212210 08/28/2012 CITY OF CARMEL, INDIANA VENDOR: 355214 Page 1 of 1
ONE CIVIC SQUARE GENUINE PARTS COMPANY-INDIANA Pp��g
s' a CARMEL, INDIANA 46032 5959 COLLECTIONS CENTER DRIVE CHECK AMOUNT: $130.93
CHICAGO IL 60693 CHECK NUMBER: 212210
CHECK DATE: 8/28/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1207 4350000 08501898 99 . 98 844217
1207 4350000 08501898 30 . 95 845027
Control No. 7343276
RAW
CARIVIEL NnPf4
1441 S 61.111FORD AVE STE 140 Y (Ni",R PEI,,!I T-GF,►-'7--I ND
REF BY VER BY 5'.-.)53 COLLECTION CIFR. DR.
MWEL, III 46032-er,:c. CHICAGO IL.L. 606393,
RECEIVED
1000060178442177 By x
ALL GOODS RETURNED MUST BE ACCOMPANIED BY THIS INVOICE
ACCT NO. SOLD TO DATE M,(Wjo�M M I STORE NO. I EMP SR
A5 00 1898 CITY OF (,'faRMEL/BR00K!"*)'FII C)8,"1`}/*c'."0 -7 016017 25 10 112 184421 -
I cl v I c so 1. a f 1. TIME PURCHASE ORDER NO. ATTENTION
CARMEL, IN 46C).312--i2c584 NPE- 3-14.24 2 ZI.
,-
1•a' Pe 1 i v e r INVOICE TYPE aiarge Sale
QUANTITY PART NUMBER LINE DESCRIPTION PRICE NET TOTAL CODE
(")0 85----805 I-4HF PREN PAJ 46 RID F :.)4. 94 .4 9. 9 13 0 C) 99. 198
mi
0 TOTAL 19 9. 9 F1
V (500(-) TAX
VAN
Conirol No.
7306992
NAPA
1441 y W- I fORft AVE 5TE 140 Y 0C*R REMITiG
�RAff�64A�Y_TL�VE(R, BY '�;':�59 t u('IL�ff1.••krC T I tX��,'4[:-i-F;,d ).R.
MX1, 1N 4&1,32--Z9& rer ( H'I(.IVEDi~i C' LL
LL 'L j q
1000060178450274 BY x �
ALL GOODS F.tETURNED MUST BE ACCOMPANIED BY THIS INVOICE
ACCT.NO. SOLD TO DATE M968MM I STORE NO. EMP SR
85--001898 CITY OF C:ARf+EL../BROOKSHI 845027 0601.7 3E 10
1 civic so I of I TIME PURCHASE ORDER NO. I ATTENTION
CFARMEL, IN 46032...25S-4 08441 _
=�1 INVOICE TYPE } 4 ryry
1.._ w i�f1.r' C Sal j.l.�
QUANTITY PART NUMBER LINE DESCRIPTION PRICE NET TOTAL CODE
2. 00 P-PI235H3 L-MP WIN WB 7. 48 4. 9900 9. 98
2. 00 7151151. 13K COIJ1:-1A--*1 `. C,E". 3. 49()) 6. .*34,.a
1. 00 7701748 8 BK DUCT TAP 23. 92 2 1 3. 9900 1099
sm a
(TOTAL )� MISC.� TAX I� f1a •.�)(_i TOTAL
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))
08/12/12 845027 Repair Parts $30.95
08/14/12 844217 Repair Parts $99.98
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
GPC-IND
IN SUM OF $
5959 Collection Ctr. Drive
Chicago, IL 60693
$130.93
ON ACCOUNT OF APPROPRIATION FOR
Brookshire Golf Club
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1207 845027 43-500.00 $30.95 1 hereby certify that the attached invoice(s), or
1207 844217 43-500.00 $99.98 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
Zz2 d 4,1
Director, Brooks re Golf Club
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund