241693 02/03/15 CITY OF CARMEL, INDIANA VENDOR: 060700
® ONE CIVIC SQUARE CLARK TIRE INC CHECK AMOUNT: $**-"**69.00*
r. ? CARMEL, INDIANA 46032 622 C SOUTH RANGELINE RD CHECK NUMBER: 241693
CARMEL IN 46032 CHECK DATE: 02/03/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4350101 144394 69.00 TRASH COLLECTION
LARK 6222 S. Rangeline Road
"YOU ARE RIDING ON OUR REPUTATION" Carmel, IN 46032
4w IRE (317) 844-4839
ational PENS IL
I,THE UNDERSIGNED,HEREBY AGREE UNTIL SUCH TIME AS THIS ACCOUNT IS PAID IN FULL BY ME,THE SELLER SHALL RETAINTITLETk 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 THEE NT OF DEF 77"PH�YNIENT OF ANY AMOUNT DUE,AND
IF THIS ACCOUNT IS PLACED IN THE HANDS OFAN AGENCY OR ATTORNEY FOR COLLECTION OR LEGAL ACTION TO PAY AN ADDITIONA HARGE� UU � T OST OF COLLECTION INCLUDING
AGENCY AND.ATTORNEY FEES AND COURT COSTS INCURRED AND PERMITTED BY LAWS GOVERNING THESE TRANSACTIONS. (-,/�
A finance charge of 13/4%Per Month will he charged on all Accounts 30 days Past Due.Annual Percentage Rate is 21%.(Minimum 75) RECEIVED ED B
SOLD TO: CARMEL POLICE DEPT. 6000/01 SHIP TO SAME INVOICE# 144394
THREE CIVIC SWARE
CARMEL IN 46032
CLIST.P.O.# MAKE-MODEL ID# MILEAGE •_, T %NE ROUTE SLM SHIP VIA ORDER# PAGE REMARKS
571-2530 0 1 N/A 16644@ 1
INVOICE DATE INVOICE PREVIOUS SHIPPED TERMS
NUMBER INVOICE NUMBER
Opened d'U.
01/29/2015 144354 NET 10TH 01/29/15 12:@,'x:02 7
STOCK NUMBER SIZE DESCRIPTION UNIT
SHIP
ORDERS SHIPPEED PREV.SHIP PRICE T F.E.T. EXTENSION
- yti f
SCRAP SCRAP TIRE 23 23 3.00 .00 69.00
METHOD OF PAYMENT:
CHARGE: 69.00
CHANGEv .00
Thank you for your bu=siness
OT misc.LABOR TAX% AMUNTAX F.E.T. AO T n 1 N,,YQ, I qq JT0 A
69.00 ��69:00
"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))
01/29/15 144394 scap tires $69.00
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.
ALLOWED 20
Clark Tire
IN SUM OF $
622 C South Rangeline Road
Carmel, IN 46032
$69.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel Police Department
PO#/Dept. INVOICE NO. ACCT#!TITLE AMOUNT
Board Members
1110 I 144394 I 43-501.01 I $69.00 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, Ja uary 29, 2015
V41Z Chief of Police
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund