HomeMy WebLinkAbout250388 10/07/15 CITY OF CARMEL, INDIANA VENDOR: 366394
d ONE CIVIC SQUARE POMPS TIRE-LAFAYETTE CHECK AMOUNT: S"""`499.64*
f = CARMEL, INDIANA 46032 2700 SCHUYLER AVENUE CHECK NUMBER: 250388
LAFAYETTE IN 46905 CHECK DATE: 10/07/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
601 5023990 910027327 499.64 OTHER EXPENSES
SHPN577695619
POMP'S TIRE-LAFAYETTE INVOICE #: 910027327
2700 SCHUYLER AVE
PAGE: 1
LAFAYETTE, IN 47905
765/742-4000
CUSTOMER: CITY OF CARMEL WATER OPER SHIP TO: DELIVERED VIA S. RUMMEL
3450 W 131ST STREET
2266
CARMEL, IN
46074
CREATED BY DBL
REF NUMBER: DR1205427
FAX NUMBER: 3177332053
WORK: 317/733-2855 0 PO NUMBER: GOV
SALESMAN: MICHAEL S RUMMEL
INVOICE DATE: 08/31/15 TERMS: 1 PMT DUE 10TH OF MON AFTR INV
-------------------------------------------------------------------------------
PRODUCT MECHANIC QUANTITY PRICE F. E.T. EXTENSION
-------------------------------------------------------------------------------
LT245/75R17/10 TRANSFRC AT WL 4 124.66 498.64
205F222
TIRE USER FEE - IN 4 .25 1.00
950L13
Registration: Serial# VN43TR50615 Quantity 4
Gov F/S 7130
CM# 6438269765 Pv
MERCHANDISE: 498.64
OTHER: 1.00
OFFICE COPY INVOICE TOTAL: 499.64
GOVERNMENT 499.64
***A COPY OF THIS INVOICE HAS BEEN EMAILED**
Printed Name signature
LUG NUTS MUST BE RE-TORQUED AFTER 50-100 MILES.
Page 1
Prescribed by State Board of Accounts
Form No.301 (Rev.1995) ACCOUNTS PAYABLE VOUCHER
TO
ADDRESS
Invoice Date Invoice Number Item Amount
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
Mo. Day Yr. Signature Title
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.
Mo. Day Yr. Officer Title
Voucher No. Warrant No.
ACCOUNTS PAYABLE DETAILED ACCOUNTS
MUNICIPAL WATER DEPT. "NOT .
CARMEL, INDIANA
Favor Of
Total Amount of Voucher $
Deductions
I
( - a 1 -7
Co Sc.S
Amount of Warrant $ - c� (,q
Month of Yr
Acct.
VOUCHER RECORD No.
Source of Supply
Water Treatment
Transmission and Dist.
Customer Accounts ;
Administrative and General
Operation-Maintenance
Utility Plant in Service
Constr.Work in Progress
Materials and Supplies
Customers Deposits
Total
Allowed
Board of Control
Filed
Official Title
BOYCE FORMS•SYSTEMS 1-800-382-8702 325