245446 05/20/15 (9,
CITY OF CARMEL, INDIANA VENDOR: 060700
ONE CIVIC SQUARE CLARK TIRE INC CHECK AMOUNT: S*******"66.00*
CARMEL, INDIANA 46032 622 C SOUTH RANGELINE RD CHECK NUMBER: 245446
CARMEL IN 46032 CHECK DATE: 05/20/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4350101 145248 66.00 TRASH COLLECTION
622C S. Rangeline Road
"YOUARERIDING ON OUR REPUTATION" LARK Carmel, IN 46032
4wrIR�E�
(317) 844-4839
` PENNY IL
rational
I,THE UNDERSIGNED,HEREBY AGREE UNTIL SUCH TIME AS THIS ACCOUNT 1S PAID IN FULL BY ME,THE SELLER SHALL RETAIN TITLE TO TH GOODS HEREBrH1
SED NOSE LER SHALL HAVE
A SECURITY INTEREST IN SAID GOODS TO SECURE THE PAYMENT UNTIL MY ACCOUNT IS FULLY PAID.I FURTHER AGREE THAT IN THE EVEN F DEFAULT INY. NT 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 CH E EQUAL TOS E N 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�s 21%.(Minimum 75) RECEIVED BY
SOLD TO: CARMEL POLICE DEPT. 6000/01 SHIP TO:SANE ��CE# 145248
THREE CIVIC SQUARE
CARMEL IN 46032
CUST P.O.# MAKE-MODEL ID# MILEAGE T L-EPHO E ROUTE SLM SHIP VIA ORDER# PAGE REMARKS
571-2500 0 5 N/A 168257 1
INVOICE DATE INVOICE PREVIOUS SHIPPED TERMS
NUMBER INVOICE NUMBER
— Opened
05/12/2015 145248 NET 10TH 05/12/15 12:11:42 B
STOCK NUMBER SIZE DESCRIPTION DUNIT
SHIP
ORDERS SHIPPEED PREV.SHIP PRICE T F.E.T. EXTENSION
SCRAP SCRAP TIRE 22 22 3.00 .00 66.00
METHOD OF PAYMENT:
CHARGE: 66.00
CHANGE: .00
Thank you for your business
TAXABLE PARTS LABOR TAX% AMOUNT TAX F.E.T. AMOUNT nt rAorlN DICEQkWT
66.00 66.00
"You're Riding On Our Reputation"
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))
05/12/15 145248 scrap tires $66.00
1 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
VOUCHER NO. WARRANT NO.
ALLOWED 20
Clark Tire
IN SUM OF $
622 C South Rangeline Road
Carmel, IN 46032
$66.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel Police Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT
Board Members
1110 I 145248 I 43-501.01 I $66.00 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
Frid May 15, 2015
Chief of Police
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund