249643 09/23/15 �Coq
`y..__•_,,f CITY OF CARMEL, INDIANA VENDOR: 060700
® ONE CIVIC SQUARE CLARK TIRE INC CHECK AMOUNT: $**... .155.95"
�: � CARMEL, INDIANA 46032 622 C SOUTH RANGELINE RD CHECK NUMBER: 249643
9M(>UNG�� CARMEL IN 46032 CHECK DATE: 09/23/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4350101 146334 66.00 TRASH COLLECTION
601 5023990 146436 89.95 OTHER EXPENSES
i
LARK CARMEL All Claims and Returns MUST Be Accompanied By THIS INVOICE
622 C. South Rangeline Road TERMS:NET 10TH FOLLOWING DATE OF PURCHASE.A SERVICE CHARGE
Carmel, IN 46032 OF 13/4%PER MONTH WILL BE ADDED TO PAST DUE BALANCE(MINIMUM
(317)844-4839 CHARGE.75).THE ANNUAL PERCENTAGE RATE IS 21%.
IR
� FAX(317)844-6561 AGRICULTURAL EXEMPTION CERTIFICATE
STATE DEPARTMENT OF REVENUE—SALES TAX DIVISION
I HEREBY CERTIFY UNDER THE PENALTIES OF PERJURY THAT THE PERSONAL
PROPERTY PURCHASED BY THE USE OF THIS EXEMPTION CERTIFICATE WILL BE
DIRECTLY USED IN THE DIRECT PRODUCTION OF AGRICULTURAL PRODUCTS FOR
TOMORESALE.
I X
— CUSTOMER'S SIGNATURE
UNIROYAL
CARMEL POLICE DEPT. 6000/01 SAME INVOICE# 146334
SOLD TO: THREE CIVIC SNARE SHIP TO:
CARMEL IN 46032
CUST. P.O. # MAKE-MODEL ID# MILEAGE [3iTEL-EPHONE "ROUTE SLM SHIP VIA ORDER# PAGE REMARKS
571-2500 s5 �/A 1170411 1i
EE' E i
INVOICE DATE I INVOICE PREVIOUS SHIPPED TERMS
NUMBER „ INVOICE NUMBER nened 1 v Operator # 8
0$!26/2815 146334 { PNET 10TH X8/26/15 15:42:24 8
I v �
STOCK NUMBER I SIZE DESCRIPTION _--------„ounNmv"D -,�EV.,SHIP_.� PRICE
' UNIT T F.E.T. EXTENSION
_ OROERS', SHIPPE �PR ,
SCRAP 5CRAP TIRE 2' i 3.00 #- ; .00 X03
METHOD OF PAYMENT: s
CHARGE: 66.00
CHANGE: .00 I ..
I
l t
PARTS LABOR TAX% TAXABLE TAX F.E.T MISC PLEASE INIU07GE�TOTAl1IT
AMOUNT AMOUNT
66.00 66.00 -
"Ours is A Reputation You Can Ride On”
CUSTOMER COPY
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))
08/26/15 146334 Scrap Tire $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.
Clark Tire ALLOWED 20
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 146334 43-501.01 $66.00 I 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
Tuesday, September 15, 2015
Chief of Police
41Z
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
i
LARK 622C S. Rangeline Road
"YOU ARE RIDING ON OUR REPUTATION" Carmel, IN 46032
4w IRE (317) 844-4839
ationai PENS IL
1,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 LAR'S 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:
CARMEL WATER DISTRIBUTION 6300/01 SAME INVOICE# 146436
3450 W. 131ST ST.
CARMEL IN 46074
CUST P.O.# MAKE-MODEL ID# MILEAGE TELEPHONE ROUTE SLM SHIP VIA ORDER# PAGE REMARKS
853
#133 #133 129917 716-3934 0 5 NIA 170609 1
INVOICE DATE INVOICE PREVIOUS SHIPPED TERMS
NUMBER INVOICE NUMBER
Opened by Operator
04/09/2015 146436 NET 10TH 09/04/15 09:32:55 8
STOCK NUMBER SIZE DESCRIPTION QUANTITSHIPPEYD PKV.___ SHIP PUNITRICEORDERS T F-E T. EXTENSION
AL2 EACH PASSENGER 4 WHEEL ALIGNMENT 1 1 89.95 .00 89.95
METHOD OF P YNENT:
CHARGE: 89.45
CHANGE: .00
Thank you for your business Mech: Doug K
PARTS LABOR TAX% TAXABLE TAX F.E.T. MISC. INVOICE TOTAL
AMOUNT AMOUNT LASE FAY I It) WII
84,95 89.45
"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 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 9/15/2015
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
9/15/2015 146436 $89.95
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 Officer
VOUCHER # 153021 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 i
Board members
PO# INV# ACCT# AMOUNT Audit Trail Code
146436 01-6500-05 $89.95
7
I
Voucher Total $89.95
Cost distribution ledger classification if
claim paid under vehicle highway fund