220795 06/04/2013 CITY OF CARMEL, INDIANA VENDOR: 354275 Page 1 of 1
ONE CIVIC SQUARE T B A&OIL WAREHOUSE, INC
CARMEL, INDIANA 46032 2425 E 30TH ST CHECK AMOUNT: $24.32
INDIANAPOLIS IN 46218-2724 CHECK NUMBER: 220795
CHECK DATE: 6/4/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
601 5023990 03LI8054 24 . 32 OTHER EXPENSES
TBA North Invoice
309 Gradle Dr. No. 03LI8054
Carmel, IN 46032
317-574-1957 FAX: 317-574-1982 lllIIIII IIII ) I IIIIIIIIII111111I��III�IIIIS
II I I I II I I II Page 1
10:00:45 May 15 2013
CUSTOMER NUMBER Invoice NUMBER Invoice DATE PACKING SLIP TERMS WHSE
314 03LI8054 j 05/15/13 03SY9714001 NET 10TH 030
BILL TO: SHIPPED TO:
CITY OF CARMEL WATER CITY OF CARMEL WATER
3450 W. 131ST ST. 3450 W. 131ST ST
CARMEL, IN 46074 CARMEL, IN 46074
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Dept: 002 CITY'OF CARMEL WATER Contact: /317-733-2853 Route: NORTH Direction:
YOUR P.O.NUMBER ORDER DATE CSR SHIPPED VIA CARTONS OPER
05/15/13, 10:00:40 400013 MIKE BYRD N NORTH A 413
UNIT ORDER BACK INV LIST CORE NET NET EXT
ITEM DESCRIPTION BIN OTY ORDERED OTY PRICE PRICE PRICE CORE PRICE
HAS LF110F HASTINGS OIL FILTER U EA 12 0 16 5.99 0.00 1.52 0.00 24.32
TX: 010 4
TOTAL PURCHASE TOTAL LIST TOTAL MDSE TOTAL CORE FREIGHT TAX PCT TAX AMT INVOICE TOTAL PAYMENTS BALANCE DUE
24.32 95.84 24.32 0.00 0.00 0.00 24.32 0.00 24.32
2.08% service charge on past due accounts(25% per annum).
Core returns must be in original box. All new returns must
be resalable. No return after 30 days without invoice.
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VOUCHER # 131711 WARRANT # ALLOWED
354275 IN SUM OF $
TBA WAREHOUSE-INDY
2425 E 30TH STREET
INDIANAPOLIS, IN 46218
.i
Carmel Water Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO# INV# ACCT# AMOUNT Audit Trail Code
03LI8054 01-6500-05 $24.32
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Voucher Total $24.32
Cost distribution ledger classification if
claim paid under 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 of service rendered, by whom, rates per day, number of units,
price per unit, etc.
Payee
354275
TBA WAREHOUSE-INDY Purchase Order No.
2425 E 30TH STREET Terms
INDIANAPOLIS, IN 46218 Due Date 5/28/2013
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
5/28/2013 03LI8054 $24.32
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
Date Officer