HomeMy WebLinkAbout192566 12/07/2010 CITY OF CARMEL, INDIANA VENDOR: 363306 Page 1 of 1
~f ONE CIVIC SQUARE TRIPLE S OF INDY INC CHECK AMOUNT: $340.22
CARMEL, INDIANA 46032 405 S 9TH ST
ELWOODIN 46036 CHECK NUMBER: 192566
CHECK DATE: 12/7/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2201 4232000 9898 340.22 TIRES TUBES
Printed: 11/18/2010 1:21:52 PM INVOICE Sales Receipt #9898
Store: IN 11116/2010
Cashier: User12
Page 1
TRIPLE S TIRE INDIANAPOLIS
405 So. 9th Street
ELWOOD, IN 46036
(765) 552 -5765
FAX: (765) 552 -5761
REMIT PAYMENT ABOVE
Bill To:
Carmel Street Dept,
3400 W 131 ST
Westfield, IN 46074
Oescription 1 Descript 2 Ply Size Qty Price Ext Pricera)
SERVICE CALL TRAVEL AND HOURLY FEES 1 $125.00 $125.00
Labor retail Mt /DisMt,Repair,On /Off, Inspect 1 $75.00 $75.00
25" O -RING 1 $27.10 $27.10 T
SEALER SEALER PER GALLON 3 $31.54 $94.62 T
FUEL SURCHARGE 1 $18.50 $18.50
Subtotal: $340.22
Exempt 0 Tax: +$0.00
Ship 11/16/2010 516112 Shipping:
RECEIPT TOTAL: $340.22
Account: $340.22
Signature
Previous Account Balance: $0.00
SWO #516112
EQ #1 SALT LOADER JD624
PLEASE PAY FROM THIS INVOICE SALES RECEIPT. TERMS NET 30
WITH BILLING QUESTIONS CALL 765- 552 -5765 THANK YOU
I IIIIII VIII VIII Illll VIII !III !III
9898
c
VOUCHER NO. WARRANT NO.
ALLOWED 20
Triple S. of Indy, Inc.
IN SUM OF
405 S. 9th Street
Elwood, IN 46036
$340.22
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members
2201 9898 42- 320.00 $340.22 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
9 Thursday, December 02, 2010
Street Commissioner
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))
11/16/10 9898 $340.22
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