212130 08/28/2012 CITY OF CARMEL, INDIANA VENDOR: 00350350 Page 1 of 1
ONE CIVIC SQUARE AUTOZONE INC
€ CHECK AMOUNT: $1,511.92
CARMEL, INDIANA 46032 PO BOX 116067
ATLANTA GA 30368067 CHECK NUMBER: 212130
CHECK DATE: 8/28/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1207 4350000 262241389704 1, 511 . 92 EQUIPMENT REPAIRS & M
{I F11199tozoff0�
Page : 1 of 1
1445 S RANGE LI
CARMEL, IN 46032
317 846-1274
Customer Information Order Information
BROOKSHIRE GOLF CLUB - CITY OF INVOICE NUMBER. . 2622413897 04
12120 BROOKSHIRE PKWY COMM SPECIALIST. HALL, THEODORE MICHAEL
CARMEL, IN 46033- ORDER DATE . . . . . . 8/17/2012 11 : 06a
PHONE. . . . . . 317 846-7431 QUOTE DELIVERY. . 08/17/2012 12 : 35p
PO NUMBER. .
Items
Sugg.
Qty Sku Description List Cost Core Amount
8 999396 T1275 GOLF CART BATTERY 376 .10 188.99 0.00 1511.92
Misc OSB SKU
NO VEHICLE GIVEN For The Above Items
NO VEHICLE GIVEN For The Above Items
MSDS can be ordered upon request
Payment Appry Amount
7245 331057 0 A4LLOE 1511 . 92
2622413897081712C
Subtotal 1511 . 92
Tax 0 . 00
Total 1511 . 92
'The signature above acknowledges customer's agreement to be bound by all terms outlined in the AutoZone Commercial Customer Charge Account
Aareement,as amended W3M t\Me to Came.
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))
08/17/12 2622413897 04 Batteries $1,511.92
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.
ALLOWED 20
AutoZone
IN SUM OF $
1445 S. Range Line
Carmel, IN 46032
$1,511.92
ON ACCOUNT OF APPROPRIATION FOR
Brookshire Golf Club
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1207 1 2622413897 04 I 43-500.00 I $1,511.92 1 hereby certify that the attached invoice(s), or
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
Wednesday, August 22, 2012
Z,,,— 0 (L /
Director, Brookshir Golf Club
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund