183161 03/16/2010 CITY OF CARMEL, INDIANA VENDOR: 182450 Page 1 of 1
ONE CIVIC SQUARE LEBANON TIRE AUTO SVC CHECK AMOUNT: $549.25
t. CARMEL, INDIANA 46032 1310 W SOUTH ST
LEBANON IN 46052 CHECK NUMBER: 183161
CHECK DATE: 3/16/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER A DESCRIPTION
651 5023990 L120278 549.25 OTHER EXPENSES
LEBANON rXFZa AUTO► S11C
1310 W SOUTH STREET
LEBANON, IN 46052
(765)482 -5027 '00
FEDERAL TAX ID# 351145753
lY1r
gNVO =CE 02/24/10 02/24/10
08:00 AM 08:00 AM
TERR: 7798
PAGE: 01 COPY: 01 NONSIG: 173531
BILL TO: CITY OF CARMEL (EO5)
760 THIRD AVENUE SW
CARMEL, IN 46032
PHONE 1....... (317)571 -2634 EXT. VEH YEAR /MAKE.
PHONE 2....... (317)710 -2321 EXT. VEHICLE MODEL,.
DATE REQUESTED 02/23/10 VEHICLE COLOR.
TIME REQUESTED LICENSE /STATE.
RETURN PARTS.. NO ODOMETR IN /OUT NA
SALESMAN...... 002 002 PRIOR INVOICE. 118482
OTHER INFO.... COOPER WATER TREATMENT PLANT 96TH ST
ACCOUNT COB TC CUST# TYPE /STATE
779800168 4 01 00168 4 IN
SLSM TECH PRODUCT CODE BC QTY DESCRIPTION PARTS LBR /EXCISE LINE TOTAL
002 390- 315 -352 -0 R 1 120OR20 HK AM06 438.00 .00 438.00
002 017 093 -002 R 1 TIRE DISPOSAL .00 6.00 6.00
002 017 046 -120 R 1 ROAD SERVICE PER HR /PER MAN (REG TIME) .00 75.00 75.00
002 017 040 -101 R 1 MT- DISMOUNT .00 30.00 30.00
REMEMBER TO SERVICE YOUR TRANSMISSION EVERY 15000 TO 30000 MILES! WE THANK YOU FOR YOUR BUSINESS WITH US.
PARTS TOTAL........ 438.00
CHARGED AMOUNT 549.25 LABOR TOTAL........ 111.00
STATE TIRE FEE .25 SUB TOTAL.......... 549.00
74------- TAXABLE AMOUNT .00 SALES TAX.......... 00
CUSTOMER AUTHORIZATION FOR TOTAL a N V 0 C E T O TA L !SS 4 9 as
BUYING PLAN... A OF PAYMENTS. 1 PAY START DATE 03/10/10 DISCOUNT...... *NET*
Ca
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VOUCHER 105046 WARRANT ALLOWED
i
182450 IN SUM OF
LEBANON TIRE AUTO SVC
1310 W SOUTH ST
LEBANON, IN 46052
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
L120278 01- 7502 -06 $549.25
i
Voucher Total $549.25
Cost distribution ledger classification if
claim paid under vehicle highway fund
Prescribed by State Board of Accounts City Form No. 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 of service rendered, by whom, rates per day, number of units,
price per unit, etc.
Payee
182450
LEBANON TIRE AUTO SVC Purchase Order No.
1310 W SOUTH ST Terms
LEBANON, IN 46052 Due Date 3!912010
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
3/9/2010 L120278 $549.25
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
5 f&
Date Officer