244459 04/21/15 Cqy
CITY OF CARMEL, INDIANA VENDOR: 060700
4 a1
.a a•' ONE CIVIC SQUARE CLARK TIRE INC CHECK AMOUNT: $r**r"`""89 95`
Q CARMEL, INDIANA 46032 622 C SOUTH RANGELINE RD CHECK NUMBER: 244459
CARMEL IN 46032 CHECK DATE: 04/21/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
601 5023990 144948 89.95 OTHER EXPENSES
SARK 622C S. Rangelme Road
"YOU ARE RIDING ON OUR REPUTATION" Carmel, IN 46032
(317) 844-4839
ri RE
Jational PE,:°'�
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: SHIP TO:
CAR1 CL k11A ER DISTRIBUT ION 6;,t%,Oil�1 SME 1NIJOICU 14-948
j
l� 64Y1 W. 131ST JI.
CARTE ' IN 46074
CUST.P.O.# MAKE-MODEL ID# MILEAGE TELEPHONE ROUTE SLM SHIP VIA ORDER# PAGE REMARKS
1733
_20153
4139 131(427 51 7'16-3939 O 1 N/A 167600 1
INVOICE DATE INVOICE PREVIOUS SHIPPED TERMS
NUMBER INVOICE NUMBER
?,enea uy up-1Yatat' tt 1
W1M20I5 144948 NET 10TH 04/11,3115 15:.2'.41 G
STOCK NUMBER SIZE DESCRIPTION QUANTITY UNIT T F.E.T. EXTENSION
ORDERS SHIPPED PREV.SHIP PRICE
AL2' E ail PASSEi�JE 4 U11- L ALIGSMIENT I i 89.55 FM 69195
METHOD OF PAYMENT:
MARGE. 49.G:5
C M INGE. 00
i
i�
t
L .r
Thank you for your businoss HRch. J23es
PARTS LABOR TAX% TAXABLE TAX F.E.T. misc. INVOICE TOTAL
AMOUNT AMOUNT
F EASIE PAY THIS AH Lod I
95 TT
"You're Riding On Our Reputation"
VOUCHER # 151545 WARRANT# ALLOWED
60700 IN SUM OF $
CLARK TIRE INC CARMEL
622 C SOUTH RANGELINE RD
CARMEL, IN 46032
Carmel Water Utility
ON ACCOUNT OF APPROPRIATION FOR a
Board members
PO# INV# ACCT# AMOUNT Audit Trail Code
144948 01-6500-07 $89.95
Voucher Total $89.95
Cost distribution ledger classification if
claim paid under vehicle highway fund
I
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
60700
CLARK TIRE INC CARMEL Purchase Order No.
622 C SOUTH RANGELINE RD Terms
CARMEL, IN 46032 Due Date 4/17/2015
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
4/17/2015 144948 $89.95
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
Date icer