HomeMy WebLinkAbout304107 10/10/16 ` �.G,q,�• CITY OF CARMEL, INDIANA VENDOR: 366480
ONE CIVIC SQUARE POMP'S TIRE CHECK AMOUNT: $*****2,038.36*
CARMEL, INDIANA 46032 ATTN:AR DEPARTMENT CHECK NUMBER: 304107
Po BOX 1630 CHECK DATE: 10/10/16
GREEN BAY WI 54305-1630
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4351000 830072052 2,038.36 AUTO REPAIR & MAINTEN
VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts city Form No.201 (Rev.1995)
POMP'S TIRE ALLOWED 20 ACCOUNTS PAYABLE VOUCHER
ATTN: AR DEPARTMENT IN SUM OF$ CITY OF CARMEL
PO BOX 1630 An invoice or bill to be properly itemized must show:kind of service,where performed,dates service
GREEN BAY, WI 54305-1630 rendered,by whom,rates per day,number of hours,rate per hour,number of units,price per unit,etc.
$2,038.36 Payee
Purchase Order#
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire 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
830072052 43-510.00 $2,038.36 1 hereby certify that the attached invoice(s),or 9/26116 830072052 E343 $2,038.36
1120 101 1120 101
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, September 26,2016
David Haboush
Fire Chief
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
20Cost distribution ledger classification if claim paid motor vehicle highway fund. Clerk-Treasurer
A' REMTTANCE ADDRESS:
z. POMP'S TIRE SERVICE, INC. POMP'STIRE SERVICE, IINC.
ATTN: AR.DEPARTMENT
Fggg_w, '�" �� P.O. BOX 1630
Ti1RESERVIC.E GREEN BAY, WI 54305-1630
POMP'S TIRE-LEBANON WORK ORDER #: 830072052
1316 WEST SOUTH STREET
PAGE: 1
LEBANON, IN 46052
765/482-4359
CUSTOMER: CITY OF CARMEL FIRE DEPT
2 CIVIC SQUARE
2009963 FIRE HEADQUARTERS
CARMEL, IN
46032
CREATED BY JM
REF NUMBER: TRK43
FAX NUMBER: 317-571-2615
BUSINESS: 317/571-2600 0
SALESMAN: SHANE RUMMEL
WRK ORD DATE: 09/22/16 TERMS: 1 PMT DUE 10TH OF MON AFTR INV
PRODUCT MECHANIC QUANTITY PRICE F.E.T. EXTENSION
12R22.5/16 FIS T-663 4 342.07 1368.28
151F009
TIRE USER FEE - IN 4 .25 1.00
950L13
ROAD SERVICE - REGULAR 3.50 85.00 297.50
RS
CARMEL INDIANA
STANDARD BRASS TRUCK VALVE 2 7.50 15.00
TVALV
TRUCK REJECT AND SCRAP CHARGE 2 9.00 18.00
TDISP
SPECIALTY TRUCK VALVE STEM 2 9.95 19.90
TVALVS
825X22.5 STEEL HUB PILOT WHEELS 2 114.43 228.86
MISWHE
INNER BUDD NUT RIGHT 10 4.99 49.90
SUPL
INNER BUD NUT LEFT 8 4.99 39.92
SUPL
MERCHANDISE: 1721.86
LABOR: 297.50
OTHER: 19.00
WORK ORDER TOTAL: 2038.36
A finance charge of 1,5%per month 18%APR)will be added to the unpaid balance after 30 days,
CUSTOMER ESTIMATE SELECTION 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 aoknowledged on vehicle to
will not exceed the estimate without your 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
1.1 request an estimate in writing before you begin repairs. in case of Bre,theft,accident,damage from freezing due.to lack of anti-freeze or any othercauses beyond your control.
2.Please proceed with repairs but call me before continuing CUSTOMER SIGNATURE X
if price will exceed $
3.I do not want an estimate, ADDITIONAL WORK AUTHORIZED BY:
Do you want the replaced parts you are entitled l09❑YES ❑NO ESTIMATED PRICE OF flEPAIFS
A.M. Name
$❑This vehicle received without face to face contact. �T� phi iE P.M. N0.CALLED NEW ESTIMATE