240651 01/07/15 Coq
CITY OF CARMEL, INDIANA VENDOR: 060700
ONE CIVIC SQUARE CLARK TIRE INC CHECK AMOUNT: $**......31.44*CARMEL, INDIANA 46032 622 C SOUTH RANGELINE RD CHECK NUMBER: 240651
9M�iUH L� CARMEL IN 46032 CHECK DATE: 01/07/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4351000 144029 31.44 AUTO REPAIR & MAINTEN
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622C S. Rangeline Road
"YOU ARE RIDING ON OUR REPUTATION" Cannel, IN 46032
4w (317) 844-4839
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I,THE UNDERSIGNED.HEREBY AGREE UNTIL SUCH TIME AS THIS ACCOUNT IS PAID IN FULL BY ME,THE SELLER SHALL RETAIN TITLE TO THE GOODS HEREBY PURCHASED AND SELLER SHALL HAVE
A SECURITY INTEREST IN SAID GOODS TO SECURE THE PAYMENT UNTIL MY ACCOUNT IS FULLY PAID,I FURTHER AGREE THAT IN THE EVENT OF DEFAULT IN THE PAYMENT OF ANY AMOUNT DUE,AND
IF THIS ACCOUNT IS PLACED IN THE HANDS OF AN AGENCY OR ATTORNEY FOR COLLECTION OR LEGAL ACTION TO PAY AN ADDITIONAL CHARGE EQUAL TO THE COST OF COLLECTION INCLUDING
AGENCY AND ATTORNEY FEES AND COURT COSTS INCURRED AND PERMITTED BYLAWS GOVERNING THESE TRANSACTIONS.
A finance charge of 13/4%Per Month will be charged on all Accounts 30 days Past Due.Annual Percentage Rate is 21%.(Minimum 75) RECEIVED BY
SOLD TO: CARMEL FIRE DEPT. 5900/01 SHIP TO.-SAME INVOICE# 144029
TWO CIVIC SQUARE
CARMEL IN 46032
CUST. P.O.# MAKE-MODEL ID# MILEAGE TELEP_HgJyE ROUTE SLM SHIP VIA ORDER# PAGE REMARKS
571-2609 0 5 N/A 165664 1
INVOICE DATE INVOICE PREVIOUS SHIPPED TERMS
NUMBER INVOICE NUMBER
Openid u
12/17/2014 144029 NET 10TH 12/17/14 11:56:29 7
STOCK NUMBER SIZE DESCRIPTION QUANTITY UNIT ORDERS F.E.T. EXTENSION
ORDERS SHIPPED PREV SHIP PRICE
REPAIR TIRE LOOSE
CELL 690-4283
1825 18/8.5-9,5-10X8 COOPER TUBE TR13 1 1 16.44 02 .00 16.44
CH EACH TIRE CHANGE 1 1 15.00 .00 15.00
METHOD OF PAYMENT:
CHARGE: 31.44
CHANGE: .00
I
Thank i u s q� e Mike
PARTS LABOR TAX% CUStUTK ouNJ5218 No. TAX F.E.T. AMOUNT PLEASEIN,ar'ICE�q,TAL'JT
31.44 03120155-002-0 31.44
"You're Riding On Our Reputation"
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))
144029 EMS Cart $31.44
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
VOUCHER NO. WARRANT NO.
ALLOWED 20
Clark Tire
IN SUM OF $
622 South Rangeline Road
Carmel, IN 46032
(#1 $31.44
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1120 144029 43-510.00 $31.44 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 JAN
v- y-
Fire Chief
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund