HomeMy WebLinkAbout176148 08/19/2009 "�f CITY OF CARMEL, INDIANA VENDOR: 354290 Page 1 of 1
ONE CIVIC SQUARE BOONE COUNTY AUTOMOTIVE, INC
f, CHECK AMOUNT: $21.14
CARMEL, INDIANA 46032 1212 W MAIN ST
LEBANON IN 46052 -2324
CHECK NUMBER: 176148
*t.
CHECK DATE: 8/19/2009
DEPARTMENT ACCOUNT PO NUMBER I N UMB ER AMOUNT DESCRIPTION
1205 4231500 737381 21.14 OIL
ry
x
t 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
AGRIC ULTURAL EXEMPTION CERTIFICATE NAPA 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
directly used in the direct production of agricultural products for resale. j
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
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 fine's 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 item,ilems.
NO R ON ELE CTRICA L PARTS.
ACCT SOLD TO DATE TIME STORE EMP is
o808 CITY O CARMEL-- BUILDING IYIA 1' NT. 8/05/ 13 d 38 1 10000E ,1333 0E,1.33 36 7373
S CE# I C I V I C SQUARE CHASE ORDER ATTENTION
CFaRt *EL., IN QWEXEMPTIOW TOR MAYORS OFFICE
'41 't�E;C )3
AD TERM S,1t- 4,vC df_te 10th CHARGE„_SAI_E
4 DELIVERY:
PART NUMBER LN DESCRIPTION QUANTITY PRICE NET TOTAL
1394. F" I L l%AAPnGOL_D OIL F I l_T'ER 2. 00 12. 24o 6.590 13.18
75-0 P.OL I AAA WART 5W30 -11. 3. 360 1.990 7> 9
Above Item cn Sale
jif-
2 5 RESTOCK FEE 1") U o'; U G al
REMIT T'O, 1212 W I+1AI Ta)( 7! TAXTAI ?L_E 3 00
L.,FBANON IN 4t 0
SIGNATURE TOTAL CHARGE SALE 2 1.1
II (LL GOODS RETURNED Ml/ST BEACCOMPAN/ED BY THIS INVOICE
PresAl ed by State Board of Accounts City Form No. 201 (Rev. 1995)
t 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.
NAPA Auto Parts Payee
Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
08/05/09 737381 Oil Oil Filter
Total $21.14
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 *8Lj7j09_WARRANT NO.
p ALLOWED 20
ain treet IN SUM OF
Lebanon, IN 46n-r;9_2324
$21.14
ON ACCOUNT OF APPROPRIATION FOR
GENERAL FUND
1205 ADMINISTRATION
Board Members
PO# or INVOICE NO. ACCT #!TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
bill(s) is (are) true and correct and that the
1285 315 $21.14 materials or services itemized thereon for
which charge is made were ordered and
received except
20
r
Sig to re---
Cost distribution ledger classification if
Title
claim paid motor vehicle highway fund