168881 02/17/2009 CITY OF CARMEL, INDIANA VENDOR: 354290 Page 1 of 1
ONE CIVIC SQUARE BOONE COUNTY AUTOMOTIVE, INC
O CARMEL, INDIANA 46032 1212 W MAIN ST CHECK AMOUNT: $84.92
LEBANON IN 46052 -2324 CHECK NUMBER: 168881
CHECK DATE: 2/17/2009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1192 4351000 8081 7.49 720585
1192 4351000 8081 5.09 720788
1205 4237000 8081 11.97 719686
1205 4237000 8081 40.79 719852
1205 4237000 8081 19.58 720838
l 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
APA AGRICULTURAL EXEMPTION CERTIFICATE agricultural use i
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 reported before using or installing. Returns "The factory warranty constitutes all of the warranties with respect to the sale of this itemlitems. The seller hereby expressly
Q1 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 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/items.
NO RETURN ON ELECTRICAL PARTS. t'
ACCT SOLD TO DATE TIME STORE EMP
CIT 1 C. r't CA F. w ;°--1 r t C1I i F.1 r) 7 1 '-A P
08081 CIT OI= C�RMf�:L....L 1 ra T-
SR 1 CIVIC SQUARE PURCHASE ORDER ATTENTION
CARMF_L, IN
4G- 032 TAX EXEMPTION:
i4D TERMS;i ,t- 4 1 r-,4 -in r arc ant c:' 13 DELIVERY:] JF l RUi.�I!
PART NUMBER LN DESCRIPTION QUANTITY PRICE NET TOTAL
PL30071 JqBH PREMIUM DRIVE BELT 1. cat'? 64.3 ''•I•f_?r 790 40.79
10 0
to
rw% RESTOCK FEE. SIAbtot i1 40.7`
REMIT TO `121.2 try) IYJASl \I 'T•ax 7% TOXTABLE 3 0.00
LEBANON .i\I A'6o52
SIGNATURE
AL' LG ODDS RE TURNED MUSTBEACCOMPANIEDBY THIS INVOICE TOTAL— CHARGE SAL. 40. 7�
Please Remit To: H H Automotive Supply 1212 W. Main St. Lebanon, IN 46052
AGRICULTURAL EXEMPTION CERTIFICATE
INDIANA DEPARTMENT OF REVENUE SALES TAX DIVISION agricultural use
i certify under the enalties of er'u that the personal roe LIMITED WARRANTY PLEASE READ
I hereby fy p p .fry p property rty purchasetl by the use of this exemption certificate will be
tlil 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 respect to the sale of this Merchants. The seller hereby expressly
C must be made within TEN DAYS and must be accompanied by this INVOICE NUMBER. This disclaims all warranties, either express or implied, inclutling any implied warranty of merchantability or fitness for a part icular
property is sold to you with the definite understanding that it is purchased for resale, unless tax purpose and the seller neither assumes or 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 iteMitems.
NO RETURN ON ELECTRICAL PARTS.
ACCT :SOLD TO DATE TIME STORE EMP 611111 0
08081 CITY Of CA RMEL_ -BU I L DING MA TNT. NT. 1 -.,51 L OW0 13 7196 ,96
SR 1 CIVIC SOUA RE PURCHASE ORDER ATTENTION
C'.flRMEL., I I I
tr.s'
TAX EXEMPTION:
AD TERMS:.Io v cltte 1 (th CHARGE SALE'
1.2 DELIVERY:
PART NUMBER LN DESCRIPTION QUANTITY PRICE NET TOTAL
1 394 F TL NAPA GOLD OIL FILTER 1.00 12. 240 F. 59 6.59
75 NOL NAPA QUART 51430 2.00 3. 360 2. Gil 5.38
.r`
r
25! RESTOCK FEE IJD 0 r 11, o 97
RE TO. 1212' W MAIn[ Tax 7% TAXTnBLE. t) cjt t
LEBANON IN, 1 +605
SIGNATURE TOT At- CHARGE SALE 11.97
/ALL GOODS RETURNED MUST BE ACCOMPANIED BY THIS INVOICE
p o
N APA Auto Peru of Carrne�
111 Medical Drive o Carmel, Indiana 46032 o 317 -844 -3973 D Fax: 317 -844 -6220
Please Remit To: H H Automotive Supply o 1212 W. Main St. °Lebanon, IN 46052
1„II,I )�I{ II I'III AGRICULTURALEXEMPTION- SALES CERTIFICATE agricultural use
TAX DIVISION
J U l� I f u V r )W OF REVENUE
INDIANA DEPARTMENT
W LIMITED WARRANTY PLEASE READ
I hereby certify under the penalties of perjury that the pe rsonal 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 ante. Errors should be rdetl before using or installing. Returns "The factory warranty constitutes all of the warranties with respect to the Sale of this i[em4lems The seller hereby expre551y
must be made within TEN DAYS and must be accompanied epo by this fNVOICE NUMBER. This disclaims all warrantes, either express 0r implied, including any implied warranty of merchantability or fitness far a particular
property is sold to you with the definite understanding that it is purchased (or resale, unle55 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 JC% RESTOCK{NG CHARGE. sale of this ischn items.
NO RETURN ON ELECTRICAL PARTS.
ACCT SOLD TO DATE TIME STORE EMP
iI. CITY OF' Ctl- x1JILD1NG I 1.E 29 /l O; :16 0) 0 0o&1. 3 ?i:, 120838
SR 1. CIVIC EOUARi- PURCHASE ORDER ATTENTION
CARME:L, IN
t 1 4 G 0 3 TAX EXEMPTION:
AD TERMS:IIa Svc bloc 10th CHARGE: SALE
DELIVERY:
PART NUMBER LN DESCRIPTION QUANTITY PRICE NET TOTAL
ff
'2006 Ch evr�y1.tw g T�°far Si1ve rams 1.500 1. Ton 2W r� �7C'.5 q t'
l: �„t {uld:.f_ I A P BL A DE i 0 1. 8 x 3c 0 f 0 9. 58 fj
25! f?f:I:;TOCK FEE" bllotat,.:_1 I, `3 n a
REMIT TO, 1212 W tY1AJ,NJ Tax TAXI 3 0.00
I_.EBA IONI IN,, 460
�p
SIGNATURE TOT CH(- RGIE SALE 1'j.
ALL GOODS RETURNED MUST BE ACCOMPANIED BY THIS INVOICE
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))
01/16/09 719852 Premium Driv Belt
Napagold Oil Filter Oil
ae $11 97
$19.58
Total $72.34
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.
1 20
Clerk- Treasurer
VOUCHER N82 NO.
p y ALLOWED 20
ain 6treet IN SUM OF
Lebanon IN 46052 -2324
$72.34
ON ACCOUNT OF APPROPRIATION FOR
GENERAL FUND
1205 ADMINISTRATION
C, Board Members
PO# or
DEPT. INVOICE NO. ACCT #/TITLE AMOUNT I hereby certify that the attached invoice(s), or
bill(s) is (are) true and correct and that the
i 295 719852 31U 40.79 materials or services itemized thereon for
1205 719686 370 qii a 7 which charge is made were ordered and
received except
1205 720838 370 $19.58
20
ig,pature,/
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
NAPA Auto Parts of Carmel r
s
111 Medical Drive Carmel, Indiana 46032 317 844 -3973 a Fax: 317 844 -6220
Please Remit To: H H Automotive Supply 1212 W. Main St. *Lebanon, IN 46052
NAPA AGRICULTURAL EXEMPTION CERTIFICATE agricultural use
INDIANA DEPARTMENT OF REVENUE -SALES TAX DIVISION LIMITED WARRANTY PLEASE EASE READ
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 reported before using or installing. Returns "The factory warranty constitutes all of the warranties with respect to the sale of this itemltems. The seller hereby expr
C 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 far a partl
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 wit
has been added to the price. ALL RETURNS SUBJECT TO 10% RESTOCKING CHARGE of this iternfilems.
NO RETURN ON ELECTRICAL PARTS.
