187751 07/21/2010 CITY OF CARMEL, INDIANA VENDOR: 00351640 Page 1 of 1
ONE CIVIC SQUARE CLARK TIRE FISHERS
CARMEL, INDIANA 46032 Po Box iss CHECK AMOUNT: $130.00
FISHERS IN 46038
CHECK NUMBER: 187751
CHECK DATE: 7/21/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1207 4350000 00115338 130.00 EQUIPMENT REPAIRS M
r a
126TH REYNOLDS ROAD;(HWY 37 NO.)
r t�,�~�� Servlce�1 your Farm,
P.O. BOX 195 Comniefdal�gltedor�on the Road;
FISHERS INDIANA 46038:
317- 842 -0544 OR 1 0'444 5985
Ma �f�t j A I o Br Availab
80 le t,•
TIRE FISHERS Fdx.317- 577 -3956 s 1
f
NAME f ADDRESS ACCOUNT NO s� HOMEiPHON E t$ y REFERENCE
BRD( KSI'I 1•NOCA 1 w:.,rr�
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BRI]iJI4SHIRE GI3L! CLUB P O NO WORK PHOtdE' y ,'DATE !TIME
13120 BROOKSHIRE PARKWAY r 1�7 F 4 67 1 67110 1
RESALE NO tn i VIN ,WO ES NO
CARt4E1 f IN 450330 4�4 t Wi7�d►�7r4►B
YEAR I MAKE l MODEL m LICENSE NO TACO t 141 E BAR NO
.aN>wxT INSsz c
•t° �.,.`�C. �i gd a q
SAVE PARTS ALL PARTS,NEW.UNLESS PROMISED DATE.I TIME :•iE'MILEAQ'E' „t, n"� r WRETTEN By
Y N pTHER
1N ISESPECIEIED`
�r
ORIGINAL �t FREE ROTATION:•
REVISED t s( EVERY"5'000 MILES)
REVISED 2
I acknowledge notice and oral approval of an increase in the original estimate price. ❑°`ROAD HAZARD WARRANTY
X
P ARTS /�T per+
!°Il l- �7 V I �Ef7i7
FEW ill o a a o
2. 560385 i 22.5X10.50ATURF TRAC RS 54:75 129.50 300 INDIANA T1' FEE 6.54.
I r RUSSELL., 4W%67
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Reason Far or gittal estiaate:
Any warranties on the rtemlltems, sold hereby are those made by the manufeclurer The seller, CLARK :TIRE, hereby expressly'.
disclaims ^all warranties, either express•or implied, Including any, implied, warranlysof merchantability orfitness for a particular,
purpose, and CLARK TIRE neither assume's nor authorizes any other person to assume for It. shy liability in Connection with the sale'
of this
ItemAtems. 3 a
1 g
n 0 9
A SERVICE CNARGE OF 1 V. PER MONTH (21% ANNUALLY) WILL�BE CHARGED ON ALL ACCOUNT PAST DUE 30�'DAYS NET 10115 PROX •II� i
l THE UNDERSIGNED,
HE AGREE .THAT FWTHE EVENT "OF DEFAUL? IN THE.PAYMENT OF =ANY AMOUNT DUE .AND IF THIS. ACCOUNT IS PLACED IN 11 PARTS 12 511Z
THE HANDS.,OF AN AGENCY OR ATTORNEY FOR COLLECTION OR,LE'GAL ACTION T PA 'A ADDITIONAL.. CHARGE EQUAL TO`THE COST.OF•
COLL'ECTION.INCLUDING AGENCY ANO ATTORNEY FEES AND COURT .COSTS INCURRED AND.PERMITTED BY LAW, GOVERNING THESE TRANSACTIONS' LABOR 0 512
'I tierebq authorize the relir wor to ,;p,,,.ygg don along with 114 necessary- materlals:,YOU and your ;employees may operate vehicle for purposes of testing;. OTHER
mspeclion;. pr delivery my ris An) pr meet nie s hen,is acknowled! o
dgen.vehlcle to secure the amount of repairs thereto. It Is also understood erstood that
you will not'be held r onsibl or bbbb�rr or- ame to cars br:articles.lefl in cars incase of fire; theft or any. other: cause. beyond your control. SUBLET
Signature X 6 SUBTOTAL 130. OIZ
TA x
Rec'd-By TOTAL, 13. tZ
CASH AMOUNT CHECK AMOUNT. CHECK NO. C.C. AMOUNT; C -C. TYPE C.C. APPROVAL CODE ON ACCOUNT THANK
136.60• YOU!
VOUCH NO, WARRANT NO.
ALLOWED 20
Clark Tire Fishers
IN SUM OF
126THJ Reymolds Road (Hwy 37 NO.)
Fishers, IN 46038
$130.00
ON ACCOUNT OF APPROPRIATION FOR
Brookshire Golf Club
PO# Dept. INVOICE NO, ACCT /TITLE AMOUNT Board Members
1207 IN00115338 43- 500.00 $130.00 1 hereby certify that the attached invoice(s), or
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
Friday, July 09, 2010
Director, Brook ire Golf Club
Title
Cost distribution ledger classification if
claim paid motor 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 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))
07/07/10 IN00115338 Parts $130.00
1 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