159790 05/28/2008 CITY OF CARMEL, INDIANA VENDOR: 354290 Page 1 of 1
q 0 ONE CIVIC SQUARE BOONE COUNTY AUTOMOTIVE, INC
CARMEL, INDIANA 46032 1212 w MAIN ST CHECK AMOUNT: $20.23
LEBANON IN 46052 -2324
CHECK NUMBER: 159790
CHECK DATE: 5/28/2008
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1205 4237000 ACCT 08081 20.23 697926
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3-7Z0s NAPA A its of Carmel
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Au Pa Ca
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
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APA AGRICULTURAL EXEMPTION CERTIFICATE agricultural use E
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 repoto 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
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 fora 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 item(tems.
NO RETURN ON ELECTRICAL PARTS.
ACCT SOLD TO DATE TIME STORE EMP
t`rpti i CITY 01 Gf1F?h1El_- tJC!_I7TI1Ca NIf1Il T. �ftE, /C)f� ltr���' 1t7i;)C.06133 �9 697926
SR =.L I I,J PURCHASE ORDER ATTENTION
A l -4 TAX EXEMPTION:,
y,_ t..1 -A
AD TERMS:y ma Al r, 13 L,.,�. E
DELIVERY:
PART NUMBER LN DESCRIPTION QUANTITY PRICE NET TOTAL
SF- 16, F C I LJH MINE.—UP P I (DU 4 1. i: i
I~'1M US2 r WWS 51.111i +1E R BLEND 6.00 1.
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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
NAPA Auto Parts Purchase Order No.
Terms
Date Due
Invoice Invoice
Description Amount
Date Number (or note attached invoice(s) or bill(s))
0511610 697926 Motor tune-up 160z. summ
Total $20'23
r1d COrreCt and k have audited same in accordance
�O\C�S1 or `ct��ls�; is (are) true a
1
VOUCH
ALLOWED
W& H Automotive Supply
1212 W. Main Street IN SUM OF
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$20.23
ON ACCOUNT OF APPROPRIATION FOR
GENERAL FUND
1205 ADMINISTRATION
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PO# or INVOICE NO. ACCT #/TITLE AMOUNT I hereby certify that the attache Me �be
DEPT.
bill(s) is (are) true and correct and �otce(s rs
1205 97926 370 $20.23 materials or services itemized th th at th
which charge is made were ord fo
received except ahq
20
S ature
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund