243561 3 /24/2015 r 44q
CITY-OF CARMEL, INDIANA VENDOR: 366480
ONE CIVIC SQUARE POMP'S TIRE CHECK AMOUNT: $""'1,451.70`
=Q CARMEL, INDIANA 46032 ATTN:AR DEPARTMENT CHECK NUMBER: 243561
PO BOX 1630 CHECK DATE: 03/24/15
GREEN BAY WI 54305-1830
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2201 4232000 910026803 1,085.70 TIRES & TUBES
2201 4232000 910027325 366.00 TIRES & TUBES
SHPN577537507
POMP'S TIRE-LAFAYETTE INVOICE #: 910027325
2700 SCHUYLER AVE
PAGE: 1
LAFAYETTE, IN 47905
765/742-4000
CUSTOMER: CITY OF CARMEL STREET DEP SHIP TO: DELIVERED VIA S. RUMMEL
3400 W 131ST STREET
2264
CARMEL, IN
46074
CREATED BY DBL
REF NUMBER: SHANE
FAX NUMBER: 3177332005
WORK: 317/733-2001 0
SALESMAN: MICHAEL S RUMMEL
INVOICE DATE: 03/18/15 TERMS: 1 PMT DUE 10TH OF MON AFTR INV
-------------------------------------------------------------------------------
PRODUCT MECHANIC QUANTITY PRICE F.E.T. EXTENSION
-------------------------------------------------------------------------------
TRK DISMOUNT&MOUNT ON UNIT/SHP 9121 3 32.00 96.00
TDMS
STANDARD BRASS TRUCK VALVE 3 8.00 24.00
TVALV
POWDER COAT RIM/WHL RECONDITON 3 32.00 96.00
RECON
USED 8.25X22.5 10H HP STL WHL 3 50.00 150.00
UWHL
MERCHANDISE: 270.00
LABOR: 96.00
INVOICE TOTAL: 366.00
ON ACCOUNT A/R-
***A COPY OF THIS INVOICE HAS BEEN EMAILED**
Printed Name Signature
. LUG NUTS MUST BE RE-TORQUED AFTER 50-100 MILES.
Page 1
SHPN577538463
POMP'S TIRE-LAFAYETTE INVOICE #: 910026803
2700 SCHUYLER AVE
PAGE: 1
LAFAYETTE, IN 47905
765/742-4000
CUSTOMER: CITY OF CARMEL STREET DEP SHIP TO: DELIVERED VIA S. RUMMEL
3400. W 131ST STREET
2264
CARMEL, IN
46074
CREATED BY DBL
REF NUMBER: DRM937240
FAX NUMBER: 3177332005
WORK: 317/733-2001 0 PO NUMBER: SHANE
SALESMAN: MICHAEL S RUMMEL
INVOICE DATE: 03/19/15 TERMS: 1 PMT DUE 10TH OF MON AFTR INV
-------------------------------------------------------------------------------
PRODUCT MECHANIC QUANTITY PRICE F.E.T. EXTENSION
-------------------------------------------------------------------------------
315/80R22.5/20 CONT HSU2 WT US 2 468.10 936.20
514C045
TIRE USER FEE - IN 2 .25 0.50
950L13
GOV CN GING3AA7
TRUCK MOUNT - SHOP 9115 2.00 15.00 30.00
TMS
10 OZ BAG EQUAL TYPE B 40/CASE 2 20.00 40.00
010E
STANDARD BRASS TRUCK VALVE 2 7.50 15.00
TVALV
POWDER COAT RIM/WHL RECONDITON 2 32.00 64.00
RECON
- - CM#5056377811 DJS - - - - --
MERCHANDISE: 1055.20
LABOR: 30.00
OTHER: 0.50
INVOICE TOTAL: 1085.70
GOVERNMENT 1085.70
***A COPY OF THIS INVOICE HAS BEEN EMAILED**
Printed Name signature
LUG NUTS MUST BE RE-TORQUED AFTER 50-100 MILES.
Page 1
VOUCHER NO. WARRANT NO.
ALLOWED 20
Pomp's Tire Service, Inc.
A/R Department IN SUM OF$
p. O. Box 1630
Green Bay, WI 54305-1630
$1,451.70
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO#/Dept. INVOICE NO. I ACCT#/TITLE AMOUNT Board Members
2201 910027325 42-320.00 j $366.00 1 hereby certify that the attached invoice(s), or
2201 910026803 1 42-320.00 $1,085.70 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
a I�15
Y r -cr
ree Comm�issioner
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
Prescribed b State Board of Accounts
Y 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 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))
03/18/15 910027325 $366.00
03/19/15 910026803 $1,085.70
I
I
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