242073 2 /10/2015 CITY OF CARMEL, INDIANA VENDOR: 366480
® ONE CIVIC SQUARE POMP'S TIRE CHECK AMOUNT: $*******530.76*
CARMEL, INDIANA 46032 ATTN:AR DEPARTMENT CHECK NUMBER: 242073
Po eox 1630 CHECK DATE: 02/10/15
GREEN BAY WI 54305-1630
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
601 5023990 910025703 464.76 OTHER EXPENSES
601 5023990 910026187 66.00 OTHER EXPENSES
SHPN577499190
POMP'S TIRE-LAFAYETTE INVOICE #: 910025703
2700 SCHUYLER AVE
LAFAYETTE, IN 47905 PAGE: 1
765/742-4000
CUSTOMER: CITY OF CARMEL WATER OPER SHIP TO: DELIVER VIA SHANE
3450 W 131ST STREET
2266 -
CARMEL, IN
46074
CREATED BY JEFF
REF NUMBER: DR0180743
FAX NUMBER: 3177332053
WORK: 317/733-2855 0
SALESMAN: MICHAEL S RUMMEL
INVOICE DATE: 01/27/15 TERMS: 1 PMT DUE 10TH OF MON AFTR INV
-------------------------------------------------------------------------------
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# 8X11TR71613 Quantity 4
APPROVAL#7130
CM#6431656497 DJS
MERCHANDISE: 463.76
OTHER: 1.00
INVOICE TOTAL: 464.76
GOVERNMENT 464.76
**A COPY OF THIS INVOICE HAS BEEN EMAILED**
Printed Name Signature
LUG NUTS MUST BE RE-TORQUED AFTER 50-100 MILES.
Page 1
SHPN577498456
POMP'S TIRE-LAFAYETTE INVOICE #: 910026187
2700 SCHUYLER AVE
LAFAYETTE, IN 47905 PAGE: 1
765/742-4000
CUSTOMER: CITY OF CARMEL WATER OPER SHIP TO: SCRAP TIRE INVOICE
2266
3450 W 131ST STREET P/U VIA S. RUMMEL
- --
CARMEL, IN
46074
CREATED BY DBL
FAX NUMBER: 3177332053
WORK: 317/733-2855 0
SALESMAN: MICHAEL S RUMMEL
INVOICE DATE: 01/26/15 TERMS: 1 PMT DUE 10TH OF MON AFTR INV
-------------------------------------------------------------------------------
PRODUCT MECHANIC QUANTITY PRICE F.E.T. EXTENSION
-------------------------------------------------------------------------------
LIGHT TRUCK SCRAP DISPOSAL FEE 11 6.00 66.00
LDISP
OTHER: 66.00
INVOICE TOTAL: 66.00
ON ACCOUNT A/R 66.00
***A COPY OF THIS INVOICE HAS BEEN EMAILED''°*
Printed Name signature
LUG NUTS MUST BE RE-TORQUED AFTER 50-100 MILES.
i0-
W
Page 1
VOUCHER # 142955 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
910026187 01-6500-05 $66.00
I
I
Voucher Total 52 ,�b a
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
performed, 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 2/5/2015
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
2/5/2015 910026187 $66.00
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