164153 09/30/2008 CITY OF CARMEL, INDIANA VENDOR: 354290 Page 1 of 1
ONE CIVIC SQUARE BOONE COUNTY AUTOMOTIVE, INC CHECK AMOUNT: $27.52
CARMEL, INDIANA 46032 1212 W MAIN ST
LEBANON IN 46052 -2324 CHECK NUMBER: 164153
CHECK DATE: 9/30/2008
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2200 4231500 1824 27.52 709379
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E APA NAPA Auto Parts 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 I hereb agricultural use
AGRICULTURAL EXEMPTION CERTIFICATE INDIANA DEPARTMENT OF REVENUE -SALES TAX DIVISION LIMITED WARRANTY PLEASE READ
er u ro en urchased b lion certificate will be Y certi N under the P enalties of P I N that the P ersonal P P YP Y the use of this exem P directly used in the direct production of agricultural products for resale.
Ple examine these parts at once. Errors should be reponetl before using or "fhe facto warren constitutes all of the warranties with respect to the sale of this itenVitems. The seller hereby expressly ase installing Returns ry ry must be made within TEN DAYS and must be accompanied by this INVOICE NUMBER. This tlisclaims 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 itemltems.
NO RETURN ON ELECTRICAL PARTS.
ACCT SOLD TO DATE TIME STORE EMP INVOICE NO
0 1. 82 4 CAWEL. ENGI:NE:E:RING, 1NCo rl /1.G!!iS 08. 1.9 i3iatt061,33 33 1 709379,
4 I i:, EAST MADISON S1 "RIB ET PURCHASE ORDER ATTENTION
SR V- I RKL I N, I fy E
,46O5_ TAX EXEMPTION:
TERMS:
I DELIVERY: l
PART NUMBER LN DESCRIPTION QUANTITY PRICE NET TOTAL
1522 I L. �•IAPAGOLD OIL FILTER 1. 13. (_)00 7. S 7. 99
5- -050 10L C.,?I►APT 5W30 7. 00 3.490 2
'25% RESTOCK FEE 27.
9
REMIT TO: 1212 W MA t- Tax 7% TAXTABLE 0.
LEBANON IN, 46052
SIGNATURE TOTAL CHARGE SALE ;=7.
AGOODS RETURNED MUST BE ACCOMPANIED BY THIS INVOICE
Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No. 201 (Rev. 1995)
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
Boone County Automotive
Purchase Order No.
1x12 W. Main*' Street
Terms
Lebanon, IN 46052 -2324
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
9/16/08 709379 Oil and oil filter $27.52
$27.52
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
VOUCHER NO. WARRANT NO.
ALLOWED 20
Ronne County Automotive IN SUM OF
1212 W. Main Street
Lebanon, IN 46052 -2324.
$27.52
ON ACCOUNT OF APPROPRIATION FOR
Department of Engineering
Board Members
PO# or INVOICE NO. ACCT #/TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
n/a 709379 2200- 4231500 $27.52 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
2000
Si ap re
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund