221020 06/18/2013 CITY OF CARMEL, INDIANA VENDOR: 00352042 Page 1 of 1
ONE CIVIC SQUARE DON HINDS FORD CHECK AMOUNT: $19.68
CARMEL, INDIANA 46032 12610 FORD DRIVE
o� FISHERS IN 46038 CHECK NUMBER: 221020
CHECK DATE: 6/18/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 328247 19 . 68 OTHER EXPENSES
12610 Ford Drive * Fishers, IN 46038 D
Phone (317) 849-9000 * Fax (317) 813-130
Parts Direct (317) 813-1301 JUN 112013
01 . 750 `4 -60c;ww.donhinds.com By
ALL RETURNED PARTS MUST BE RECEIVED WITHIN 30 DAYS, BE IN THE ORIGINAL PACKAGE, AND ACCOMPANIED BY THIS INVOICE. WE ARE NOT
ALLOWED TO ACCEPT RETURNS ON ELECTRICAL OR SPECIAL ORDER PARTS. PLEASE PREPAY WHEN ORDERING SPECIAL ORDER PARTS.
DATE ENTERED YOUR ORDER NO. DATE SHIPPED INVOICE DATE INVOICE
11 JUN 13 JEFF COOPER 11 JUN 13 NUMBER 328247
0 ACCOUNT NO. CA2634 H PAGE 1 OF 1
D CARMEL WASTEWATER UTILITIES P
JOE FAUCETS
0 3450 W 131ST ST o
CARMEL, IN 46074
(317) 571-2634
bHIP VIA SLSM. [/L NU. I I:HIVI6 19697 CHARGE FISHERS IN
sNiP ;PART NO..:>: : ::.: ....:. .
..
PARTS HOURS
0 F1P:Z*67:31*BE':: FILTER ASY - 5.-10.. 1:.i 28 19, 68_
Mon - Fri
7:30 - 5:30
Saturday
... 8:00 - 3:00
SERVICE HOURS
Mon - Fri
,.. 7:30 5:30
q.
Saturday
8:00 - 3:00
CASHIER SE
X.
Mon - Fri
AT 5:30
Saturday
AT 3:00
BODY SHOP
80
PARTS 19 . 68 ?4944� SUBLET
FREIGHT
0 . 00
SALES TAX 0 . 00 *001
+&Hal
CUSTOMER'S SIGNATURE _
11300 X TOTAL:::: $19 . 6 8
DISCLAIMERS OF WARRANTIES
Any warranties on the product sold hereby are those made by the manufacturer.The seller hereby expressly disclaims all warranties,either expressed or implied,including
any implied warranty of merchantability or fitness for a particular purpose,and the seller neither assumes nor authorizes any other person to assume for it any liability in
connection with the sale of said products.
I •I""0-' CUSTOMER COPY
i
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
00352042
DON HINDS FORD Purchase Order No.
12610 FORD DRIVE Terms
FISHERS, IN 46038 Due Date 6/12/2013
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
6/12/2013 328247 $19.68
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
- /a/X/
Date Off icgx
VOUCHER # 135740 WARRANT # ALLOWED
00352042 IN SUM OF $
DON HINDS FORD
12610 FORD DRIVE
FISHERS, IN 46038
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO# INV# ACCT# AMOUNT Audit Trail Code
328247 01-7502-06 $19.68
Voucher Total $19.68
Cost distribution ledger classification if
claim paid under vehicle highway fund