HomeMy WebLinkAbout300205 07/12/16 ;. CITY OF CARMEL, INDIANA VENDOR: 366394
ONE CIVIC SQUARE POMP'S TIRE-LAFAYETTE CHECK AMOUNT: $*******230.00*
s•. _� CARMEL, INDIANA 46032 2700 SCHUYLER AVENUE CHECK NUMBER: 300205
9�;���oN�� LAFAY ITTE IN 46905 CHECK DATE: 07/12/16
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
601 5023990 9100436711 230.00 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 7/5/2016
Invoice Invoice Description
Date Number -(or note attached invoice(s) or bill(s)) Amount
7/5/2016 910043671 230.00
hereby certify that the attached invoice(s), or bill(s) is (are)true and
-orrect and I have audited same in accordance with IC 5-11-10-1.6
Date Officer
SHPN577023907
POMP'S TIRE-LAFAYETTE INVOICE #: 910043671
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: DR1451806
FAX NUMBER: 3177332053
BUSINESS: 317/733-2855 0 PO NUMBER: GOV
SALESMAN: SHANE RUMMEL
INVOICE DATE: 06/27/16 TERMS: 1 PMT DUE 10TH OF MON AFTR INV
-------------------------------------------------------------------------------
PRODUCT MECHANIC QUANTITY PRICE F.E.T. EXTENSION
-------------------------------------------------------------------------------
P235/70SR16 DEST A/T OWL 2 114.75 229.50
026F767
TIRE USER FEE - IN 2 .25 0.50
950L13
Registration: Serial WB08DA22815 Quantity 2
GOV BFS 7130
BSCM# 6448086261 PV
MERCHANDISE: 229.50
OTHER: 0.50
OFFICE COPY INVOICE TOTAL: 230.00
GOVERNMENT 230.00
***A COPY OF THIS INVOICE HAS BEEN EMAILED
Printed Name Signature
LUG NUTS MUST BE RE-TORQUED AFTER 50-100 MILES.
Page 1
POMP'S TIRE SERVICE, INC. POMP'1STIRES RVICESINC.
P ' S ATTN: AR DEPARTMENT
P.O. BOX 1630
ryIRESERVIEE.` " S GREEN BAY,WI 54305-1630
POMP'S TIRE-LAFAYETTE WORK ORDER #: 910043671
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: DR1451806
FAX NUMBER: 3177332053
BUSINESS: 317/733-2855 0 PO NUMBER: GOV
SALESMAN: SHANE RUMMEL
WRK ORD DATE: 06/13/16 TERMS: 1 PMT DUE 10TH OF MON AFTR INV
PRODUCT MECHANIC QUANTITY PRICE F.E.T. EXTENSION
P235/70SR16 DEST A/T OWL 2 114.75 229.50
026F767
TIRE USER FEE - IN 2 .25 0.50
950L13
Registration: Serial WB08DA22815 Quantity 2
GOV BFS 7130
MERCHANDISE: 229.50
OTHER: 0.50
WORK ORDER TOTAL: 230.00
A finance charge of 1.5%per month 181/9 APR will be added to the unpaid balance after 30 days.
CUSTOMER ESTIMATE SELECTION 1 1 hereby authorize the below repair work to be done along with necessary materials.You and your employees may operate
You are entitled to a price estimate for the repairs you have authorized.The repair price may be less than the estimate but vehicle for purposes of testing,inspection or delivery at my risk.An express mechanic's lien is acknowledged on vehicle to
will not exceed the estimate without your permission.Your signature will indicate your estimate selection. secure line amount of repairs thereto.You will not be held responsible for loss or damage to vehicle or articles left in vehicle
1.1 request an estimate in writing before you begin repairs. �— — in case of fire,theft,accident,damage from freezing due to lack of anti-freeze or any other causes beyond your control.
2.Please proceed with repairs but call me before continuing CUSTOMER SIGNATURE X,- ,,/ _.
if price will exceed S---....._._... _ ............... -- ----- -=-rG
3.1 do not want an estimate. ADDITIONAL WORK AUTHORIZED BY:,_
'" ESTIMATED PRICE OF REPAIRS — —
Do you want the replaced parts you are entitled to?EYES Lf NO � A.M. Name