HomeMy WebLinkAbout237947 10/08/2014 CITY OF CARMEL, INDIANA VENDOR: 366480
ONE CIVIC SQUARE POMP'S TIRE CHECK AMOUNT: $*******464.76*
CARMEL, INDIANA 46032 ATTN:AR DEPARTMENT CHECK NUMBER: 237947
PO BOX 1630 CHECK DATE: 10/08/14
GREEN BAY WI 54305-1630
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
601 5023990 910022522 464.76 OTHER EXPENSES
SHPN577409187
POMP'S TIRE-LAFAYETTE INVOICE #: 910022522
2700 SCHUYLER AVE
PAGE: 1
LAFAYETTE, IN 47905
765/742-4000
CUSTOMER: CITY OF CARMEL WATER OPER
- - -3450 W-131ST STREET
2266
CARMEL, IN
46074
CREATED BY TIM AJ
REF NUMBER: DR1132322
FAX NUMBER: 3177332053
WORK: 317/733-2855 0
SALESMAN: MICHAEL S RUMMEL
INVOICE DATE: 09/22/14 TERMS: 1 PMT DUE 10TH OF MON AFTR INV
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PRODUCT MECHANIC QUANTITY PRICE F.E.T. EXTENSION
-------------------------------------------------------------------------------
LT245/75R16/10 TRANSFRC AT BL 4 115.94 463.76
189F582
TIRE USER FEE - IN 4 .25 1.00
950L13
Registration: serial# xx Quantity 4
FIRESTONE GOVERNMENT SALE APPROVAL#7130
BS CM 6427708215
MERCHANDISE: 463.76
OTHER: 1.00
INVOICE TOTAL: 464.76
GOVERNMENT 464.76
Printed Name Signature
LUG NUTS MUST BE RE-TORQUED AFTER 50-100 MILES.
Page 1
VOUCHER # 141896 WARRANT# ALLOWED
366480 IN SUM OF $
Pomp's Tire
PO BOX 1630
GREEN BAY, WI 54305-1630
Carmel Water Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO# INV# ACCT# AMOUNT Audit Trail Code
910022522 01-6500-04 $464.76
Voucher Total $464.76
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
erformed dates of service rendered by whom rates per day, number of units
price per unit, etc.
Payee
366480
Pomp's Tire Purchase Order No.
PO BOX 1630 Terms
GREEN BAY, WI 54305-1630 Due Date 9/29/2014
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
9/29/2014 910022522 $464.76
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