321681 02/13/18 •C9q
CITY OF CARMEL, INDIANA VENDOR: 00351 179
;•; ONE CIVIC SQUARE FIRESTONE TIRE &SERVICE CENTER CHECK AMOUNT: $*******893.57
CARMEL, INDIANA 46032 PO BOX 403727 CHECK NUMBER: 321681
ATLANTA GA!30384-3727 CHECK DATE: 02/13/18
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
G51 5023990 183587 893.57 OTHER EXPENSES
VOUCHER NO. 177304 WARRANT NO. ALLOWED 20 Prescribed by State Board of Accounts City Form No.201 (Rev 1995)
Vendor# 00351179 IN SUM OF$ ACCOUNTS PAYABLE VOUCHER
FIRESTONE COMPLETE AUTO CARE CITY OF CARMEL
PO BOX 403727 An invoice or bill to be properly itemized must show: kind of service,where performed,
ATLANTA, GA 30384-3727 dates service rendered, by whom, rates per day, number of hours, rate per hour,
numbers of units, price per unit,etc.
Payee
893.57 00351179 Purchase Order No.
ON ACCOUNT OF APPROPRATION FOR FIRESTONE COMPLETE AUTO CARE Terms
Carmel Wasterwater Utility PO BOX 403727 Due Date
BOARD MEMBERS
I hereby certify that that attached invoice ATLANTA, GA 30384-3727
(s),
or bill(s)is(are)true and correct and that
PO# ACCT# the materials or services itemized thereon DATE INVOICE# Description
DEPT# INVOICE# Fund# AMOUNT for which charge is made were ordered and DEPT-# FUND# (or note attached invoice(s)or bill(s)) AMOUNT
183587 01-7500-02 $893,57 and received except 2/1/2018 183587 $893.57
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
Customer Invoice FIRESTONE COMPLETE AUTO CARE Service Advisor:
183587 . CARMEL 01 NICK
01/30/2018 1314 S RANGE LINE RD 317.848.5886
CARMEL, IN. 46032-2932
2014 FORD F-250 SUPER DUTY XL
CITY OF CARMEL UTIL 6.2L V8 FI FLEX VIN 6 SOHC
9609 HAZEL DELL PKWY Lic#: INDY IN Vin#:
INDIANAPOLIS, IN 46280-2935 In: 01/30/18 7:53AM Mileage: 51,900
317.716.5882 xjeff Out: 01/30/18 3:54PM
PO#S18007
Store# 020753 COMMERCIAL PO#S18007
Rev Hist Unit Extended Job
Description _____ ____ /Article#_ID__ Qty_ _ _ Price---—Price-_P_rice_____T_otal
ALIGNMENT SERVICE (12-MONTH WARRANTY) 01 76.49
ALIGNMENT SERVICE 7004578 04NN 1 76.49 76.49
FIRESTONE TIRE PACKAGE--,Z,"'_111,'1'
01 817.08
TIRE&COMING,FROM TW.W
1 ✓ °? r
000187;TRANSFORCEAT2 OW (LT265/70R1!7 E121R-N( 07�
001804'NN 14 � 1182136 72944
MILEAGEWARRANTY
DOT# VNAHTF25317 717 -, M
DOT#1 VNAHTF25317 I ! 1 ,��1 s _' .., 1; _.•. _,y _.'J i I � `_.
DOT# VNAH-TF25�17 - �-
DOT# VNAHTF25317
INDIANA TIRE FEE 7095834 04NN 4 0.25 1.00
NEW TIRE WHEEL BALANCE LABOR 7013632 04NN 4 11.04 44.16
TPMS VALVE SERVICE KIT LABOR 7008190 04NN 4 2.54 10.16
6-207A TPMS VALVE VS-950-15 7009357 04NN 4 5.95 23.80
SCRAP TIRE RECYCLING FEE 7075078 04NN 4 2.13 8.52
TIRE INSTALLATION 7015016 04NN 4 N/C N/C
Technician(s):
04 CARL
Payment History: Summary:
893.57 Parts 753.24
Total Tendered 893.57 Labor 140.33
Shop Supplies 0.00
Sub-Total 893.57
Tax Exempt(0031201550) 0.00
Total $893.57
1 have received the above goods and/or services. If this is a credit
card purchase, I agree to pay and comply with my cardholder
agreement with the issuer.
Customer Signature
Initial here to indicate you have received
the Tire Warranty Maintenance and
Safety Manual
All parts are new unless otherwise specified.
.,.T"HOW-ARE WE-DOING? ,
Tell-us about your experience today!
Coni lete a 4-minute curve fora° ''nce to.win $500'in,store services
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dYANDArVs FOR AU"i'���10T� E RCP. See reverse side for Warranty Information