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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