313009 06/28/17 .y"'`'"w. CITY OF CARMEL, INDIANA VENDOR: 060700
`'° �� CHECK AMOUNT: $**......63.00*
ONE CIVIC SQUARE CLARK TIRE INC
f ?q CARMEL, INDIANA 46032 622 C SOUTH RANGELINE RD CHECK NUMBER: 313009
♦,N, CARMEL IN 46032 CHECK DATE: 06/28/17
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DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4350101 152272 63.00 TRASH COLLECTION
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LARK 622C S. Rangeline Road
"YOUARE RIDING ON OUR REPUTATION" Carmel, IN 46032
4" FIRE (317) 844-4839
I,THE UNDERSIGNED,HEREBY AGREE UNTIL SUCH TIME AS THIS ACCOUNT IS PAID IN FULL BY ME,THE SELLER SHALL RETAIN TITLE TO THE GOODS HEREBY PURCHASED AND SELLER SHALL HAVE
A SECURITY INTEREST IN SAID GOODS TO SECURE THE PAYMENT UNTIL MY ACCOUNT IS FULLY PAID.I FURTHER 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 INCLUDING
AGENCY AND ATTORNEY FEES AND COURT COSTS INCURRED AND PERMITTED BY LAWS GOVERNING THESE TRANSACTIONS.
A finance charge of 13/4%Per Month will be charged on all Accounts 30 days Past Due.Annual Percentage Rate is 21%.(Minimum 75) RECEIVED BY
SOLD TO: CARMEL POLICE DEPT. 6888/01 SHIP TO:SAME INVOICED 152272
THREE CIVIC SM ARE
CARMEL IN 46032
CUST.P.O.# MAKE-MODEL ID# MILEAGE (31VIFUNWE ROUTELM, SHIP VIA ORDER# PACE REMARKS
571-25008 1 _ N/A 182131 1
INVOICE DATE INVOICE PREVIOUS SHIPPED TERMS
NUMBER INVOICE NUMBER
06/14/2017' 152272 NET 18TH 9/14/17 10:59:02 7OUANTffY '
STOCK NUMBER SIZE DESCRIPTION ORQERS §WEMP PREV.SHIP PRICE T F.E.T. EXTENSION
SCRAP SCRAP TIRE 21 21 3.80 00
METHOD OF PAYMOW:
CHARGE: 63.00
CHAMP: .00
'11104 yog For your business
TAXABLE PARTS LABOR TAX% AMOUNT TAX F.E.T. NT i
"You're Riding On Our Reputation"