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Home My WebLink About302666 08/31/16 CITY OF CARMEL, INDIANA VENDOR: 366394 ® ONE CIVIC SQUARE POMPS TIRE-LAFAYETTE CHECK AMOUNT: $*******626.46* ?q; CARMEL, INDIANA 46032 2700 SCHUYLER AVENUE CHECK NUMBER: 302666 M�ruN LAFAYETTE IN 46905 CHECK DATE: 08/31/16 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 2201 4232000 910046118 626.46 TIRES & TUBES VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201 (Rev.1995) POMPS TIRE-LAFAYETTE ALLOWED 20 ACCOUNTS PAYABLE VOUCHER 2700 SCHUYLER AVENUE IN SUM OF$ CITY OF CARMEL An invoice or bill to be properly itemized must show:kind of service,where performed,dates service LAFAYETTE, IN 46905 rendered,by whom,rates per day,number of hours,rate per hour,number of units,price per unit,etc. $626.46 Payee ON ACCOUNT OF APPROPRIATION FOR Purchase Order# Street Department Terms Date Due PO# ACCT# DATE INVOICE# DESCRIPTION DEPT# INVOICE# Fund# AMOUNT Board Members DEPT# FUND# (or note attached invoice(s)or bill(s)) AMOUNT 910046118 42-320.00 $626.46 1 hereby certify that the attached invoice(s),or 8/23/16 910046118 $626.46 2201 201 2201 201 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,August 23,2016 Dave Huffman Director 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 Cost distribution ledger classification if claim paid motor vehicle highway fund. Clerk-Treasurer SHPN577105946.TXT POMP'S TIRE-LAFAYETTE INVOICE#: 910046118 2700 SCHUYLER AVE PAGE: 1 LAFAYETTE, IN 47905 765/742-4000 CUSTOMER: CITY OF CARMEL STREET DEP SHIP TO: DELIVERED VIA S. RUMMEL 3400 W 131ST STREET 2264 CARMEL, IN 46074 CREATED BY DBL REF NUMBER: DR1466549 FAX NUMBER: 3177332005 BUSINESS: 317/733-2001 0 PO NUMBER: GOV SALESMAN: SHANE RUMMEL INVOICE DATE: 08/23/16 TERMS: 1 PMT DUE 10TH OF MON AFTR INV ------------------------------------------------------------------------------- PRODUCT MECHANIC QUANTITY PRICE F.E.T. EXTENSION ------------------------------------------------------------------------------- LT215/85R16/10 TRANSFRC AT BL 6 104.16 624.96 189F565 TIRE USER FEE - IN 6 .25 1.50 950L13 Registration: Serial VNOPTR82216 Quantity 6 GOV BFS 7130 BSCM# 6450158727 Pv MERCHANDISE: 624.96 OTHER: 1. 50 OFFICE COPY INVOICE TOTAL: 626.46 GOVERNMENT 626.46 **A COPY OF THIS INVOICE HAS BEEN EMAILED"*" Printed Name Signature LUG NUTS MUST BE RE-TORQUED AFTER 50-100 MILES. Page 1 FA ' POMP S TIRE SERVICE INC. 7 REMITTANCE�'ADDRESS. POMP'S TIRE SERVICE, INC.=f `ATTN: AR DEPARTMENT +firP.O. BOX 1630 SERVICEAM GREEN BAY WI 54505-1630 l�- 910046118 • POMP'S TIRE-LAFAYETTE �gk WORK ORDEr,•, 2700 SCHUYLER AVE PAGE`: 1 LAFAYETTE, IN 47905 `-;i! 765/742-4000 CUSTOMER: ' ..'CITY-OF CARMEL STREET-'DEP SHIP TO: DELIVERED VIA,,f RUNNEL 34DO W 131ST. STREET ' 2264 CARMEL, IN 46074 CREATED BY DBL_;? REF NUMBER: 'DR1466549 FAX NUMBER: 3177332005 - BUSINESS: 317/733-2001 0 PO NUMBER: GOV SALE MAN: SHANE RUMMEL WRK 'ORD DATE: 0.8/10/16 TERMS: 1 PMT DUE 10TH OF MON AFTR INV PRODUCT , MECHANIC - QUANTITY' PRICE F:.E,.'T: EXTENSTC3N LT2'15/85R16/10 .TRANSFRC-AT BL 6 104.16 624.96 189F565 ' TIRE USER. FEE - IN 6 .25 1:50 95OL13 Registration: Serial VNOPTR82216 Quantity 6 - GOV BFS 7130 MERCHANDISE: 624.96 OTHER: 1.50 WORK ORDER TOTAL: 626.46 h r% h A finance charge of 1,5%per month 18%APR will be added to the unpaid balance after 30 days, CUSTOMER ESTIMATE SELECTIONI hereby authorize tho.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 withouLyour permission.Your signature will indicate your estimate selection. secure the amount of repairs thereto You will not be held responsible for loss or damage to vehicle or articles left in vehicle in case of fire,,theft,accident,aaroage from freezing due to lack of antifreeze or any other causes beyond your control. 1.1 request an estimate in writing before you begin repairs. 2.Please p6cked with repairs but call me before continuing ' if price will exceed S -— =.............. . _—�........_. URE X�._ CUSTOMER SIGNATURE 3.1 do not want an estimate. . ApDI T IONAL WORK AUTHORIZED BY;_____, ESTI6IATEDPRICEOFREPAIRS- - " ---Do you want the replaced parts you are entitled to? "I YES NO A rA yi. t� �.. �$ _. f ;� .y�.. �``..�, • � ..' ^-sem,� �,.. �. —!.l �. � ... ... .. .�i� • j �: ��'` T _ r yj:i `,\ o-. `.` . 1 , a � ,�. _ j` .. l.' R �. A � •�,;� �, `� ��\ ,. ,.. t � .}, �-- ,�`- -�. �. .. �, _. .�- ,� `.i".� .� .;�._ � ,tet � ♦ � f yrs• t � .� ..