226940 12/11/2013 CITY OF CARMEL, INDIANA VENDOR: 00352688 Page 1 of 1
ONE CIVIC SQUARE CARQUEST CHECK AMOUNT: $92.87
CARMEL, INDIANA 46032 PO BOX 404875
ATLANTA GA 30384-4875 CHECK NUMBER: 226940
CHECK DATE: 12/11/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 2738-218328 92 . 87 OTHER EXPENSES
Great people, great products, great pricesism
�aRQUEST CQ OF IND-BASH RD IN # 9146 PAGE 1 OF 1
8357 BASH STREET REF# 347839
WOO INDIANAPOLIS, IN 46250
317-849-6300
AUTO PARTS REMIT TO: CARQUEST AUTO PARTS
IIII I IIII III III II IIIIIIIIIIIII Iill IIII� I III PO BOX 404875
ATLANTA, GA 30384-4875
21201311250273800002183280000347839608
ANY PRODUCT RETURNED FOR CREDIT MUST BE ACCOMPANIED BY THIS RECEIPT. SEE CARQUEST STORE FOR DETAILS OF THE COAST TO COAST GUARANTEE.
BCITY OF CARMEL WASTE WATER CITY OF CARMEL WASTE WATER
X9609 HAZEL DELL PARKWAY 609 HAZEL DELL PARKWAY
LINDIANAPOLIS, IN 46280 PINDIANAPOLIS, IN 46280
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CUSTOMER SALES TEAMMATE
INVOICE NO. NO DATE COST. P.O. NO. ID ID FORM OF PYMT.
2738-218328 463020 11/25/13 TRUCK 43 F1750 CHARGE
MFG.PART NUMBER ORDERED SHIPPED LIST PRICE NET NET CORE EXT.AMOUNT TAX
* NOTE: PLEASE DELIVER ASAP BM 4
1 DOR 924-110 1 1
DOOR HINGE ASSEMBLY
* RE: 924-110 2M-INV-INDIANAPO IS DC
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WARRANTY DISCLAIMER:The manufacturer's warranty,if any,constitutes the only warranty with respect to the sale of all goods.SELLER HEREBY EXPRESSELY DISCLAIMS ALL WARRANTIES,EITHER EXPRESSED
OR IMPLIED,INCLUDING ANY IMPLIED WARRANTY OF MERCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE.Seller does not authorize any person to grant any warranty or assume any liability by Seller.
SHIP VIA DELV.TIME DELV. ID T FREIGHT TAXABLE AMT. SALES TAX TOTAL CORE PREV.DEPOSIT
0 .00 0 . 00
RECEIVED PAY THIS
02 :58 PM BY x CUSTOMER COPY AMOUNT , 92.87
VOUCHER # 136971 WARRANT # ALLOWED
I
00352688 IN SUM OF $
CARQUEST AUTO PARTS
PO BOX 404875
ATLANTA, GA 30384-4875
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR ,
t
1 Board members
1
PO# INV# ACCT# AMOUNT Audit Trail Code
v
2738-218328 01-7500-02 $92.87
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Voucher Total $92.87
Cost distribution ledger classification if
claim paid under vehicle highway fund j
a
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
00352688
CARQUEST AUTO PARTS Purchase Order No.
PO BOX 404875 Terms
ATLANTA, GA 30384-4875 Due Date 12/5/2013
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
12/5/2013 2738-218328 $92.87
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