246251 06/17/15 1+y,.Coq*f
�/ \. CITY OF CARMEL, INDIANA VENDOR: 060700 ►►►►►►►► ►
® �• ONE CIVIC SQUARE CLARK TIRE INC CHECK AMOUNT: $ 37.50
�� ?� CARMEL, INDIANA 46032 622 C SOUTH RANGELINE RD CHECK NUMBER: 246251
+��JON� CARMEL IN 46032 CHECK DATE: 06/17/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4351000 145564 37.50 AUTO REPAIR & MAINTEN
i
622C S. Rangeline Road
"YOU ARE RIDING ON OUR REPUTATION" LARK Carmel, IN 46032
4) IR�E�
(317) 844-4839
motional PESIL
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: CARIMEL FIRE DEPT. 590MI SHIPTO:Lp,1E
INVOICED 145564
TWO CIVIC SQUARE
CAMEL IN 46@32
I
CUST.P.O.# MAKE-MODEL ID# MILEAGE TEgEr_tONE ROUTE SLM SHIP VIA ORDER# PAGE REMARKS
9PUAED 123573 571-2 09 0 5 N/A 16868'i 1
INVOICE DATE INVOICE PREVIOUS SHIPPED TERMS
NUMBER INVOICE NUMBER Opened by f1 t -N 8 0
wl/12/2A15 145564 NET 10TH @5112/15 16:09.53 8
STOCK NUMBER SIZE DESCRIPTION QUANTITY_ UNIT ORDERS SHIPPED PREV.SHIP PRICE T F.E.T. EXTENSION
REPAIR TIRE
iG 1G° DISMOUNT 9 MOUNT PASSENGER 1 1 16.00 .00 16.00
REPO Efr0d INSIDE REPAIR CIN VEHICLE I 1 9.50 .0.0 9.50
CS EPIC H CLEAN RESEAL TIRE BEADS i 1 1'2.00 .00 12.00
METHOD OF PAYMENT:
CHARGE: 37.50
CH"ANGE: .00
o
mank you for your bfflnes5 Hoch:7: U ug {t
PARTS LABOR TAX% l.r' T OUN1,5BLEC ) TAX F.E.T. AMOUNT u ;eFINUOI9-E11MAUNT
37.51 1+.03120155-002- 37.50
"You're Riding On Our Reputation"
r
li VOUCHER NO. WARRANT NO.
ALLOWED 20
Clark Tire
IN SUM OF $
622 South Rangeline Road
Carmel, IN 46032
$37.50
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
p0#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1120 145564 43-510.00 $37.50 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
JUN 15 2015
Fire Chief
Title
Cost distribution ledger classification if
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))
145564 C40 $37.50
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
120
Clerk-Treasurer