174516 07/08/2009 CITY OF CARMEL, INDIANA VENDOR: 362878 Page 1 of 1
ONE CIVIC SQUARE TBA WAREHOUSE CHECK AMOUNT: $164.97
CARMEL, INDIANA 46032 2425 E 30TH ST
y oN .�o INDIANAPOLIS IN 46218 CHECK NUMBER: 174516
CHECK DATE: 718/2009
DE PARTME N T ACC OUNT PO N UMBE R INV OICE N AMO D
1110 4237000 1100973 164.97 REPAIR PARTS
TBA Warehouse Invoice
2425 E 30th Street No. 01100973
Indianapolis, IN 46218
317 923 -2222 FAX: 317 923 -2233
Page 1
14:08:01 Jun 23 2009
CUSTOMER NUMBER Invoice NUMBER Invoice DATE PACKING SLIP TERMS WHSE
318 01100973 06/23/09 OIPU2533001 NET 10TH 010
BILL TO': SHIPPED TO:
CARMEL POLICE CITY GARAGE CARMEL POLICE CITY GARAGE
3 CIVIC SQUARE B 3400 W 131ST
SHIP TO 3400 131ST WSTF CARMEL, IN 46074
CARMEL, IN 46032
Dept: 002 CARMEL POLICE CITY GARAGE Contact /Phone: /317- 733 -4600
i
YOUR P.O. NUMBER ORDER DATE CSR SHIPPED VIA. CARTONS OPER
06/23/09, 14:08:00 400003 JIM RATLIFF 3 A 403
ITEM DESCRIPTION UNIT ORDER BACK INV LIST CORE NET NET EXT
BIN QTY ORDERED QTY PRICE PRICE PRICE CORE PRICE
RAF ArD1159P (DISC BRAKE PAD] UNKNOW EA 3 0 3 134.63 0.00 54.990 0.000 164.97
Original Product: ATD1159P
TOTAL PURCHASE FREIGHT TAX PCT TAX AMT INVOICE TOTAL PAYMENTS BALANCE DUE
164.97 0.00 0.00 164.97 0.00 164.97
1.5% service charge on past due accounts(18% per annum).
Core returns must be in original box. All new returns must
be resaleable. No return after 30 days without invoice.
a
I
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Prescribed by State Board of Accounts City Form No. 201 (Rev. 1995)
R^ 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
TBA Warehouse Purchase Order No.
2425 E. 30th Street Terms
Indianapolis, IN 46218 Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
6/23/09 1100973 payment for repair parts 164.97
Total
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
TMA Warehouse IN SUM OF
2425 E. 30th Street
Indianapolis, IN 46218
164.97
ON ACCOUNT OF APPROPRIATION FOR
police general fund
Board Members
PO# or INVOICE NO. ACCT #/TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
1110 1100973 370 164.97 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
July 2 20 09
Signature
Chief of Police
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund