325061 05/09/18 i F.. CITY OF CARMEL, INDIANA VENDOR: 366480
¢j ONE CIVIC SQUARE POMP'S TIRE CHECK AMOUNT: $**....*309.32*
r. r' CARMEL, INDIANA 46032 ATTN:AR DEPARTMENT CHECK NUMBER: 325061
vy, PO BOX 1630 CHECK DATE: 05/09/18
t Bio �O' GREEN BAY WI 54305-1630
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
601 5023990 830097491 309.32 OTHER EXPENSES
VOUCHER NO. 181400 WARRANT NO. Prescribed by State Board of Accounts City Form No.201(Rev 1995)
ALLOWED 20
Vendor# 366480 IN SUM OF$ 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
309.32 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
830097491 01-6500-04 $309.32 and received except 4/26/2018 830097491 $309.32
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
SHPN577140823.TXT
POMP'S TIRE-LEBANON INVOICE #: 830097491
1316 WEST SOUTH STREET
LEBANON, IN 46052 PAGE: 1
765/482-4359
CUSTOMER: CITY OF CARMEL WATER OPER
3450 W 131ST STREET
2266
CARMEL, IN
46074
CREATED BY JGM
REF NUMBER: DR1754472
FAX NUMBER: 3177332053
BUSINESS: 317/733-2855 0
SALESMAN: RODNEY RICHARDSON
INVOICE DATE: 04/25/18 TERMS: 1 PMT DUE 10TH OF MON AFTR INV
-------------------------------------------------------------------------------
PRODUCT MECHANIC QUANTITY PRICE F.E.T. EXTENSION
-------------------------------------------------------------------------------
P225/60HR16 CHAMP FUEL FIGHTER 4 77.08 308.32
F015607
TIRE USER FEE - IN 4 .25 1.00
Registration: Serial W2Y3CFL3617 Quantity 1
Registration: serial W2X3CF13817 Quantity 2
Registration: serial w2X3CF13717 Quantity 1
CM#6472647435 DJs
MERCHANDISE: 308.32
OTHER: 1.00
OFFICE COPY INVOICE TOTAL: 309.32
GOVERNMENT 309.32
•`**A COPY OF THIS INVOICE HAS BEEN EMAILED*
THANK YOU FOR YOUR BUSINESS M !
Printed Name signature
. LUG NUTS MUST BE RE-TORQUED AFTER 50-100 MILES.
Page 1
REMITTANCE Aj
POMP'S TIRS SERVICE, N:C. POMP'S TIRE SERVICE, INC.
E
ATTN: AR DEPARTMENT
P.O: BOX 1630 ✓�
GREEN BAY, WI 54305-1630 TIRE'SERVICE,INC.
WORK ORDER #: 830097491
POMP'S TIRE—LEBANON
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 JGM
FAX NUMBER: 3177332053
BUSINESS: 317/733-2855 0
SALESMAN: RODNEY RICHARDSON
WRK ORD DATE: 04/13/18 TERMS: 1 PMT DUE 10TH OF MON AFTR INV
PRODCJCT 4:' ,'w " tMECHANIC QUAITTY PRICE F zET EXTEZSION
P225/60HR16 CHAMP FUEL FIGHTER 4 77.08 308.32
F015607
TIRE USER FEE — IN 4 .25 1.00
Registration: Serial Quantity 1
MERCHANDISE: 308.32
OTHER: 1.00
OFFICE COPY WORK ORDER TOTAL: 309.32
THANK YOU FOR YOUR BUSINESS! ! ! !
*yam
CPtl�
A finance charge of 1,5%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 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 testing,'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 amountof repairs thereto.You will not be held responsible for lost 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 anti-freeze or,any other causes beyond your Control,
2..,Please proceed with repairs but call me before continuing T?
if price will exceed $ CUSTOMER SIGNATURE
3,1 do not want an estimate. ADDITIONAL WORK AUTHORIZED BY'F
ESTIMATED PRICE OF REPAIRS '
Dolyou wehtthe replaced parts you are ehUOed to?L1 YES LINO A.M. Name
.... .. . a u u,.. — ucw osruero