306881 1/06/17 CITY OF CARMEL, INDIANA VENDOR: 370797
ONE CIVIC SQUARE POMP'S TIRE-LEBANON CHECK AMOUNT: $"""""2,169.92"
1 1316 W SOUTH STREET CHECK NUMBER: 306881
CARMEL, INDIANA 46032
•s� i° LEBANON IN 46052 CHECK DATE: 01/06/17
*«ON
DEPARTMENTACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
OTHER EXPENSES
601 5023990 830076142 2,169.92
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SHPN577287931.TXT
POMP'S TIRE-LEBANON INVOICE #: 830076142
1316 WEST SOUTH STREET
PAGE: 1
LEBANON, IN 46052
765/482-4359
CUSTOMER: CITY OF CARMEL WATER OPER SHIP TO: UNIT#70
3450 W 131ST STREET
2266
CARMEL, IN
46074
CREATED BY JRM
FAX NUMBER: 3177332053
BUSINESS: 317/733-2855 0
VEHICLE: 2008 CHEVROLET C-5500
SALESMAN: SHANE RUMMEL LICENSE: 78411 IN MILEAGE: 54484
INVOICE DATE: 12/27/16 TERMS: 1 PMT DUE 10TH OF MON AFTR INV
-------------------------------------------------------------------------------
PRODUCT MECHANIC QUANTITY PRICE F.E.T. EXTENSION
-------------------------------------------------------------------------------
225/70R19. 5/14 B/S M729F 4 302.95 1211.80
227BO23
TIRE USER FEE - IN 4 .25 1.00
950L13
Registration: serial Y7AD3L24016 Quantity 3
Registration: Serial Y7AD3L23816 Quantity 1
225/70819.5/14 B/S R238 2 274.46 548.92
248B681
TIRE USER FEE - IN 2 .25 0.50
950L13
Registration: serial Y7AD3K974216 Quantity 2
TRK DISMOUNT&MOUNT BALANCE 8342 6 48.00 288.00
TDMS
SPECIALTY TRUCK VALVE STEM 6 9.95 59.70
TVALVS
TRUCK REJECT AND SCRAP CHARGE 6 9.00 54.00
TDISP
SHOP SUPPLIES 1 6.00 6.00
SUPL
VIN#1GEB5C1G08F410444
MERCHANDISE: 1826.42
LABOR: 288.00
OTHER: 55.50
OFFICE COPY INVOICE TOTAL: 2169.92
GOVERNMENT 2169.92
***A COPY OF THIS INVOICE HAS BEEN EMAILED**
THANK YOU FOR YOUR BUSINESS M !
Page 1
REMTTANCE
POMP'S TIRE SERVICE INC. POMPISTIRE SERVEICE,,INC.
ATTN: AR DEPARTMENT
` P.O. BOX 1630
TtRESERwe-E u GREEN BAY. WI 54305-1630
WORK ORDER #: 830076142
POMP'S TIRE—LEBANON
`1316 WEST SOUTH STREET
PAGE: 1
LEBANON, IN 46052
765/482-4359
CUSTOMER: CITY OF CARMEL WATER OPER SHIP TO: UNIT#70
3450 W 131ST STREET
2266
CARMEL, IN
46074
CREATED BY JRM
FAX NUMBER: 3177332053
BUSINESS: 317/733-2855 0
VEHICLE: 2008 CHEVROLET C-5500
SALESMAN: SHANE RUMMEL LICENSE: 78411 IN MILEAGE: 54484
WRK ORD DATE: 12/14/16 TERMS: 1 PMT DUE 10TH OF MON AFTR INV
PRODUCT MECHANIC QUANTITY PRICE F.E.T. EXTENSION
225/7OR19.5/14 B/S M729F 4 302 .95 1211.80
227BO23
TIRE USER FEE — IN 4 .25 1.00
950L13
225/7OR19.5/14 B/S R238 2 274 .46 548.92
248B681
TIRE USER FEE — IN 2 .25 0.50
950L13
TRK DISMOUNT&MOUNT BALANCE 6 48 .00 288.00
TDMS
SPECIALTY TRUCK VALVE STEM 6 9.95 59.70
TVALVS
TRUCK REJECT AND SCRAP CHARGE 6 9.00 54.00
TDISP
SHOP SUPPLIES 1 6.00 6.00
SUPL
MERCHANDISE: 1826.42
LABOR: 288.00
OTHER: 55.50
WORK ORDER TOTAL: 2169.92
THANK YOU FOR YOUR 3USINESS! ! ! !
A finance charge of 1,5%per month 18%APR)will be added to the unpaid balance after 30 days.
CUSTOMER ESTIMATE SELECTION I 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 Jesting,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 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 fire,theft accident,damage from freezing due to lack of antifreeze or any other causes beyond your control.
2.Please proceed with repairs but call me before continuing
if price will exceed S....._. __.:....... CUSTOMER SIGNATURE X c ,�•.�7`... .__..._._ ...__._.,3$.. � ..
3.1 do not want an estimate. -- ESTNATEG F REPAIRS "
ADDITIONAL WORK AUTHORIZED BY:-
PRICE O ` ....
Do you want the replaced parts you are entitled to?LjYES 'J NO S A.6i Nage