248279 08/12/15 ��u ��p"° CITY OF CARMEL, INDIANA VENDOR: 060700
® Y 1 ONE CIVIC SQUARE CLARK TIRE INC CHECK AMOUNT: $********66.00*
:. ,�� CARMEL, INDIANA 46032 622 C SOUTH RANGELINE RD CHECK NUMBER: 248279
',y`�«oN.�` CARMEL IN 46032 CHECK DATE: 08/12/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4350101 146003 66.00 TRASH COLLECTION
622C S. Rangeline Road
YOU ARE RIDING ON OUR REPUTATION" LARK
Carmel, IN 46032
:� (317) 844-4839
national PENS IL
I,THE UNDERSIGNED,HEREBY AGREE UNTIL SUCH TIME AS THIS ACCOUNT IS PAID IN FULL BY ME,THE SELLER SHALL RETAIN TITLE TO THE GOODS HEREBY PURCHASED AND SELLER SHALL HAVE
A SECURITY INTEREST IN SAID GOODS TO SECURE THE PAYMENT UNTIL MY ACCOUNT IS FULLY PAID.I FURTHER AGREE THAT IN THE EVENT OF DEFAULT IN THE PAYMENT OF ANY AMOUNT DUE,AND
IF THIS ACCOUNT IS PLACED IN THE HANDS OF AN AGENCY OR ATTORNEY FOR COLLECTION OR LEGAL ACTION TO PAY AN ADDITIONAL CHARGE EQUAL TO THE COST OF COLLECTION INCLUDING
AGENCY AND ATTORNEY FEES AND COURT COSTS INCURRED AND PERMITTED BY LAWS GOVERNING THESE TRANSACTIONS.
A finance charge of 13/4%Per Month will be charged on all Accounts 30 days Past Due.Annual Percentage Rate is 21%.(Minimum 75) RECEIVED BY
SOLD TO: CARMEL POLICE DEPT. 6000/01 SHIP TOE,A�1E INVOICE#r 146003
THREE CIVIC SWURE
CARMEL IN 46032
CLIST.P.O.# MAKE-MODEL ID# MILEAGE Z TEL-EP.y,--O E ROUTE SLM SHIP VIA ORDER# PAGE REMARKS
511-2500 0 O NIA 169746 1
INVOICE DATE INVOICE PREVIOUS SHIPPED TERMS
NUMBER INVOICE NUMBER
u
vN i.cOperator n'
07/27!2015 146I.Q NET 10TH 07/27/15 14:13:28 6
STOCK NUMBER SIZE DESCRIPTION QUANTITY UNIT T F.E.T. EXTENSION
ORDERS SHIPPED PREV.SHIP PRICE
SCRtP
SCRAP TIRE 22 22 3.00 .00 66.0011
METHOD OF PAYMENT:
CHARGE: 66.00
CHANGE: .00
i
Thank you for your business
PARTS LABOR TAX% TAXABLE AMOUNT TAX F.E.T. AMo NT p rnTOTAL,.-
66.00 .u� 021
"You're Riding On Our Reputation" .
VOUCHER NO. WARRANT NO.
ALLOWED 20
Clark Tire IN SUM OF$
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 146003 43-501.01 I $66.00
I hereby certify that the attached invoice(s), or
I I
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,August 07, 2015
'=A" c'),
Chief of Police
Title
ifi if
Cost distribution ledger classification �
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))
07/27/15 146003 scrap tires $66.00
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
, 20
Clerk-Treasurer