167274 12/23/2008 CITY OF CARMEL, INDIANA VENDOR: 354290 Page 1 of 1
ONE CIVIC SQUARE BOONE COUNTY AUTOMOTIVE, INC CHECK AMOUNT: $161.13
CARMEL, INDIANA 46032 1212 W MAIN ST
LEBANON IN 46052 -2324 CHECK NUMBER: 167274
CHECK DATE: 12/23/2008
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBE AMOUNT DESCRIPTION
1120 4237000 7996 161.13 717184
Please Remit To: H H Automotive Supply 1212 W. Main St. •Lebanon, IN 46052
A R LIMITED WARRANTY PLEASE READ AGRICULTURAL EXEMPTION CERTIFICATE agricultural use
INDIANA DEPARTMENT OF REVENUE -SALES TAX DIVISION
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 itemltems. The seller hereby expressly Y P
C 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 iternfitems.
NO RETURN ON ELECTRICAL PARTS.
ACCT SOLD TO DATE TIME STORE EMP
9 CITY OF CA RMEt_. -�F� I RE DEPT 15 /t y8 12 w 51 l Uc�y0061. 33 3 717 i. apt
r,
7..C,
SR E C I V I C SQUARE CARMEL, 11\1 PURCHASE ORDER ATTENTION
43 46032
TAX EXEMPTION:
AD TERMS�ao svc due 10t ti tit. '.D i__r...
1 DELIVERY: urt t✓r.
PART NUMBER LN DESCRIPTION QUA NTITY PRICE NET TOTAL
2002 Chevrolet frucE: Tahoe
AD -765 ADO DISC PAD 1.w 15`„ 91.0 76. 76x:7;
20021 Chevrolet 1'ruck Tahoe
60 W I P BLADE 2. 00 26. i" 13.090 26. 1 s.
AD-7662 ADO DISC PAD 1. 0 116. t_a 0 5 8.23 0 5
5 8. 23
s=
c5' RESTOCK FEE c,_ k. -1- n a- 7 1 E 10 13
REMIT T O. 121. W MAIN Tau 7% TAXTABLE 3 {7 r, 00
LEBANON 111, 46052
SIGNATURE d
TOTAL C.FIf- RGE SALE 1.610 1 3
ALL GOODS RETURNED MUST BE ACCOMPANIED BY THIS INVOICE b rppi'
Prescribed by State Board of Accounts
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice or bill to be properly itemized must show: kind of service, where performed, dates
whom, rates per day, number of hours, rate per hour, number of units, p service rendered b
nce per unit, etc. y
Payee
Purchase Order No.
Terms
Date Due
Invoice Invoice Description
Date Number (or note attached in or bill(s)) Amo unt
717184 Brake Pads Fire Marshal
3
ry F
I hereby certify that the attached invoice(s), or bill(s), is (are) true and correct and I have audited same in acco
with IC 5- 11- 10 -1.6
rg ance
20
Clerk- Treasurer
/ARRANT NO. 20
ALLOWED
qty Automotive IN SUM OF
0 ain Street
460
$161.13
O
J OF APPROPRIATION FOR
G
Fire Department
o -7
INVOICE NO.
ACCT #/TITLE AMOUNT Board Members
�epti. 717184 42- 370.00 $161.13 1 hereby certify that the attached invoice(s), or
Q p I 0 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
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Title
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r' �tion ledger classification if
st distri fund
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