171750 04/29/2009 +4 CITY OF CARMEL, INDIANA VENDOR: 354290 Page 1 of 1
o ONE CIVIC SQUARE BOONE COUNTY AUTOMOTIVE, INC
CARMEL, INDIANA 46032 1212 w MAIN ST CHECK AMOUNT: $36.92
LEBANON IN 46052 -2324
CHECK NUMBER: 171754
CHECK DATE: 412912009
DEPARTMENT ACCOUN P NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1205 4351000 8081 27.33 725979
1205 4351000 8081 9.59 727934
NAPA Auto Parts of Carmel
111 Medical Drive Carmel, Indiana 46032 •317 -844 -3973 Fax: 317 844 -6220
r Please Remit To: H H Automotive Supply 1212 W. Main St. *Lebanon, IN 46052
AGRICULTURAL EXEMPTION CERTIFICATE
INDIANA DEPARTMENT OF REVENUE -SALES TAX DIVISION LIMITED WARRANTY PLEASE READ •l El
certificate will be
directly used in the direct production of agricultural products for resale. ory
Please examine these pads at ante. Errors Should be reported before using or installing. Returns "The fact warranty constitutes all of the warranties with respect to the sale of this i temltems. The seller hereby expressly,
Gf 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 for a particular
property S 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'
NAPA I hereby certify under the penalties of perjury that the personal property purchased by the use of this exemption certi agricultural use
has been added to the price. ALL RETURNS SUBJECT TO 10% RESTOCKING CHARGE. sale of this itemlitems.
N R ON ELEC P A R TS.
ACCT SOLD TO DATE TIME STORE EMP
8081 CITY OF CA[IMEL.- BUILDING MAIN f. 3/27/x9 15u40 :,00006133, 33 7 5979
SR I CIVIC SQUARE PURCHASE ORDER ATTENTION
CA RMEL, IN
41• 4603 TAX EXEMPTION:
AD TERMS~ o Sit r' (Ii_ke 1l CI- IFdRCI"_: SALE
DELIVERY: Q�
PART NUMBER LN DESCRIPTION QUANTITY PRICE NET TOTAL
i:;W40 y!CB vm 3: i._ 1. oil- O "I" OW4 00 9. 7. IDq- 0 i. a„ 518 y'
1118 IL. 9(4- 1 At:OLD OIL F=ILTER 1,,.l. i20 4,10 11.350 1.1o35 S:�41.
REMIT TO. 1212 W Mr -iTl \i Ta)t 7 A TAX ABLE 3 0.00
X a
SIGNATURE TO T AL CHARGE SALE 27. 31
ALL GOODS RETURNED MUST BEACCOMPANIED BY THIS INVOICE
Prescribed bv'Utate 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.
nn [Payee
Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
0AL. Butb 'ES1
Total "l 'T3q
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 NO.
t y ALLOWED 20
4' \cA-N I 1 IN SUM OF
l X12- W INS lock y E�re e;
tp
ON ACCOUNT OF APPROPRIATION FOR
Board Members
PO# or INVOICE NO. ACCT #/TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
G 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
20
Sgi naturg
L vci o
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
_'7
NAPA Auto Parts of Carmel 4d>
111 Medical Drive Carmel, Indiana 46032 317 844 -3973 Fax: 317 844 -6220
1 r Please Remit To: H H Automotive Supply 1212 W. Main St. Lebanon, IN 46052
I ��I AGRICULTURAL EXEMPTION CERTIFICATE
agricultural use
J I I I L IN LIMITED WARRANTY PLEASE READ
DEPARTMENT OF REVENUE -SALE SALES TAX DIVISION T!'
y{ l
I hereby certify under the penalties of perjury that the personal property purchased by the use of this exemption certificate will be 1
tlirectlY used in the direct production of agricultural products for resale.
Please examine these parts at once. Errors should be reported before using or installing. Returns "The factory warranty constitutes all of the warranties with respell to the sale of this itemAtems: 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 for a particolar
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 itemidems,
NO RETU ON ELECT PARTS.
ACCT SOLD TO DATE TIME STORE EMP
08081 CITY OF I:'ARMEL- SUIE._DIl F-3 MAINTe 4I20%a09 lb 41 l0�0006133 1 3,0 1 27934
1 CIVIC SGIUARE PURCHASE ORDER ATTENTION
SR TI
CARMEL., IN
41. 4 G 032 TAX EXEMPTION:
AD TERMSr CI svr- di -te 10th CHARGE SALE
17 DELIVERY:G'jR TRUCK i
PART NUMBER LN DESCRIPTION QUANTITY PRICE NET TOTAL
9006 I_MP HAL BULB 1.0o 11.670 `J- 31 9. 5
LA 1
,=S% RESTOCK FEE 5 is It w u t✓t i 9.59
9
REMIT TO.- 1 W MA 1: N Tea 7% TA XTABL.E 3 0. 00
0
LEBANON ON I N, 4E1:15
s IGNAtURE TOTAL CHARGE SALE "1 19 9
ALL GOODS RETURNED MUST BE ACCOMPANIED BY THIS INVOICE P l�
Presr-ibed 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
NAPA Auto Parts
Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
04120/0 727934 Hal. Bulb
Total $9.59
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
--V OUCHER Ne NO.
Automotive Supply ALLOWED 20
1212 W. Main Street IN SUM OF
IN 46962-2324
$9.59
ON ACCOUNT OF APPROPRIATION FOR
GENERAL FUND
1205 ko m I Board Members
DEPT o r INVOICE NO. ACCT #/TITLE AMOUNT I hereby certify that the attached invoice(s), or
bill(s) is (are) true and correct and that the
1205 727934 510 $9.59 materials or services itemized thereon for
which charge is made were ordered and
received except
20
A
u
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
1