HomeMy WebLinkAbout258005 04/26/16 CITY OF CARMEL, INDIANA VENDOR: 366480
,. CHECK AMOUNT: $*******460.00*
ONE CIVIC SQUARE POMP'S TIRE
CARMEL, INDIANA 46032 ATTN:AR DEPARTMENT CHECK NUMBER: 258005
vM�TON` PO BOX 1630 CHECK DATE: 04/26/16
GREEN BAY WI 54305-1630
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
601 5023990 910040791 460.00 OTHER EXPENSES
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
366480
Pomp's Tire Purchase Order No.
PO BOX 1630 Terms
GREEN BAY, WI 54305-1630 Due Date 4/11/2016
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
4111/2016 910040791 $460.00
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# 161197 WARRANT# ALLOWED
366480 IN SUM OF $
Pomp's Tire
PO BOX 1630
GREEN BAY, W1 54305-1630
Carmel Water Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO# INV# ACCT# AMOUNT Audit Trail Code
910040791 01-6500-07 $460.00
Voucher Total $460.00
Cost distribution ledger classification if
claim paid under vehicle highway fund
SHPN5779230I0
POMP'S TIRE-LAFAYETTE INVOICE #: 9I004079I
2700 S[HUYLER AVE
PAGE: I
LAFAYETTE, IN 47905
765/742-4000
CUSTOMER: CITY OF CARMEL WATER OPER SHIP TO: DELIVERED VIA S. RUMMEL
�450 W I3I5T STREET
2260
CARMEL, IN
46074
CREATED BY DBL
REF NUMBER: DRI388400
FAX NUMBER: 31773]205]
BUSINESS: 3I7/7]]-2855 0 PO NUMBER: GOV
SALESMAN: SHANE RUMMEL
INVOICE DATE: 04/06/I8 TERMS: l PMT DUE 10TH OF MON AFTR INV
-----------------------------------------------------_-_--_---_----_-_------_-_
PROOU[T MECHANIC QUANTITY PRICE F.E.T. EXTENSION
-------------------------------------------------------------------------------
' P23S/7USm16 DEST A/T OWL 4 114.75. 459.00
OZ6F707
TIRE USER FEE - IN 4 .35 1.00
95DLI]
Registration; Serial# W80804233I5 Quantity 4
GOV QF5 7130
BSCM# 6445399788 PV
MERCHANDISE: 459'00
OTHER: 1.00
OFFICE COPY INVOICE TOTAL: 460.00
GOVERNMENT 460.00
+**A COPY OF THIS INVOICE HAS BEEN EMAILED**
Printed Name signature
~ 5O
LUG NUTS MUST BE RE-TORQUED AFTER 50-100 MILES.
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