172799 05/27/2009 CITY OF CARMEL, INDIANA VENDOR: 362891 Page 1 of 1
ONE CIVIC SQUARE D F DISTRIBUTORS, INC CHECK AMOUNT: $119.87
CARMEj INDIANA 46032 800 CANAL STREET
EVANSVILLE IN 47713 CHECK NUMBER: 172799
CHECK DATE: 5/2712009
DEPARTMENT T ACCOU PO N INVOICE NUMBER AMOUN DESCRIPTION
2201 4232100 284347 119.87 GARAGE MOTOR SUPPZE
C D NVOICE Distributors, Inc Inc.
800 CANAL STREET
EVANSVILLE, IN 47713 Number 284347
(812)867 -2441 Fax(812)867 -6822 Date 04/08/09
Cleveland, OH Columbus, OH Evansville, IN Indianapolis, IN Louisville, KY Nashville, TN page 1
BrH To: CARMEL STREET DEPT Ship To: CARMEL STREET DEPT
006163 C Oil.,
3400 W 131ST STREET
i CARMEL, IN 46ff: l y bo 3 a' CO
IN 46074
V;. N
ly. Wh Freight Ship Via
Reference Shi ed Sales erson Terms Tax Code Doc J
VERBAL MIKE 04/08/09 010 ERIC EFFIN NET 30 IN 245140 04 PRE /ADD UPS
n
:i
term Description o'rdid Ordered Shipped Back UM Price UM Extension
2 -520- 008 830 -00 PACKING STD H -HL32 10 10 0 EA 3.65 EA 36.50
2- 097- 009 454-00 BRZ BUSHING G -H -HL l 1 0 EA 23.04 EA 23.04
2- 095 001 454 -02 IDLER BUSHING BRZ 1 1 0 EA 23.04 EA 23.04
3- 309- 001- 999 -00 GASKET SET HEAD H- 1. 1 0 EA 6.43 EA 6.43
2- 433 -004- 291 -00 IDLER PIN STEEL HJ 1 1 0 EA 17.28 EA 17.28
2- 316- 003 806 -30 GASKET RV HT G -HL 1 1 0 EA 1.20 EA 1.20
Merchandise Misc Disc.
iscount Tax Freight Total Due
107.49 .00 .00 12.38 119.87
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
Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
04!08109 284347 $119.87
1 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.
D F Distributors, Inc. ALLOWED 20
IN SUM OF
00 Canal Street
Evansville, IN 47713
$119.8
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO# Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Members
2201 284347 42- 321.00 $119.87 1 hereby certify that the attached invoice(s), or
bills) is (are) true and correct and that the
materials or services itemized thereon for
which charge is made were ordered and
received except
l) Thyrsday/ilffy 21, 2009
V St eet Commissioner
}racy �Tltle'i??i??�r1Si`
Cost distribution ledger classification if
claim paid motor vehicle highway fund