251533 11/18/15 >; CITY OF CARMEL, INDIANA VENDOR: 00351179
® it ONE CIVIC SQUARE FIRESTONE TIRE& SERVICE CENTER CHECK AMOUNT: $"""""171.97"
CARMEL, INDIANA 46032 PO BOX 403727 CHECK NUMBER: 251533
+.y,roN ATLANTA GA 30384-3727 CHECK DATE: 11/18/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
G51 5023990 157297 146.49 OTHER EXPENSES
1192 4351000 157506 25.48 AUTO REPAIR & MAINTEN
� WORK ORDER FIRE�"|01--11::
l5/506 1314 S RANGE LJNE RD 10 JAY
11/03/2015
2014 SiU;M1i
CITY OF CARMEL, BUILDING & CODE 2.5L 1-14 F]
1 CIVIC SQ LIC # 90 lH »1W �
CARMEL, IN 46032-2584
440.856.6909 xDAVE
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Numbe, TO Qty Part Labq% Price To<��)
COURTESY CHECK 0.00
COURTESY CHECK 01704693& 1 N/C HAI
FLAT REPAIR & BALANCE 55 SERIES AND ABOVE W/TPMS <Front-Left) 25.48
700 5.95
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Flat rate charged per internal & Mitchell labor manuals Mounting Instructions �����- ------7,,64
Time In: 03:27PM 11/03/2015 Laho' 17.84
Cust Status: Drop Off Appt: No Pay Type: Unspecified
Wheel Lock:
P.525,4�
: 29 We Support AGE Tax 0.00
TorI�buA�ud Total 25.48
PROGRAM Certification
SxnpwxmmmFOR AUTOMOTIVE psP^/m uv`
I ACKNOWLEDGE THAT I HAVE REVIEWED THIS DOCUMENT OF REPAIR AND SERVICE WORK.I HEREBY AUTHORIZE THE ABOVE WORK TO BE DONE,INCLUDING THE INDICATED,
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))
11/03/15 157506 $25.48
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
VOUCHER NO. WARRANT NO.
ALLOWED 20
Firestone Complete Auto Care
IN SUM OF $
P.O. Box 403727
Atlanta, GA 30384
$25.48
ON ACCOUNT OF APPROPRIATION FOR
Carmel DOCS
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1192 I 157506 I 43-510.00 I $25.48 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
Monday, November 16, 2015
Director
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
Customer Invoice FIRESTONE COMPLETE AUTO CARE Service Advisor:
157297 CARMEL 11 SCOTT
10/29/2015 1314 S RANGE LINE RD 317.848.5886
1' CAR EL, IN. 46032-2932
CITY OF CARMEL UTIL CARRY OUT
9609 HAZEL [)ELI-PKWY Lic#: Vin M
INDIANAPOLIS, IN 46280-2935 In: 10/27/15 9:47AM Mileage: 0
317.571.2634 �1640 Out: 10/29/15 9:53AM
Store#02075 COMMERCIAL
Rev Hist Unit Extended Job
Description /Article# ID Qty Price Price Total
FLAT REPAID&BALANCE 55 SERIES AND ABOVE 1 11
(Front-Left) I'
TIRE NOT REPAIRABLE... HOLE IN SIDEWALL
FIRESTONE TIRE PACKAGE 1 11 146.49
077563 DESTINATION A/T P-METRIC OWL P245/75 17 077563 16NN 1 131.37 131.37
110S
DOT# V N ObA23015
INDIANA TI E -EE 7095834 16NN 1 0.25 0,25
NEW TIDE H EL BALANCE LABOR 7013632 16NN 1 11.04 11.04
RUBBERV LV STEM 7015040 16NN 1 1.70 1.70
SCRAP TIR RCYCLING FEE 7075078 16NN 1 2.13 2.13
TIRE INSTALLATION 7015016 16NN 1 N/C N/C
Technician(s):
16 JOHN 11
Payment History: Summary.
Comm/DIr Acct 146.49 Parts 133.07
Total Tendered 146.49 Labor 13.42
Shop Supplies 0.00
I
Sub-Total 146.49
Tax Exempt(0031201550) 0.00
Total $146,49
I have received the above goods and/or services. If this s a credit
card purcha® , I agree to pay and comply with my cardholder
agreement with the issuer.
Rev
Revision History: Amt Init
Customer Signature 1) 10/27/2015 01:24PM 129.50 CITY OF CA 317.571.2634 Ext.1640
Initial here to indicate you have received
the Tire Warranty Maintenance and
Safety Manual.
All parts are new unless otherwise specified.
I acknowledge notice and oral approval of
an increase in the original estimated price.
Signature or Initials
HO ARE WE DOING?
Tell us ab ut your experience todayl
Complete a 4-minute surve for a chance to win$500 in store services
Visit www.FirestoneSurve .cv 1 within 4 days and enter Code 020753-157297
www.Fl restoln GompleteAutoCalre.com
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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
00351179
FIRESTONE COMPLETE AUTO CARE Purchase Order No.
PO BOX 403727 Terms
ATLANTA, GA 30384-3727 Due Date 11/5/2015
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
11/5/2015 157297 $146.49
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 # 156599 WARRANT # ALLOWED
00351179 IN SUM OF $
FIRESTONE COMPLETE AUTO CARE
PO BOX 403727
ATLANTA, GA 30384-3727
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO# INV# ACCT# AMOUNT Audit Trail Code
157297 01-7500-02 $146.49
1
Voucher Total $146.49
Cost distribution ledger classification if
claim paid under vehicle highway fund