247196 07/15/15 CITY OF CARMEL, INDIANA VENDOR: 00351640
` ONE CIVIC SQUARE CLARK TIRE FISHERS CHECK AMOUNT: $********68.25*
Po BOX 196 CHECK NUMBER: 247196
�9M ,rte, CARMEL, INDIANA 46032 FISHERSIN 46038 CHECK DATE: 07/15/15
r ETON�
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1207 4350000 IN00146257 68.25 EQUIPMENT REPAIRS & M
126TH & REYNOLDS ROAD (HWY 37 NO.) FAST!Service at our Farm,
P.O. BOX 195 y
FISHERS, INDIANA 46038 Commercial Site or on the Road.
317-842-0544 OR 1-800-444-5985 All Major Brands Available
TIRE FISHERS
-Fax 317-577-3956
NAME/ADDRESS ACCOUNT NO. HOME PHONE REFERENCE NO.
BR00i:Ji-i t 31 7) 571--2427 T.N001'1.6257
AROORESHIRE GOLF CLUB P.O.NO. WORKPHONE DATE/TIME
12120 BROOKGHIRE PAIiUAY (2s 17) 420-1676 07/07/15 2.09
RESALE NO. VIN NO. WO-ES NO.
CARMEL, IN, 4GO33 W0Qi1210'82_--;7
YEAR/MAKE/MODEL LICENSE NO. TAG NO. NEXT INSP.DATE BAR NO.
SAVE PARTS ALL PARTS NEW UNLESS PROMISED DATE/TIME MILEAGE WRITTEN BY
Y N OTHERWISE SPECIFIED ril j
MOUNT DATE TIME EMPLOYEE PHONE CUSTOMER
ORIGINAL ❑ FREE ROTATION
REVISED 1 (EVERY 5,000 MILES)
REVISED 2
I acknowledge notice and oral approval of an increase in the original estimate price. ❑ ROAD HAZARD WARRANTY
X
PARTS & OTHERS LABOR
CITY. PART NO. DESCRIPTION
1 'CA510981 CAR 18-959-8/4 SMOOTHY GB.00 68.G0 1.00 IIDIANA TIRE FEE 0.25
I
Reason for original estit:!ate:
Any warranties on the Itemfitems sold hereby are those made by the manufacturer.The seller CLARK TIRE,hereby expressly
disclaims all warranties either express or implied,Including any implied warranty of merchantability or fitness for a particular
purpose and CLARK TIRE neither assumes nor authorizes any other person to assume for it any liability in connection with the sale
of this if'emfitems.
A SERVICE CHARGE OF 1% PER MONTH(21%ANNUALLY)WILL BE CHARGED ON ALL ACCOUNT PAST DUE 30 DAYS.NET 10th PROX. •
I,THE UNDERSIGNED HEREBY AGREE THAT IN THE EVENT OF DEFAULTAN THE PAYMENT OF ANY AMOUNT DUE AND IF THIS ACCOUNT IS PLACED IN PARTS
THE HANDS OF AN AGENCY OR ATTORNEY FOR COLLECTION OR 0EGAL ACTION TO PAY AN ADDITIONAL.CHARGE EQUAL TO THE COST OF E.S. 00
COLLECTION INCLUDING AGENCY AND ATTORNEY FEES AND COUR]'/OSTS INCURRED AND PERMITTED BY LAW GOVERNING THESE TRANSACTIONS
//////// ��,��/ LABOR ISI. ;_c
I hereby authorize the repair work to bon�afong w/2",
he ng,3s ry ma rials.You and your employees may operate vehicle for purposes of testing, OTHER
inspection,or delivery t! y risk.An exFre ec�ianten i (, dged on vehicle to secure the amount of repairs thereto.It is also understood that
you will not be held resible for s damage t cars o i Les left in cars In case of fire,theft or any other cause beyond your control. SUBLET
Signature X �_ / SUBTOTAL 68. 25
-TAX — Ill. 00
Recd BY TOTAL
CASH AMOUNT CHECK AMOUNT CHECK NO. C.C.AMOUNT C.C.TYPE C.C.APPROVAL CODE ON ACCOUNT THANK
58.25 YOU! J
I
VOUCHER NO. WARRANT NO.
Clark Tire Fishers ALLOWED 20
IN SUM OF$
P.O. Box 195
Fishers, IN 46038
- -- -- -- — —$68.25 -- — —-
ON ACCOUNT OF APPROPRIATION FOR
Brookshire Golf Club
PO#/Dept. INVOICE NO. ACCT#lrITLE AMOUNT Board Members
1207 I IN00146257 I 43-500.00 I $68.25 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
Friday, July 10, 2015
f I
Director, Brooks a olf Club
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
II
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 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))
07/07/15 IN00146257 Repair Parts $68.25
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
120
Clerk-Treasurer