167271 12/23/2008 CITY OF CARMEL, INDIANA VENDOR: 354290 Page 1 of 1
f ONE CIVIC SQUARE BOONE COUNTY AUTOMOTIVE, INC
0 CHECK AMOUNT: $346.92
CARMEL, INDIANA 46032 1212 W MAIN ST
LEBANON IN 46052 -2324 CHECK NUMBER: 167271
CHECK DATE: 12/23/2008
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1150 4238900 1898 346.92 OTHER MAINT SUPPLIES
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Please Remit To: H H Automotive Supply 1212. W. Main St. Lebanon, IN 46052
N
AN AGRICULTURAL EXEMPTION CERTIFICATE agricultural use El
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
directly 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 itemftems. The seller hereby expre�
41 must be made within TEN DAYS and must be accompanied by this INVOICE NUMBER. This disclaims all warranties, either express or implied, inclutling any implied warranty of merchantability or fitness fora panic
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 will
has been added to the price. ALL RETURNS SUBJECT TO 10% RESTOCKING CHARGE. sale of this itenYitems.
NO RETURN ON ELECTRICAL PARTS.
A
ACCT SOLD TO DATE Y TIME STORE EMP =1 0 L
0I FR 'r6 CITY OF CARMEL 15/08 ;I.2..- 05 1000061.33 33 19 7 1716E}
SR BROOK SHIRE GOLF CLUB PURCHASE ORDER ATTENTION
121.20 BROOI'.SH I RE PARKWAY
41 CARMEL, IN 460' =3 TAX EXEMPTION:
AD KEEP COG`( INV TERMS'aILI a.td tJ-HLt.
1. 5 DELIVERY: UK I NUL s
PART NUMBER LN DESCRIPTION QUANTITY PRICE NET TOTAL
821 --1359 BF. 3 8INX.:0FT HOSE REEL t. t�!I X75. 070 168.970 337.
to "7 MAC MAC E1IiTTERY'ROTEL'_r _,c:. tams Qn 240 �a. [�`?li 8 .99 Above Item c Sale
41 A-S
o
X
i
5 RESTOCK, FEE c" +,r+ 1
REMIT "TO: 1; --'12 W MAIN Tax* 71 TAXTANLE 3 0. 00
LEBANON IN, 4E052
X 4y� SIGNATURE TOTAL. CHARGE SALE 346.9-2
ALL GOODS RETURNED MUST BE ACCOMPANIED BY THIS INVOICE
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
ft y Purchase Order No.
I2/ 10, 'cold Terms
L �Gdfy Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
oY 3 i f2
Total 3 Z
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
WARRANT NO.
#�u
k ALLOWED 20
t d 04 14rOd e 0aaf j 11
IN SUM OF
T
3�G•�v
ON ACCOUNT OF APPROPRIATION FOR
/.sal
4 J Board Members
Po# or +J INVOICE NO. ACCT #/TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
'0 G 3 lfi 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
"Siqnatu �e
4 Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund