321303 01/25/18 J CITY OF CARMEL, INDIANA VENDOR: 366480
�b it ONE CIVIC SQUARE POMP'S TIRE CHECK AMOUNT: $*******519.56*
CARMEL, INDIANA 46032 ATTN:AR DEPARTMENT CHECK NUMBER: 321303
PO BOX 1630 CHECK DATE: 01/25/18
GREEN BAY WI 54305-1630
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
601 5023990 830093566 519.56 OTHER EXPENSES
VOUCHER NO. 173945 WARRANT NO. Prescribed by State Board of Accounts City Form No.201(Rev 1995)
ALLOWED 20
Vendor # 366480 IN SUM OF$ ACCOUNTS PAYABLE VOUCHER
Pomp's Tire CITY OF CARMEL
PO BOX 1630 An invoice or bill to be properly itemized must show: kind of service,where performed,
GREEN BAY, WI 54305-1630 dates service rendered, by whom, rates per day, number of hours, rate per hour,
numbers of units, price per unit,etc.
Payee
519.56 366480 Purchase Order No.
ON ACCOUNT OF APPROPRATION FOR Pomp's Tire Terms
Carmel Water Utility PO BOX 1630 Due Date
BOARD MEMBERS
I hereby certify that that attached invoice(s), GREEN BAY, WI 54305-1630
or bill(s)is(are)true and correct and that
PO# ACCT# the materials or services itemized thereon for DATE INVOICE# Description
DEPT# INVOICE# Fund# AMOUNT which charge is made were ordered and DEPT# FUND# (or note attached invoice(s)or bill(s)) AMOUNT
830093566 01-6500-05 $519.56 and received except 1/18/2018 830093566 $519.56
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
Cost distribution ledger classification if claim paid motor vehicle highway fund. 20_
Clerk-Treasurer
SHPN577904322.TXT
POMP'S TIRE-LEBANON INVOICE #: 830093566
1316 WEST SOUTH STREET
PAGE: 1
LEBANON, IN 46052
765/482-4359
CUSTOMER: CITY OF CARMEL WATER OPER
3450 w 131ST STREET
2266
CARMEL, IN
46074
CREATED BY 7DC
REF NUMBER: DR1586260
FAX NUMBER: 3177332053
BUSINESS: 317/733-2855 0
SALESMAN: RODNEY RICHARDSON
INVOICE DATE: 01/17/18 TERMS: 1 PMT DUE 10TH OF MON AFTR INV
-------------------------------------------------------------------------------
PRODUCT MECHANIC QUANTITY PRICE F.E.T. EXTENSION
-------------------------------------------------------------------------------
LT245/75R17/10 TRANSFORC AT2 OWL 4 129.64 518.56
F000184
TIRE USER FEE - IN 4 .25 1.00
Registration: Serial VN43TF24917 Quantity 2
Registration: Serial VN43TF24717 Quantity 2
Emailed to tmorgan@carmel .in.gov on 01/04/18 at 14:34:09. Document type: WRKO
CM 6469059724 T7
MERCHANDISE: 518.56
OTHER: 1.00
OFFICE COPY INVOICE TOTAL: 519.56
GOVERNMENT 519.56
*A COPY OF THIS INVOICE HAS BEEN EMAILED"*
THANK YOU FOR YOUR BUSINESS! ! ! !
Printed Name signature
. LUG NUTS MUST BE RE-TORQUED AFTER 50-100 MILES.
Page 1
REMITTANCE ADDRESS:
POMP':S TIRE SERVICE,INC P " M P: :S TIRE S E RVI C E, INC. 0 0�
ATTN:AR DEPARTMENT -
PO. BO.X1630
GREEN BAY,.1Nt:54305-1630 TIRE SERVICE,INC.
WORK RK
ORDER � :83'0093566
POMP'S TIRE–:LEBANON --
13'16 WEST SOUTH STREET: –
PAGE: 1
_.:..LEBANON, IN 46052
765/482-.4359
: : CUSTOMER: CITY OF CARMEL WATER OPER
:.:.
3450 W..131ST .STREET
2266
-CARMEL, :IN:
. 46074:. .
CREATED BY JDC
FAX NUMBER: 3177332053
BUSINESS: 317/733,-2855 0 _
SALESMAN: RODNEY RICHARDSON
WRK :ORD DATE: 01/04/18: TERMS: 1 :PMT. DUE 10TH OF :MON. AFTR INV
PRODUCT` MECHANIC QUANTITY PRICE FET EXTENSION
LT245/75R17/10 TRANSFORC AT2 OWL 4 129:.64 518.56
F000184
"TIRE USER FEE - 'IN 4 .25
Registration: Serial ' Quantity 1 '
Registration: Serial Quantity 1 _
Registration: Serial Quantity 1
Registration-: Serial Quantity: . . 1
MERCHANDISE: 518.56
OTHER.:.. 1.00
...
WORK ORDER.TOTAL: 519.56
***A COPY OF THIS WORKORDER HAS BEEN EMAILED***
THANK. YOU: FOR YOUR BUSINESS! ! II
r
A finance charge of M%5 per month 18%APR will be added to the un aid balance after 30 days,
CUSTOMER ESTIMATE SELECTION I hereby authorize the below repair work to be done along with necessary:materials.You and your employeesmay 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 dsk.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 vdll not beheld responsible for loss or damageto vehicle or articles left in vehicle .
1.I 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 CUSTOMER SIGNATURE X
if price will exceed $,
3.I do not-want an estimate. ADDITIONAL WORK AUTHORIZED V
Do you want the replaced ads you are entitled to? YES NO ESTIMATED PRICEOF.REPAIRS
Y P P y ❑ ❑ � AM.: Name '
0This vehicle received without face to face contact.. --TA—TE E ----TW— P.M. N0.CALLED NEW ESTIMATE .