7t" 'SQU PURCHASEORDER_# ATTENTION
SR.#
ta�33t a TAX";EXEMPTION "s
k';qp �I TERMS:
DELI�UERY'
PART °NUMBER E LN DESCRIPTION QUANTITY `n` 1 PRICE x NET TOTAL'
m4 1 CTERY� Q RLE~ I3t L.T J,
n c.
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P a
4 I
l� 7
p p� y I� A
i6:T Y r�J
d r y I
t SIGNATURE
T.O1 �3L 7 CI- HA `SALE
ALL GOODS RETURNED MUST DE ACCOMrAN/ED BY THIS INVOICE
i
t
4t IV'APA Auto Parts ofi.C:arniel
1 T1= Medical Drive Carmel, ndiana 46032 317- 844 =3973 F6k:.317. -844 =6220
Rlease Remlt•To: H H Automotive Supply 1212 W Mam St •iebanon; "IN 46052
..AGRICULTURAL EXEMPTION CERTIFICATE n
Y agncu R use 1�}
`INDIANA DEPARTMENT OF REVENUE •SALES TAX DIVISION LIMITED WARRANT`/ PLEASE READ y
s f thi, t fi will
fhereb c nl under'the enalties of p e 'u that'the personal ro en urchased b the use o s exem ton berti rate be
Y e fy P, P,0 rY P. P.P YP Y P
direclIY used in;th6 direct production of agricultural products for resale: t v." `tt
r elease examine these parts at once: Errors should be reported before using or installing. Returns 'The factory warranty.constitutes all of the.warranties;with respect to the sale of this itemltems. The seller hereby expressly,
O must be inade within TEN DAYS and must be accoi4anied,by this INVOICE NUMBER. This disclaims nil warranties, either express or implied, including any implied;warraniy of merchantability orfitness for a partictilar
property is sold to you with the definite undetstanding,that It is purchasedYor resale; unless tax Purpose's d the seller neither assumes nor authorizes any,other person to assume for it any liability connecbon'wRh the 4 -1
sale .of this'Ite�iems
r has been added to the price: ALL' RETURNS SU BJECT TO 10 RESTOCKING CHARGE.
RETURN'ON ELECTRICAL PARTS
SOLD` Att TIME STORE #`EMP 0
Gs�`S czrt� o c� RtC L #`iFdE3C'T /!cAtiyB tk,i7 lUf�ia0E,i
G t) 'T tUAIe CD
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PURCHA RDER# TTENTION
w s
TAX EXEMPTION:
TERMS Ut cdrtC 1 \rlifl 4rn—in 4 )i�ILG
DEL
IVERY:
tF; °PARTtNUMBER ;y LN' DESCRIPTION.. (QUANTITY; PRICE„ 'NET .:r' TOTAL
f'1'�f1it LMf'. FLir,.= nl i r tC�f He �t 4.
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L EBANON I' �I�tq;� A,() 'f r:
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sIGNdTURE V. TtITAI t CHARGE Sf�L�'.
ALL GOO DS RETURNED MUST BE ACCOMPANIED BY THIS INVOICE
1+ j
ly.`f1 f :I
NAPA Auto Parts ofCarrmel''
111.-Medical. Drive Ga.rmel; lndiana 46032 •317- 844 3973•+ Fax: 317 =844 -6220
Please %Remit,To: H &`H Au tomotive'Supply 1212 -W: Mam St •'Lebanon;'IN 46052 E ,t
AGRICULTURAL EXEMPTION CERTIFICATE uft
agncural use f
INDIANA DEPARTMENT OF REVENUE. SALES TAX, DIVISION DIVISION k
y 'MITED WARRANTY PLEASE READ
i I hereby certify under.the penalties of pepury that the personal property'purchased by the use of this ex amphon,cemhcate will be
directly used in the direct production of agricultural products for resale.
Please examine these parti at once. Errois should be}eported before using or installing. R This disclai
Returns
must The factory warranty constitutes all of the viarranties.with respect.to the sale o} this itemhtems. The seller hereby expresslyl
tie made within TEN DAYS and must be accompamed by this'INVOICE NUMBE. ms all warranties, eithe[ ezpress of im plied including any implied warranty of merchantabiliryprfttne r person'to assume for it any liability in connection with ss for a particular+
propertyis sold to you With the definite understandingg that it is purchased for resale. unless tax
purpose and the selletneithey assumes nor authorizes any othe the:
has been added to the price. ALL RETURNS SU&lECT TO�10 /RESTOCKING CHARGE. sale of thisitetems I E
NO RETURN ON ELECTRICAL PARTS.