ACCT SOLD TO DATE TIME STORE EMP
)F,tliL31 C I T Y OF CnRMEL -BI.J I LTA I NG MA I NT. 1/ 05 1000061.33 061.33 12 1 7 ;:..,0-78P
SR 1• C IVIC SGIUARC PURCHASE ORDER ATTENTION
CARMEL, IN
4 1 4E032 TAX EXEMPTION:
AD TERM§T vc di-te di-t 1 s:tt h CHFIRGE GALE
23 DELIVERYf-I JR TRUCK
PART NUMBER LN DESCRIPTION QUANTITY PRICE NET TOTAL
2005 Fard TH.Ack 7sc a Pe
NE1 0 3w I 4 I PIER BLADE 1.1 00 7. 5. 090 5.o9
l' I
I
1�
25'f frRESTOCK FEE :;I U D T; o'r a 1
REMIT I "f o 121.2 W MATH Tax 7:j TnXTABLE 3 Cz- oo
L E BA KID [%I Iti�,6052 L f
SIGNATURE TOTAL CHARGE SALE F 5-((
I
ALL GOODS RETURNED MUST BE ACCOMPANIED BY THIS INVOICE
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
NAPA AGRICULTURAL EXEMPTION CERTIFICATE agricultural use
INDIANA DEPARTMENT OF REVENUE •SALES TAX DIVISION
I hereby certify under the penalties of perjury that the personal property purchased by the use of this exemption certificate will be LIMITED WARRANTY PLEASE READ
directly 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 respect to the sale of this itemfitems. The seller hereby expressly
G+ disclaims all warranties, either express or implied, including any implied warranty of merchantability or fitness for a particular
pro
must he made within TEN DAYS and must be accompanied by this INVOICE NUMBER. This purpose and he seller neither assumes nor authorizes any other person to assume for it any liability in connection with the'
perty is sold to you with the definite understanding that it is purchased for resale, unless tax
has been added to the price. ALL RETURNS SUBJECT TO 10% RESTOCKING CHARGE. sale of this d the
NO RETURN ON ELECTRICAL PARTS.
ACCT SOLD TO DATE TIME STORE EMP INVOICE NO
08081. CITY OF CnRMEL -BUILDING IYif I NT. 1/26/09 14 1 b: 000061;33 s:R 720585
85
SR 1 CIVIC SQUARE PURCHASE ORDER ATTENTION
CARMEL, IN �Pp�l� l...pA Co •,r. ljm.v c�
4.1 46032 TAX EXEMPTION:
AD ITERM19J10 ivc due 1()'t `t CHARGE. SALE
1 DELIVERY:
PART NUMBER LN DESCRIPTION QUANTITY PRICE NET TOTAL
50-018-1 41P 31-ADE t.00 I A.. 1. F 0 7.490 7> 49
t
U
253% ("RESTOCK FEE 311 Q l; 0 G4 _,A 1 7. 49
RI=M •TO.• 12:1.W
MA Ta,'< 7". T AXTABLE 3 0. I:�I
I,_E.IIAgk9N I11, '�•Er r?}h
X
SIGNATURE TOTAL .CHAR(;E SALE =49
ALL GOODS RETURNED MUST BE ACCOMPANIED BY THIS INVOICE
Prescribed by State Board of Accounts City Form No. 201 (Rev. 1995)
ACCOUNTS PAYABLE VOUCHER
a
CITY OF CARMEL
q
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))
01/26109 720585 wiper $7.49
01/28/09 720788 wiper $5.09
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. WARRANT NO.
ALLOWED 20
H H Automotive/NAPA
n /l A IN SUM OF
1212 W. Main Street
Lebanon, IN 46052
$12.58
ON ACCOUNT OF APPROPRIATION FOR
Carmel DOCS Department
PO #yDept. INVOICE NO. ACCT /TITL AMOUNT board Members
92 ___Z29 43- 510.00 $7.49 I hereby certify that the attached invoice(s), or
1192 720788 43- 510.00 $5.09 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
rids Fe ary 13
Director, DOC
Title,
Cost distribution ledger classification if
claim paid motor vehicle highway fund