216044 01/09/2013 CITY OF CARMEL, INDIANA VENDOR: 355214 Page 1 of 1
ONE CIVIC SQUARE GENUINE PARTS COMPANY-INDIANA Pp��
CARMEL,INDIANA 46032 5959 COLLECTIONS CENTER DRIVE1ECK AMOUNT: $34.41
CHICAGO IL 60693 CHECK NUMBER: 216044
CHECK DATE: 1/9/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1207 4350000 08501898 34 .41 EQUIPMENT REPAIRS & M
100006017 Time: 11:02 Date: 12/21/2012 Page: 1/1
CARMEL NAPA
1441 S GUILFORD AVE STE 140
REF BY VER BY Employee. 36 TIGE
_ CARMEL, IN 46032-2922 Sales Rep: 10 PHIL
° (317) 844-3973
€ Accounting Day: 21
1898 - Promised Time: Ln §
CITY OF CARMEL/BROOKSHIRE GOLF Attention: l0
1 CIVIC SQ Tax Exemption: (rl ?
® CARMEL, IN 46032-2584 PO#: i
Terms: NET 10. i 61
€ I.I1 Y
CO €
U r
U
•Part Numbery r`=Line : ' DesAcriptiom Quantity Pribe Net „'Total° O
� :.-.
35012 ZNBF B FLUID DOT 3-12OZ 2.00 5.56; 3.2900 6.58 O
813-5506 BK `POLY ARMOUR BRK LINE 3.001 4.11, . 3.3900: 10.17
302 X 4 WH ;FITTING ; 2.00 2.92` 2.6900 5.38 [ O I
813-1224 ;BK BRAKE LINE 1.00 6.961 : .. .5.7900' 5.79 i O
813-1225 BK BRAKE LINE 1.00 7.771' 6.4900, 6.49
co
Subtotal 34.41 j
Indiana Sales Tax 70000% 0.00 #
� 9
Customer Signature
ALL GOODS RETURNED MUST BE ACCOMPANIED BY THIS INVOICE {(
REMIT:GPC-IND .Charge Sale 34.41 z i
5959 COLLECTION CTR.DR.
CHICAGO ILL. 60693. 2 v
CUSTOMER COPY o
! H
VOUCHER NO. WARRANT NO.
ALLOWED 20
GPC-IND
IN SUM OF $
5959 Collection Ctr. Drive
Chicago, IL 60693
$34.41
ON ACCOUNT OF APPROPRIATION FOR
Brookshire Golf Club
0�150 cY S'-1
PO#/Dept. INVOICE NO. I ACCT#/TITLE AMOUNT Board Members
1207 I 859936 I 43-500.00 I $34.41 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
Friday, January 04, 2013
Director, Brookshi Golf Club
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
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))
12/21/12 I 859936 I Repair Parts I $34.41
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