242818 03/03/15 �4�q
q, CITY OF CARMEL, INDIANA VENDOR: 366394
ONE CIVIC SQUARE POMPS TIRE-LAFAYETTE CHECK AMOUNT: $*******1 19.69*
;� =q CARMEL, INDIANA 46032 2700 SCHUYLER AVENUE CHECK NUMBER: 242818
°Mi�eN�o.� LAFAYETTE IN 46905 CHECK DATE: 03/03/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
601 5023990 910026494 119.69 OTHER EXPENSES
SHPN577516388
POMP'S TIRE-LAFAYETTE INVOICE #: 910026494
2700 SCHUYLER AVE
PAGE: 1
LAFAYETTE, IN 47905
765/742-4000
CUSTOMER: CITY OF CARMEL WATER OPER SHIP TO: DELIVER VIA SHANE
3450 W 131ST STREET
2266- - - -- - - -
CARMEL, IN
46074
CREATED BY TIM
REF NUMBER: DR247475
FAX NUMBER: 3177332053
WORK: 317/733-2855 0
SALESMAN: MICHAEL S RUMMEL
INVOICE DATE: 02/18/15 TERMS: 1 PMT DUE 10TH OF MON AFTR INV
-------------------------------------------------------------------------------
PRODUCT MECHANIC QUANTITY PRICE F.E.T. EXTENSION
-------------------------------------------------------------------------------
P235/70SR16 WRANGLER SR-A WL 1 119.44 119.44
1836407418
TIRE USER FEE - IN 1 .25 0.25
950L13
Registration: serial# 4808DY1R4814 Quantity 1
GOVERNMENT APPROVAL# G0002624
CM#61055210 D]S
MERCHANDISE: 119.44
OTHER: 0.25
INVOICE TOTAL: 119.69
GOVERNMENT 119.69
"*A COPY OF THIS INVOICE HAS BEEN EMAILED'
Printed Name Signature
LUG NUTS MUST BE RE-TORQUED AFTER 50-100 MILES.
Page 1
VOUCHER # 151033 WARRANT # ALLOWED
366480 IN SUM OF $
Pomp's Tire
Ave-
Fze
G ?r65--1636---'
Carmel Water Utility +
ON ACCOUNT OF APPROPRIATION FOR
r
Board members
PO# INV# ACCT# AMOUNT Audit Trail Code
I
910026494 01-6500-05 $119.69
Voucher Total $119.69
I
i
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
I
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.
I
i
Payee
366480
Pomp's Tire Purchase Order No.
PO BOX 1630 Terms
GREEN BAY, WI 54305-1630 Due Date 2/20/2015
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
2/20/2015 910026494 $119.69
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 5-11-10-14fficer
Date