183796 03/29/2010 ��c• CITY OF CARMEL, INDIANA VENDOR: 00351179 Page 1 of 1
ONE CIVIC SQUARE FIRESTONE TIRE SERVICE CENTER
CHECK AMOUNT: $257.97
CARMEL, INDIANA 46032 1314 RANGELINE ROAD
CARMEL IN 46032 CHECK NUMBER: 183796
CHECK DATE: 3/29/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1192 4232000 101145 222.48 TIRES TUBES
1192 4351000 101145 35.49 AUTO REPAIR MAINTEN
Custome Invoice FIRESTONE COMPLETE AUTO CARE Service Advisor:
161145._1 CARMEL 03 KRISTI
03;12/2010 1314 S RANGE LINE RD 317.848.5886
CARMEL, IN. 46032
2006 FORD ESCAPE
CITY OF CARMEL, BUILDING CODE 4 -140 2.31- DOHC
ONE CIVIC SQUARE Lic 91 IN Vin
CARMEL, IN 46032 In: 03/12/10 9:02AM Mileage: 48,090
317.571.2418 xLISA Out: 03/12/10 11:37AM
F;�21627
Store 020753 COMMERCIAL PO #21627
Rev Hist Unit Extended Job
Description /Article ID Qty Price P r ic e_ T
SYNTHETIC BLEND OIL CHANGE UP TO 5 Qts 03 35.49
OIL CAP 4.5 QTS.
OIL VISC SAE 5W -20 Premium Synthetic Blend Motor Oil
The Manufacturer recommends an Oil Change based on
mileage of 3000 miles See Owner's manual for specific
requirements.
P960 OIL FILTER 7005781 09TN 1 3.99 3.99
USED FILTER R CHARGE 70750.51 09TN 1 2.50- 2.50-
OIL CHANGE LABOR 7029718 09NN 1 9.00 9.00 r
5W20 SYNTHETIC BLEND UP TO 5 QTS 7023809 09TN 1 20.00 20.005/
COURTESY CHECK 03
WE NEED TO LOOK AT THE RR TIRE. THEY THINK
THEY NEED A NEW TIRE
COURTESY CHECK 7046930 09NN 1 N/C N/C
FIRESTONE TIRES WITH UNI -T, PACKAGE 2 03 222.48
054375 DESTINATION LE W/ UNI -T P OWL P235/70R16 054375 09TN 2 110.99 221.98'
XL107S
DOT# VN08D105009
DOT# VN08D105009
INDIANA TIRE FEE 7095834 09NN 2 0.25 0.50
TIRE INSTALLATION 7015016 09NN 2 N/C N/
ORDER NOTES
HOOD DAMAGE PTS
AIR FILTER HOSE WAS NOT ATTATCHED PROPERLY AND MISSING PTS
Technician(s):
09 DUSTIN STIDD
Payment History: ff Summary:
Gomm /Dlr Acct 757 Labor 2
Total Tendered 27.7
Shop Supplies 0.00
Sub T6tal 257.97
.Tax °:(•�A9` -J��
Total
I have received the above goods and /or services. If this is a credit
card purchase, I agree to pay and comply with my cardholders
agreement with the issuer.
Rev
Revision History: Amt J Init
Customer Signature 1) 03/12/2010 10:24AM 119.01 CITY OF CA 317.571.2418 Ext.LISA
2) 03/12/2010 11:03AM 119.01 CITY OF CA 317.571.2418 Ext.LISA
Initial here to indicate you have received
the Tire Maintenance Warranty Book.
All parts are new unless otherwise specified.
Page I uI Inv! 091014.306004
VOUC.IER NO. `WARRAN NO.
ALLOWED 20
Fires�bne Complet Auto Care
IN SUM OF
2021 Sunnydale. Blvd.
Clearwater, FL 33765
2 5 7. 9 7
ON ACCOUNT OF APPROPRIATION FOR
Carmel DOCS Department
PO# 1 Dept. INVOICE NO. ACCT #!TITLE AMOUNT Board Members
1192 101145 43- 510.00 $35.49 1 hereby certify that the attached invoice(s), or
1192 101145 42 320.00 $222.48 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
ursday, March 25, 2010
rector, D
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
Prescribed by State Board of Accounts City Form No. 201 (RV.v. 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))
03/12/10 101145 Oil change Unit 91 $35.49
03/12/10 101145 New Tires Unit 91 $222.48
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