167270 12/23/2008 CITY OF CARMEL, INDIANA VENDOR: 354290 Page 1 of 1
0 ONE CIVIC SQUARE BOONE COUNTY AUTOMOTIVE, INC CHECK AMOUNT: $28.79
CARMEL, INDIANA 46032 1212 W MAIN ST
•y off; LEBANON IN 46052 -2324 CHECK NUMBER: 167270
CHECK DATE: 12123/2008
DEPARTMENT ACCOUNT PO NUMBER INV NUMBER AMOUNT DESCRIPTION
1115 4232100 7983 28.79 GARAGE MOTOR SUPPIE
.r-
Please Remit To: H H Automotive Supply 1212 W. Main St. *Lebanon, IN 46052
AGRICULTURAL EXEMPTION CERTIFICATE agricultural use
AN INDIANA DEPARTMENT OF REVENUE SALES TAX DIVISION 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
direct) used in the direct 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 itemlitems. 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 particular
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 itemlitems.
NO RETURN ON ELECTRICAL PARTS.
ACCT SOLD TO DATE TIME STORE EMP
CITY OF' i:.PjRlYIEL_ /POLICE DEF�.rr .2116108 1.3:1. 1000061 133 23 71 r2 ='99
CIVIC aCx ?lJARE PURCHASE ORDER# ATTENTION
SR IRI`IEL IN C LAI— r
d i"
46032 TAX EXEMPTION-.,F{
AD KEEP COPY INV TERMSt,10 =Vc dI_te :!(_)tti t°►11Fzttit �fal_.l�
DELIVERY:
PART NUMBER LN DESCRIPTION QUANTITY PRICE NET TOTAL
h BW- 1:..2 OW WINTER WIPER BLADE. 2. io. 810 6n 480 12:. 3c,
2000 =ard Crown U:i ct ori.z�
213.72 SF1 I=RO SELECT OIL F'ILTR 1,r Of) 4. grit.} 2. 380 2.
75- NOL NAPA 1 OL+l:: 0 QT 5. 00 :3. 3E"10 2.690 1..:3. 45
E:5% RESTOCK F EE: C.,.sa a 1 28
REIVI I "I' TO: 1 W IYIA I I Tax 7% TAX TABLE 3 0 11
LEBANOhl IN, 46
SIGNATURE TOTAL- 7 CHARGE S ALE 28.79
ALL GOODS RETURNED MUST BE ACCOMPANIED BY THIS INVOICE
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))
12/16/08 I 717299 I I $28.79
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 NO. !!ARRANT NO.
H H Automotive Supply ALLOWED 20
IN SUM OF
1212 W. Main Street
Lebanon, IN 46052
$28.79
ON ACCOUNT OF APPROPRIATION FOR
Carmel C Communications
PO# /"Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members
1115 717299 42- 321.00 $28.79 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
Wednesday, December 17, 2008
Director
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund