182915 03/03/2010 CITY OF CARMEL, INDIANA VENDOR: 182450 Page 1 of 1
ONE CIVIC SQUARE LEBANON TIRE AUTO SVC
,i. CHECK AMOUNT: $1,350.52
CARMEL, INDIANA 46032 1310 W SOUTH ST
LEBANON IN 46052 CHECK NUMBER: 182915
CHECK DATE: 3/3/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4351000 120018 1,350.52 AUTO REPAIR MAINTEN
Feb 161010'01a P
ILEBp► i BYRE ^u TO S
310 W SOUTH STREET
:LEBANON, IN 46052
(765 )462 -5027 C 'V
FEDIRAL TAX ID4 351145753
N VO I C E 02/09/10 02/16/10
d-- 2 s 09:34 AM 08:53 AM
7798 016099- 120018 TERR: 7798
PAGE:
01 COPY: 01 NCNSIG: 173531
SILL TO: CARJIEL FIRE DEPT
B03 VANVOORST
2 CIVIC SQUARE
CARMEL, IN 46032
PHONE 1....... (317)664 -0 95B I:XT. VEH YEAR /MAKE,
PHONE 2....... (317)571 -2615 EXT. FAX VEHICLE MODEL,
DATE REQUESTED 02/09/10 VEATCLE COLOR.
TIME REQUESTED LICENSE /STATE.
RETURN PARTS.. NO ODOMETR IN /OUT NA
SALESMAN...... 002 002 PRIOR INVOICE. 1
P O NUMBER.... VANVOORST
ACCOUNT COB TC CUST# T�'PElSTA E
;79800259 2 0 00259 4 IN
S_SM TECH PRDDJCT CODE BC ;TY 7ES
PARTS LBR,'EXCISE LINE TOTAL
002 ;55 -51? 111 0 G 295i75R225 G G182 RSO TL 28;,13 _00 1_56.52
GS NJMBER. G073D; :9 QTY. 4 N0, MC37EDHR2209
002 017 041 -263 4 NEW VALVE STEM 4.5C 00 18.00
002 017 040 -101 2 MT- EISNOUN7 .00 25.00 100.00
CO2 017 046 -100 R FM -45 106TH &COLLEGE .00 OC .00
CO2 017 046 -120 R ROAD SERVICE PER HPIPER MAN IREG TIME) C0 75 00 75.00
REMEMBER TO SERVICE Y3UR 1RAV`_M.SS10N EVERY _5000 TO 30000 MILES' WE HANK YOL ;OR YOUR BUSINESS WITF LS.
PAP,TS TOTAL...•.... 11- ?4.52
CHARGED AVOGNT 1350.52 LABOR TOTAL i 75.00
STATE TIRE FEE 1.00 SUB TCTA.L. 1249.52
X TAXABLE AMOLNT .00 SALES TAX 00
CUSTUfER AUTHORIZATION FOR TO AL X N V O 1-C E T FA l_ 1 j 3 5 0 5 Z
BLYING PLAN.. A OF PM-'ENTS. I PAY STAR DATE 03/10110 DISCOUNT...... -N
How Did We Do Today? We Want Your Feedback! c') -,'66.402.3523
Tell us for a chance to �iIN a $500 Gas Card Enter Ccde:
See Official Rules in stores and at ,vem.c)c:yeartires,comigascdrd for details. 0470017353100188
Nc purchase necessary. Two winner; Der ma Must call within 7 days. Void where prDhiz)ited_
SEE REVERSE <!,.I[0E FOR =NIhOF2TANT S^FETY
w^R AN.tl1 W^FZFZ^M_FY XMFOl2M^ FXC 14
i
HAVE A QUESTION OR PROBLEM?
Please tale our slam manager. Ne value your opi• ion as much as your
business. &hnuld you need additional assistance, call our
CUSTOMER ASSISTANCE LINE 1.800- 321 2136
VOUCHER NO. WARRANT NO.
ALLOWED 20
Lebanon Tire
IN SUM OF
1310 West South Street
Lebanon, IN 46052
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO# Dept. INVOICE NO, ACCT #!TITLE AMOUNT Board Members
1120 120018 43- 510.00 $1,350.52 1 hereby certify that the attached invoice(s), or
"M fzRa2y4fiffi 2 bill(s) is (are) true and correct and that the
materials or services itemized thereon for
which charge is made were ordered and
received except
ivav
Fire Chief 'A
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
Prescribed by State Board of Accounts City Form iCv; 201 (Rev. 1995)
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice or bill to be properly itemized must show: kind of service, where performed, dates service rendered, by
whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc.
Payee
Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
120018 HM45 $1,350.52
120018 $1,350.52
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
20
Clerk- Treasurer