243480 03/24/15 ��4�q
q,% '; CITY OF CARMEL, INDIANA VENDOR: 060700
j; °` ONE CIVIC SQUARE CLARK TIRE INC CHECK AMOUNT: $********25.00*
a CARMEL, INDIANA 46032 622 C SOUTH RANGELINE RD CHECK NUMBER: 243480
'M�roN.-"` CARMEL IN 46032 CHECK DATE: 03/24/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4351000 144733 25.00 AUTO REPAIR & MAINTEN
LARK 622C S. Rangeline Road
"YOUARE RIDING ON OUR REPUTATION" Carmel, IN 46032
W (317) 844-4839
ri RE
motional PENS IL
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 BY LAWS 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: CARMIEL FIRE DEPT, 5W00/01 SHIP TO:SpgF: INVOICE# 144733
TWO T
Ir1O CIU.0 SQUARE
CARS.EL M 46IZI32
CUST. P.O.# MAKE-MODEL ID# MILEAGE TE4EP ONE ROUTE SLM SHIP VIA ORDER# PAGE REMARKS
1#452: 571-2EM 0 1 NVA 10180 1
INVOICE DATE WVOICE PREVIOUS SHIPPED TERMS
NUMBER INVOICE NUMBER
Opened t.-, Operator �
03/16/2015 144733 NET 10TH 03/10/15 08;5ta14 r
STOCK NUMBER SIZE DESCRIPTION QUANTITY UNIT T F.E.T. EXTENSION
ORDERS SHIPPED PREY.SHIP PRICE
REPAIR LOOSE TIRE
6130-42:83
JASON
CS EACH CLEAN $ RESEAL TIRE BEAUS 1 1 25.03 .00 25.W
METHOD OF PAYMENT:
11111E1.
zi',A1V8E:
.00 � ,
111
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(hank yuu for your business 'ceche JAea
PARTS LABOR TAX% „r• AMOULTc_i TAX F.E.T. AMOUNT Fil Pclq INVOICE TOTAL�;
25.00 003120155-22-2s 25.0-�
"You're Riding On Our Reputation"
r
VOUCHER NO. WARRANT NO.
ALLOWED —20-
Clark
0Clark Tire
i IN SUM OF$
I
622 South Rangeline Road
Carmel, IN 46032
I
$25.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1120 144733 43-510.00 $25.00 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
MAR 2 3 2015
Fire Chie
Title
Cost distribution ledger classification if i {
claim paid motor 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 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))
144733 8281 $25.00
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
, 20
Clerk-Treasurer