192150 11/23/2010 CITY OF CARMEL, INDIANA VENDOR: 182450 Page 1 of 1
ONE CIVIC SQUARE LEBANON TIRE AUTO SVC
CARMEL, INDIANA 46032 1310 W SOUTH ST CHECK AMOUNT: $1,774.04
LEBANON IN 46052
CHECK NUMBER: 192150
CHECK DATE: 11/23/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4351000 126015 1,774.04 AUTO REPAIR MAINTEN
Nov 18 10 09:18a P.1
ILEBAIvon® i'YFzE Au svc
1310 W SOUTH STREET
LEBANON, IN 46052
(765) -5027
FEDERAL TAX ID# 351145753
1\I V O Z c E 11/11/10 11/11/10 Ti�F�sFAIy
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12? 41ts 0 1 S 04:58 PM 04:58 PM
7798- 016976 126015 TERR: 7798
PAGE: Cl COPY: Ol NONSIG• 173531
BILL TO: CARMEL FIRE DEPT
BOB VANVOORST
2 CIVIC SQ IARE
CARMEL, IN 46032
PHONE 1....... (317)664 -0958 EXT. VEH YEAR /MAKE,
PRONE 2....... (317)571 -2615 EXT, FAX VEHICLE MODEL.
DATE REQUESTED 11/09/10 VEHICLE COLOR.
TIME REQUESTER LICENSE /STATE.
RETURN PARTS.. NO ODOMETR IN /OUT f NA
SALESMAN...... 002 002 PRIOR INVOICE, 125067
ACCOUNT COB TC CUST# TYPE /STATE
779300 2 Dl 00259 4 IN
SLSM TECH PRODUCT COCIE BC (TY DESCR PTION" PARTS LBRiEXCISE LIWE TGTA.
022 138 799 -665 -C G 1IR225 H G288 MSA. TL 395.01 .00 1580.04
GS WMEER. 61030929 OTY. 4 NO. MC378.AHR'610
DC2 017 D�1 -263 R 4 NEW VALVE STEM 4.50 .00 19 -10
002 017 04C lCi R 4 MT DISMOLNT 00 25.00 100.00
002 017 046 -120 R i ROAD SERVICE PER HR0ER R4N (RLG TIME) CO 75,00 75,00
002 017 047 100 R 1 HOE 'JANIICORST 106 H ST &SHEBORNE 00 .00 00
REMEMBER 1 0 SERVICE YOUR EVERY 15000 TO KK OC MILES! WE THANK YOU FOR YOUR BUSINESS WITH US.
PARTS C AL. 1598.04
CHARGED AMOUNT 1774.06 LABOR TO AL........ 175.00
STATE Ti RE FEE 1.01- SUB TGTA 1773.04
X TAXABLE AMOUNT .0C SALES TA.X......... .00
CUSTCMER ALTHORiZATION FOR TCTAL Z BV VO X c E `1rO TA r 04.
BUYING PLAN... A OF PAYh -NTS, 1 PAY STAN DATE 12110/10 DISCOUfF. *,YET*
SEE RE 1/ERSE 'S JE D►IE FOR 3[MF ORTANT sAFETY
6JAaM=d\ 4G A"c WARRAIiiTl( X1'4FOIRMA r2OM
HAVE A QUESTION OR PROBLEM?
Please ke1 our slc rd manager, W— varua yaor opinion as muo, as your
business. Shou[C you need adCUllonal assistance, Call our
CUSTOMER ASSISTANCE LfNE 1.800- 321 -2136
VOUCHER NO. WARRANT NO.
ALLOWED 20
Lebanon Tire
IN SUM OF
1310 West South Street
Lebanon, IN 46052
$1,774.04
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO# Dept. INVOICE NO. ACCT #1TITLE AMOUNT Board Members
1120 126015 43- 510.00 $1,774.04 I 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
Nov 2 2 2010
Fire Chief
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 bili(s))
126015 E42 $1,774.04
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