223480 08/27/2013 CITY OF CARMEL, INDIANA VENDOR: 355214 Page 1 of 1
ONE CIVIC SQUARE GENUINE PARTS COMPANY-INDIANAPp��
� CARMEL, INDIANA 46032 5959 COLLECTIONS CENTER DRIVE CFIECK AMOUNT: $57.05
CHICAGO IL 60693
,o CHECK NUMBER: 223480
CHECK DATE: 8127/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2200 4231500 18032 57 . 05 OIL
100006017
CARMEL NAPA Time: 07:32 Invoice Number 891739§
VAN ���® 1441 S GUILFORD AVE STE 140
® REF BY VER BY Date: 08/16/2013
i
CARMEL, IN 46032-2922
.,, (317) 844-3973 Page: 1/1
18032 Employee: 1 Duane B@B@p(
® CITY OF CARMEL ENGINEERING Sales Rep: 10 Store i3 Y Y i
1 CIVIC SQ Accounting Day: 16 I OCR
m CARMEL, IN 46032-2584 _ 7
1000060178917397
- Pa_rt�`Number- 1 Lined "- ,` Descrptio�n p }wQantity' Price1Vet `_;° Totals, aY =A
7203 FIL NAPAGOLD OIL FILTER_ 2.00 12.581 3.7900 7.58 R
9187 FIL Air Filter (Gold) 1.00 37.981 11.4900 11.49 IR
75155 NOL NAPA 5W20 5 QUART ! 2.00 33.04, 18.9900 37.98
�$<\g?d'i2�X22
Delivery: Subtotal 57.05
Attention: 2-[ N Indiana Sales Tax 7.0000% 0.00
Tax Exemption: GAS` 1` 0
PO#: �� WEER
Terms: Q� GIN Ptp�
€ `+V: `ea .._ ..ice .,s--,'�°'��Y :: ,.,. _<.-. °„,::-:-,:"_... 4i �.a
� Total; ":0:5:
Charge Sale 57.05
Customer Signature
ALL GOODS RETURNED MUST BE ACCOMPANIED BY THIS INVOICE
REMIT:GPC-IND
5959 COLLECTION CTR.DR.
CHICAGO ILL. 60693 CUSTOMER COPY
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
GPC-IN Purchase Order No.
5959 Collections Center Drive Terms
Chicago, IL 60693 Date Due
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s) Amount
8/16/2013 891739 E4&E5 oil and filters $ 57.05
Total $ 57.05
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
VOUCHER NO WARRANT NO.
GPC-IN ALLOWED 20
5959 Collections Center Drive IN SUM OF $
Chicago, IL 60693
$ 57.05
ON ACCOUNT OF APPROPRIATION FOR
1 $u3Z'
Board Members
Po#
or
DEP INVOICE NO. ACCT#/TITLE AMOUNT
EPTlk I hereby certify that the attached invoice(s), or
0 891739 2200-4231500 $ 57.05 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
8/26/2013
Signatu e
Cost Distribution ledger classification if Title
claim paid motor vehicle highway fund