205465 01/17/2012 CITY OF CARMEL, INDIANA VENDOR: 355214 Page 1 of 1
0 t, ONE CIVIC SQUARE GENUINE PARTS COMPANY-INDIANA P p��g
CARMEL, INDIANA 46032 5959 COLLECTIONS CENTER DRIVE CHECK AMOUNT: $4.85
CHICAGO IL 60693 CHECK NUMBER: 205465
CHECK DATE: 1/17/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1192 4232000 08500449 4.85 TIRES TUBES
0 Control No.
auU CARMEL NAPA
1441 S WILFORD AVE STE 140 Y O Y REM IT: GPC--- I ND
RE BV_ YEA BY 5959 C:OLL_EC'1'ION C'T'R. DR.
CAR,KEL, Itd 45032 CHICAGO Es iE, 3
1000060176194649 RE CEIVED X
ALL GOODS RETURNED MUST BE ACCOMPANIED BY THIS INVOICE
ACCT. NO. SOLD TO DATE ffl DM M0 I STORE NO. EMP SR
v... t 1 O' i= (_)6017 is
1 C 11..: S{'` 1 o f 1 TIME PURCHASE ORDER NO. ATTENTION
n C:ARMEL_, IN 46 032 2.._ 258 4 10:
7 INVOICE TYPE unarge a e
QUANTITY PART NUMBER LINE DESCRIPTION PRICE NET AL CODE•
e�
L SUB MISC. TOTAL
TOTAL 0 TAX
VOUCHER NO. WARRANT NO.
ALLOWED 20
Carmel
6wom 0
IN SUM OF
144:1°S -G u i Iford -Ave n ue,_Ste 140
Carmel, IN 46032 -2922
$4.85
ON ACCOUNT OF APPROPRIATION FOR
Carmel DOCS
o
PO# Dept. INVOICE NO. I ACCT #/TITLE AMOUNT
Board Members
1192 I 7296314 I 42- 320.00 I $4.85 1 hereby certify that the attached invoice(s), or
bill(s) is (are) true and correct and that the
materials or services itemized thereon for
I which charge is made were ordered and
received except
II I
Thursday, January 12, 2012
r for
Title
Cost distribution ledger classification if n
claim paid motor vehicle highway fund
f
Prescribed by State Board of Accounts City Form No. 201 (Rev. 1995)
M ACCOUNTS PAYABLE VOUCHER
E 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
Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number or note attached invoices or bill(s
01/09/12 7296314 Tire repair kit $4.85
I
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