223663 08/27/2013 CITY OF CARMEL, INDIANA VENDOR: 361937 Page 1 of 1
` ONE CIVIC SQUARE T B A NORTH
CARMEL, INDIANA 46032 309 GRADLE DRIVE CHECK AMOUNT: $170.49
CARMEL IN 46032
CHECK NUMBER: 223663
CHECK DATE: 8/27/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4237000 03LO2516 170 .49 REPAIR PARTS
TBA North Invoice
309 Gradle Dr. No. 031-02516
Carmel, IN 46032
317-574-1957 FAX: 317-574-1982 II IIII II �� II II IIIIIII II III III II
I I III I I Page 1
14:48:26 Aug 12 2013
CUSTOMER NUMBER Invoice NUMBER Invoice DATE PACKING SLIP TERMS WHSE
318 03LO2516 08/12/13 03TF1884001 NET 10TH 030
BILL TO: SHIPPED TO:
CARMEL POLICE CITY GARAGE CARMEL POLICE CITY GARAGE
3 CIVIC SQUARE 3400 W 131ST
CARMEL, IN 46032 CARMEL, IN 46074
Dept: 002 CARMEL POLICE CITY GARAGE Contact:JASON /Route: NORTH Direction:
YOUR P.O.NUMBER ORDER DATE CSR SHIPPED VIA CARTONS OPER
08/12/13, 14:48:24 000001 ONLINE ORDERS N NORTH A 1 ACX
*** ACX Reference No: AN6179 ***
ITEM DESCRIPTION UNIT ORDER BACK INV LIST CORE NET NET: EXT
BIN QTY ORDERED QTY PRICE PRICE PRICE CORE PRICE
2009 CHEVROLET IMPALA
V6-3880cc 3.9L FLEX/FI
Vin M ID#39056
DOR 620-974 DUAL FAN ASSEMBLY NONE EA 1 0 1 325.24 0.00 170.49 0.00 170.49
TOTAL PURCHASE TOTAL LIST TOTAL MDSE TOTAL CORE FREIGHT TAX PCT TAX AMT INVOICE TOTAL PAYMENTS BALANCE DUE
170.49 325.24 170.49 0.00 0.00 0.00 170.49 0.00 170.49
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.
VOUCHER NO. WARRANT NO.
ALLOWED 20
TBA North
IN SUM OF $
309 Gradle Drive
Carmel, IN 46032
$170.49
ON ACCOUNT OF APPROPRIATION FOR
Carmel Police Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1110 I 03LO2516 I 42-370.00 I $170.49 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
Thursday, August 22, 2013
Chief of Police
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))
08/12/13 03LO2516 auto repair parts $170.49
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
20
Clerk-Treasurer