ACCT :'SOLD TO DATE a
t t TIME $TORE #1 EMP -a
f���3�F., ��'Y ARIYlEL F` R I?�i`° F i'� t i ir,fi, r 1'+-1 Y 1
PURCHASE ORDERµ# ATTENTION
I :I '.J C SCSI lA RE i
F1Fti�9L, xi>!
fa Et6
M TAX EXEMPTION:
AD TERMS .h rr :ale Wit. i r h' t ►nr�tr �.eu tw
1 7 s� 7 DELIVERY: Lj A T RL 1C!'
PART,IVUMBER LN DESCRIPTION QUANTITY,,G4 ..PRICE NET
TOTAL',
7p 9 F"IE f�IAPA �iIL FILTEP, i�� tat 9. rctY� L �`c�. 85 „`C OR
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25 RE:„�.�•'TOG', PEE S til ttat� t4ti r
R EM I T 'r 1' J.Jc
h 1 1J N AIf�l Taat AX T.�-��l.E; u3 r);, t7tt
L E ;'F�ANI31 TAl �6t� t
4 1 xG.t,
3, SIGNATURE" j r
f� ALLGOODSRETURNEDMUST .BE ACC OMPANIEDBYTHISINVOICE TOT i, ��I.' G``
I x''.®
f NAPA Auto Parts of;C.ar'mel.
111 Medical Drive,• Carmel, Indiana 46032 •317 =844 =3973 Fax.` 317- 844M6220
Please: Remit To: H &-H Automotive Supply •,1212 W Main St •Lebanon, IN 46052
AGRICULTURAL EXEMPTIONCERTIFICATE
r agricultural use
INDIANA DEPARTMENT�OF REVENUE':- SALES TAX DIVISION
AP .v!.. CAIN'
LIMITED WARRANTY PLEASE READ j
r I hereby certity,under thepenalpes o6perjury that the personal property purchased by the use of this exempbon cemhcate will be 'i
directly used .in the direct 'production products for resale.-
Please examine these part s at once: Errors should be before usin or installing. Returns 'The fa constitutes all of the warranties with respect to the sale of this item /items: The seller hereby expressly'
must be made within TEN DAYS and.must be accompanied by this INVOICE NUMBER. This disclaims all warranties, either express or implied, including any implied warranty of merchantability or fitness for a particulal
property is sold to you, with the definite understanding that it is purchased for resale, unless tax purpose end the seller'neither assumes nor authorizes any other persdn rr
.to assume for it any liability in connectlowlth K
has been added to the price: ALL RETURNS SUBJECT TO 10% RESTOCKING CHARGE. sale of !his.item/tems. k
NO RETURN ON ELECTRICAL PARTS.,.
ACCT SOLD TO DATES TIME STORE ,HEMP s
O F k.:t�lf F "FBI 1. I1 /{tq
PURCHASE R
SR r U Z V;,I ORDE ATTENTION
C�tRMEL Itrl
y
TAX 'EXEMPTION:
AD u TERMS Jo clop it)th
rFlA0s*' qa�L E,' ��r�p'�
;r r t� ,t'
DELIVERY.: �.V
f?ART'NUMBER LN g DESCRIPTION' QUANTITY PRICE °NET""` TOTArL"
Np,.T I Mp C ICK E7 3 t �t 14,; t,
r
RESTOCK 47 P
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f�EMIT TC° 1,. .W MAIN Ta3i tOT�11�LE Un 0 r
LENA 46652 n
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X 9 a i (t1 $�s�.���1i
,SIGNATlJRE y M
Al GOO AL MUST BE,i9CCOMPAN/ED BYTH/S INVOICE TUI «L w�.y.�F:. j LHAR{�E f�l._E j
4.
NA Au `Par,�� ar.r�el
w
111 Medical Drive Carmel,.lydiana 46032.0 317 844;3973 .o Fax 317 -844 6220
t
P.Iease Remit To'<H H_Automotive Supply® 1212 W Mam St •Leb "anon; IN 46052 "t accompanie
DAYS :aod mus TURAL EXEMPTIO
AGRICULN CERTIFICATE
It I
'a rtcu ura use
t c "INDIANA DEPARTMENT OF REVENUE SALES TAX DIVISION r eificate '•_!MITED WARRANTY• PLEASE .'Y, t
A PA t `A thereby certify under the penalties ofpepury'that the'personalproperty purchased by the use of this crt will be
tivectly in the dtrecfproductton pfagncbltuVal�prodpcts for resale. f' ,•b
i once. Errors should be re orted before usm or installing. aeturns •Th. factory wsrrant¢bons6tutes alfdf the warranties with "respect to the sale of.this item /items The seller hereby ex
pressly; s
C Please examine these parts a o e P 9 g 'disclaimsall warrahttes; otlher express or implied, inGudingany implied warranty of merchantability_orlit
l and the seller;deil nessfor ap
mu articular
-'st be within.TEN t be d by,this9NVOICE NUMBER. T his.'• a.
"Tprdperty,is sold to you with tfie;definite understanding thatrtris purchased.for resale, unless tax
purl nor authorizes any other person to for it any IiabtLry m'conne :lion with the
has been added to the price. ALL RETURNS SUBJECT TO 10 RESTOCKING CHARGE.' sale of this rtemltems S
NO RET ON ELEC TRICAL PARTS P +1W:
DATE t r TIME t"STORE EMP
F.
G 1f2I�lf~Iw FIRS DE fi'1 l ,<t�A 3 t f Y �l. JCW) Y:V
DE
PURCHASE ORR ATTENTION
IF7�il'IC:.M r• f
TAX' "EXEMPTION: t
AD TERMS In u�` ri,tp :1'�a� l E 11F?f,��C►I l= q�s�
DELIVERYfUTtJCI t 4�I;t
ART LN" DESCRIPTION` QUANTITY�;r'' PRICE <t b NET TOTAL
7�, 11 l NC3L' h�A�' N01' 61k. �R 3.0 G,T �f� A S
7t1t fir_` SF' 1 Ft T_t c"lL RAP NT l•'ti
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t u'yg�y���,• �'�l Sd is
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x SIGNATURE 1 GIT(al_ 1' t
ALEGOODS RETURNED MUST,•BEACCOMPAN/ED BY THIS INVOICE° i w
k
.tr
NAPA Auto P arts of 'C armel
111 Medic6l Drive CarMel Indiana 46032 •317 =844- 3973•• Fax. -317- 8447,6220'
production of agr
Please;Remlt To: H H'.Automdtive'Supply ;1212 W: Main,St. Lebanon,. IN 46052
AGRICULTURAL CERTIFICATE El
N A PA agricultural use Yy
INDIANA DEPARTMENT OF REVENUE SALES TAX DIVISION r n
y.. LIMITED WARRANTY- PLEASE READ
I hereby certify under the penalties of perjury that the personal property purchased by the use of this will be
used in the dire
directly ct lsup duct
ural pros for resale. warranties with respect to the sale of this item/items. The seller hereby xpressly;
Please ezamine.ihese parts atonce. Errorsshould be reported before using or installing Returns The factoiy warranty constitutes all of the e
O ".must be.made within TEN.DAYS; end inust.be accompanied by this INVOICE NUMBER. This; disclaims. all warranties, either expresser implied, including any implied,wadanty of merchantability or fitness for a pa
property is sold to you'with the definite'understandinglhat it is purchased for resale, unless tax• purpose and ihe'sellei�neither assumes. nor authorizes any other person.to assume for iPany liability in.connection ith the
hasbeen added.to the price. ALL RETURNS SUBJECT TO 10% RESTOCKING CHARGE. sale of this ite�tems r
NO RETURN ON ELECTRICAL PARTS: 1'
ACCT r. SOLD.TO 4_ DATE.. TIME ".STORE'# I ,gmp
iy79S, C, 7ST4`' OF F EIRE
SR t .Z 1
h?L1AF?E
TAX'EXEMPTION RURCHASE ORDER ATTENTION
Y
AD w TERMS I r e i r, a 4:': re Ir arc cni
1
DELIVER YUR, r RtJGi'
y
;PART NUMBER LN, DESCRIPTION QUANTITY; :PRICE. NET TOTAL-
I w t
En
SE R TELESC R
1 }9 I= M I 8012 -w 1 `4DJ A
�t�. i cue. �>3t �n 58 `�R °:F�
�slw{ f C:.TR,1'I,:..MAOTI•�I. ESC J n fat lr e,7c�c� 5�1
req.� A.
Y r�
25 RESTt�OK FEE,_ Sltiatr tal 41
REMIT .T 1� l; 1� f��'IE ;I i �.c 7� 'TART �L� 0 i
.SIGNATURE
dLGOODSRETURNED MUST BEACCOMPANIEDBYTHISINVOICE [�TO Chtoh'4 F. SALE 1 42
VOUCHER NO. --_,WARRANT N O.
Boone County Automotive ALLOWED 20
IN SUM OF
1212 West Main Street
Lebanon, IN 46052
$135.27
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members
1120 42- 370.00 $135.27 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
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))
Repair Parts $135.27
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