165672 11/12/2008 CITY OF CARMEL, INDIANA VENDOR: 354290 Page 1 of 1
Q� ONE CIVIC SQUARE BOONE COUNTY AUTOMOTIVE, INC CHECK AMOUNT: $20.38
S,? CARMEL, INDIANA 46032 1212 W MAIN ST
LEBANON IN 46052 -2324 CHECK NUMBER: 165672
CHECK DATE: 11/12/2008
DEPARTMENT ACCOUNT PO NUMBER INVOI NUMBER AMOU DESCRIPTION
1205 4231500 8081 20.38 OIL
NAPA Auto Parts of Carmel
111 Medical Drive Carmel, Indiana 46032.317- 844 -3973 Fax: 317 844 -6220
Please Remit To: H H Automotive Supply 1212 W. Main St. *Lebanon, IN 46052
AGRICULTURAL EXEMPTION CERTIFICATE
P t INDIANA DEPARTMENT OF REVENUE SALES TAX DIVISION agricultural use
a� LIMITED WARRANTY PLEASE READ
I hereby certify under the penalties of perjury that the personal property purchased by the use of this exemption certificate will be
used in the tlirect production of agricultural products for resale.
Please 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 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 implietl, including any implied warranty of merchantability or fitness for a particular
property is sold to you with the definite understanding that it is purchased for resale, unles tax purpose and the seller neither assumes nor authorizes any other person to assume for it any liability in connection with the 4
has been added to the price. ALL RETURNS SUBJECT TO 10% RESTOCKING CHARGE. sale of this ite�tems. `'V.yl
NO RETURN ON ELECTRICAL PARTS.
ACCT SOLD TO DATE TIME STORE EMP
08081 CI OF CA ML1. --BU -DING MA IN_I v 0 /1 o6 l5w 1 7 G 00006 13 1 33 1 7 1210 2
PURCHASE ORDER ATTENTION
SF C;ARMEL, I NI
41 TAX EXEMPTION:
AD TERMS'lo Svc df_te 10tr') L:Hf-H6h ':61-41 -k
1.5
DELIVERY:
PART NUMBER LN DESCRIPTION QUANTITY PRICE NET TOTAL
F I L INAPAGCJl...D .01L F' I LT R 1 00 :12. 24 0 F,, 590 rJ� 53
85--101
{{{dF' F ifY�{�Al.1L..1[" C)l:l_. 1.C� 1n t_tt� 1�.- ;='�4tz 1w. ?'.3t_+ t3.79
l
I f
2 5"" RES TOCf4 V: EE
'.A L.a 4 'J 4 CT J.
w
REMIT 'ruri 1212 GJ {ylAltd Tax f% I'AX'fASt_F' �.t7 -oCi
SIGNATURE I
ALL GOODS RETURNED MUST BE ACCOMPAN /ED BY THIS INVOICE 7 (JTr"1L.
r� !(^t
I.
:E t
Presctjh q 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
,NAPA Auto Parts
Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
10/1 5/08 712102 Oil Filters
Total $20.38
1 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
VOUCHER Od /10/08 WARRANT NO.
ALLOWED 20
ee IN SUM OF
Lebanon, IN 46052 -2324
$20.38
ON ACCO' FUND ION FOR
1205 ADMINISTRATION
Board Members
PO# °r INVOICE NO. ACCT #!TITLE AMOUNT I hereby certify hat the attached invoice or
DEPT. y y
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
20
nat rel
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund