213369 10/09/2012 CITY OF CARMEL, INDIANA VENDOR: 00350350 Page 1 of 1
`'•` ONE CIVIC SQUARE AUTOZONE INC
CARMEL, INDIANA 46032 PO BOX 116067 CHECK AMOUNT: $19.98
ATLANTA GA 30368-6067 CHECK NUMBER: 213369
CHECK DATE: 10/9/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 2622398766 19 . 98 OTHER EXPENSES
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Page: 1 of 1
1445 S RANGE LI
CARMEL, IN 46032
317 846-1274
Customer Information Order Information
CARMEL WASTEWATER INVOICE NUMBER. . 2622398766 09
760 3RD AVE SW COMM SPECIALIST. CHAPMAN, ALTOSIN
CARMEL, IN 46032- ORDER DATE . . . . . . 8/03/2012 10 : 29a
PHONE. . . . . . 317 571-2443 QUOTE DELIVERY. . 08/03/2012 10 : 58a
PO NUMBER. . EIDSON
Items
Sugg.
Qty Sku Description List Cost Core Amount
1 263164 39047-8 ACCESS PLUG 8FT 13 .98 6 . 99 0.00 6.99
Bell Blk 8ft Cord Access Plug
1 263173 39052-8 ALL WEATHER 12V 25 .98 12 .99 0.00 12 .99
Bell 12V All Weather Pwr Sckt
NO VEHICLE GIVEN For The Above Items
NO VEHICLE GIVEN For The Above Items
AUG 06 2012
By
..f
MSDS can be ordered upon request
Payment Appry Amount
6180 201057 0 AGAGMR 19 . 98
26223987660803120
Subtotal 19 . 98
0 . 00 "
Tax 0 -qa
Total
m0CC�2\GUS�ome�Cha<ge Pccouc� .
Au<oZone Com
b all terms out5�ned m the -
i
ent to be bound `l
er'S
d es ougtom
abov e acknoW\e t me
The enanur as amended
arement-
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 of service rendered, by whom, rates per day, number of units,
price per unit, etc.
Payee
352242
AZ COMMERCIAL (Auto Zone) Purchase Order No.
PO BOX 116067 Terms
ATLANTA, GA 30368 Due Date 10/3/2012
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
10/3/2012 2622398766 $19.98
hereby certify that the attached invoice(s), or bill(s) is (are) true and
orrect and I have audited same in accordance with IC 5-11-10-1.6
A2 15),, L �---"� yam..../'VL-,"
Date Officer
VOUCHER # 125823 WARRANT # ALLOWED
352242 IN SUM OF $
AZ COMMERCIAL (Auto Zone)
PO BOX 116067
ATLANTA, GA 30368
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO # INV# ACCT# AMOUNT Audit Trail Code
2622398766 01-7500-02 $19.98
I
Voucher Total $19.98
Cost distribution ledger classification if
claim paid under vehicle highway fund