167275 12/23/2008 CITY OF CARMEL, INDIANA VENDOR: 354290 Page 1 of 1
ONE CIVIC SQUARE BOONE COUNTY AUTOMOTIVE, INC CHECK AMOUNT: $36.95
CARMEL, INDIANA 46032 1212 W MAIN ST
LEBANON IN 46052 -2324 CHECK NUMBER: 167275
CHECK DATE: 12/23/2008
DEPARTMENT ACCOUNT PO NUMBER INVOI N UMBER AMOUNT DESCRIPTION
1205 4237000 8081 36.95 ACCT 8081.
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Please Remit To: H H Automotive Supply 1212 W. Main St. Lebanon, IN 46052 NA R AGRICULTURAL EXEMPTION CERTIFICATE agricultural use
INDIANA DEPARTMENT OF REVENUE -SALES TAX DIVISION LIMITED WARRANTY PLEASE READ
hereby certify under the penalties of perjury that the personal property purchased by the use of this exemption certificate will be_,,-
directly used in the direct production of agricultural products for resale. .I
Please examine these pans 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 t r;
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 particular. t4
property is sold to you with the definite understanding 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 the
has been added to the price. ALL RETURNS SUBJECT TO 10% RESTOCKING CHARGE. sale of this iternfitems.
NO RETURN ON ELECTRICAL PARTS.
AC->T SOLD TO DATE TIME STORE EMP
,H?s 1 C:, T`l OF t;'HN ?MEL. —L1U I l.I7I I�lG M� I lVT r. 1 1 :!C!Q 1 c c r:)7 1.00006133 30 :l (5972 y�
I CIVIL: SGIL.InRf
PURCHASE ORDER ATTENTION
SR t: ARMEL., 11\1
TAX EXEMPTION•„
AD TERMS:
1sw #t ri i R it.,r.
DELIVERY:
PART NUMBER LN DESCRIPTION QUANTITY PRICE NET TOTAL
IM Nbr• F ;:jE HU .VEH 1. I. i 40 4. i 4. 9
1`,1W RING TERMINAL. 5 E1 0 7.
78 o c�r.�; _I a r 3 �:t �.J :a n
RS 1 059 E CH ROCKER SWI 2.00 0 18e 4.30 12.490 24.98
W
c...a,. RL.STOi...N, f° E:.E 3f �v 95
REMIT TO. 1212 W MAIN Tax 7% TAXTABLE 3 0.00
!._L:PlahlON 1114, 46052
X—_ TOTAL CHARGE SALE ?rt<,i�;
SIGNATURE
ALL GOODS RETURNED MUST BE ACCOMPANIED BY THIS INVOICE tit r
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