161735 07/23/2008 CITY OF CARMEL, INDIANA VENDOR: 354290 Page 1 of 1
j ONE CIVIC SQUARE BOONE COUNTY AUTOMOTIVE, INC CHECK AMOUNT: $25.70
CARMEL, INDIANA 46032 1212 w MAIN ST
o LEBANON IN 46052 -2324. CHECK NUMBER: 161735
CHECK DATE: 7/23/2008
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2200 4231500 ACCT 8032 23.52 704009
Y
,x200 4232100 ACCT 8032 2.18 702734
NAPA Auto 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 agricultural use
I,} EVAN 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 item /items. The seller hereby expressly
p disclaims all warranties, either express or implied, including any implied warranty of merchantability or fitness for a particular
must be made within TEN DAYS and must be accompanied by this INVOICE NUMBER. This purpose and e seller neither assumes nor authorizes any other person to assume for it any liability in connection with the
property is sold to you with the definite understanding that it is purchased for resale, unless tax d th
sale of this th e ems.
.I has been added to the price. ALL RETURNS SUBJECT TO 10% RESTOCKING CHARGE.
NO RETURN ON ELECTRICAL PARTS.
t
ACCT SOLD TO DATE TIME STORE EMP 6
08i)3 C':I: "i OF CARME L. E:NG I NEEH.ING 7/ 17/08 4 c:)? 1 101000613-3 1 30 1 7040 09
ONE CI SQUARE PURCHASE ORDER ATTENTION
SR t Flt�lYlfi g IN
TAX EXEMPTION:
AD PEEP COPY INV TERM9: °qc! �ti.tt} 1(-)trl t. h11- ltttak, ��t -itWL
542 "i I
E�I,t���i I 1.F� DELIVERY.?K t stit�l:t;
to PART NUMBER LN DESCRIPTION QUANTITY PRICE NET TOTAL
n
e
2004 Chevr Trl_tck Trt a:i lBl azet- 4.2 256 CID L-G
F•IL OIL. FII_ 1e 0(.1 12. 31 7.490 7. 4.9
�5 G i°dOL NAPA 10W40 01- 7. 00 2. 800 2. 290 1 C a 03
o
I
C
m
c
I
s
C
25% RESTOCK EE=C 2
REMIT TO.- 1:::1 W IYIAI N Tax 7% TAXTABLE 3 tt c, ?r_)
L.EBAN€ N
i,
t 1
I SIGNATURE
ALL GOODS RETURNED. MUST BE ACCOMPANIED BY THIS INVOICE
I
I(A�4 �o�arts of Carmel
111 Medical Drive Carmel, Indiana 46032 .317- 844 -3973 Fax: 317 844 -6220
I Ir Please Remit, To: H H Automotive Supply 1212 W. Main St. Lebanon, IN 46052
I NAPA AGRICULTURAL EXEMPTION CERTIFICATE agricultural use
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
dire ctly used in the direct production of agricultural products for resale. Please examine these parts at once. Errors should be reported before using or installing. ReturnsThe factory warranty constitutes all of the warranties with respect to the sale of this item /items. The seller hereby expressly
G1 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 nr authorizes any other person to assume for it any liability in connection with the
61 3 NO RETURN ON ELECTRICAL PARTS TURNS SUBJECT TO 10% RESTOCKING CHARGE. sale of this item/items.
ACCT SOLD TO DATE TIME STORE EMP a
l:. I TY OF (:'Flt?h *1(::L i*NG I NEE -R T. =1 rr.,, i i n a .r r r -r
SR ':QA HASE ORDER ATTENTION"
�+•F.r TAX EXEMPTION
CARNEL, IN AD TERMS:,, s
K EEP" f:; €:.1PY 1: NV
DELIVERY:
PART NUMBER LN DESCRIPTION QUANTITY PRICE NET TOTAL
3; J I ■p yfaQ`` i:'104 r. f eat ")'r Tr -Ai 1.B1 -Rzer
31.5 L1 BULB a
0 0 1. Ei�.� 090 2. 8
0
I
a` I
N I
c
v
f &2 26272
p
Z- REEFFOCK FEE Subt
F ?!'1 "t TO,- 121.2 W P *101 I l`,I T;A x 7%. Tn X T'ABL.E 3
L_k:.StltjlO,N I N, r >�1�:: o�
I v 1 /SIGNATURE T OTAL. r }•)rah C
ALL GOODS RETURNED MUST BE AC60MPAN /ED BY THIS INVOICE j y t`,'li C•^ q y
Prescribed by State Board of Accounts City Form No. 201 (Rev. 1995)
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
4 An invoice or bill to 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
Boone Automotive
Purchase Order No.
1212 W::. Main Street
Terms
Lebanon, IN 46052 2324
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
7/17/08 704009 Oil and oil filter $23.52
7/3/08 702734 Bulb E -3 $2.18
$25.70
Total
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
VOUCHF�R NO. WARRANT NO.
Tom'
ALLOWED 20
Boone- County -An-da ptiv® IN SUM OF
1212 W. Main Street
Lebanon, IN 46052 -2324
$25.70
ON ACCOUNT OF APPROPRIATION FOR
Department of Engineering
+0� rq Board Members
PO# or INVOICE NO. ACCT #/TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
n/a 704009 2200- 4231500 $23.52 bill(s) is (are) true and correct and that the
n/a 702734 2200- 4232100 $2.18 materials or services itemized thereon for
which charge is made were ordered and
received except
,7 2069"
2
S' n re
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund