HomeMy WebLinkAbout305113 11/14/16 4�';� CITY OF CARMEL, INDIANA VENDOR: 00351640
s d 1 ONE CIVIC SQUARE CLARK TIRE FISHERS CHECK AMOUNT: $'`•."'.170.50'
=a; CARMEL, INDIANA 46032 PO BOX 195 CHECK NUMBER: 305113
�''�'r6N`�°' FISHERS IN 46038 CHECK DATE: 11/14/16
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1207 4350000 IN00154703 170.50 EQUIPMENT REPAIRS & M
VOUCHER NO. WARRANT NO. Prescribed by state Board of Accounts City Form No.201 (Rev.1995)
CLARK TIRE FISHERS ALLOWED 20 ACCOUNTS PAYABLE VOUCHER
PO BOX 195 IN SUM OF$ CITY OF CARMEL
An invoice or bill to be properly itemized must show:kind of service,where performed,dates service
FISHERS, IN 46038 rendered,by whom,rates per day,number of hours,rate per hour,number of units,price per unit,etc.
$170.50 Payee
ON ACCOUNT OF APPROPRIATION FOR Purchase Order#
Brookshire Golf Course 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
IN00265803 43-500.00 $170.50 1 hereby certify that the attached invoice(s),or 10/31/16 IN00265803 Tires $170.50
1207 1 101 1207 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
Friday, November 04,2016
A I/
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
12371 Reynolds Drive
_,_, ---------------
------_,__= CLARK TIRE FISHERS Fishers, IN 46038
s
126TH&REYNOLDS RD. 317-842-0544 sP.O.Box 195
FISHERS,IN 46038
(317)842-0544
**Original**-Copy2
;TYPE Invoice# Date By
JN. :.IN00154703 A0131/2016- 10:21- _W.,S .._
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Account Name-Address Contact
BROOKSH BROOKSHIRE GOLF CLUB H. (317)571-2427
12120 BROOKSHIRE PARKWAY
W. (317)420-1676
CARMEL,IN 46033 M. (317)000-0000
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License# Year-Model Color Mileage Engine Inspection Date
PO Number: Tag Number VIN 4:
Item DescriptionQty Parts Labor FET/Core TIC Extension
CA510981 CAR 18-950-8/4 SMOOTHY 2.00 85.00 HSE170.00
TT INDIANA TIRE FEE 2.00 0.25 HSE _ 0.50
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Estimate : Promised
Revised: Auth by: Telephone:
2nd Rev: Auth by:TTelephone-:__
—y warra—nties—on t----dh--are fThe --de6y—fm—anufauIRE,ere---�is—Tms—l— — _ ---- '
� ie ite�tems sTere yyy use mareTfhe sel eCOCRK y�expesslatwarranties,eifheer expiess— _•—"—'"—--——— —'-——
or implied,including any implied warranty of merchantability or fitness for a particular purpose and CLARK TIRE neither assumes nor authorizes any other person Totals
to assume for it any liability in connection with the sale of this item/items. ' '.,.F
RE-TORQUE LUGNUTS RECOMMENDED AFTER 100 MILES. Parts ,170.00
A SERVICE CHARGE OF I%/%PER MONTH(21%ANNUALLY)WILL BE CHARGED ON ALL ACCOUNTS PAST DUE 30 DAYS,NET 10th PROX. Labor
U 0.50
I,THE UNDERSIGNED HEREBY AGREE THAT IN THE EVENT OF DEFAULT IN THE PAYMENT OF ANY AMOUNT DUE,AND IF THIS ACCOUNT IS PLACED IN THE
HANDS OF AN AGENCY OR ATTORNEY FOR COLLECTION OR LEGAL ACTION;TO PAY AN ADDITIONAL CHARGE EQUAL TO THE COST OF COLLECTION Other, 1
INCLUDING AGENCY AND ATTORNEY FEES AND COURT COSTS INCURRED AND PERMITTED BYLAW GOVERNING THESE TRANSACTIONS. t
I hereby authorize the repair work to be done along with the necessary materials.You and your employees may operate vehicle for purposes of testing, FET/Core '
inspection,or delivery at my risk.An express mechanic's lien is acknowledged on vehicle to secure the amount of repairs thereto.It is also understood that 7
you will not be held responsible for loss or damage to cars or articles left in cars in case of fire,theft or any other cause beyond your control. Subtotal .�1'/0.50
Tax0.00
Customer Signature '
mTatal-- -'170.50
Cash: 'Check.: ;-Cr Cd: �`Chrg: 170.50
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