192788 12/15/2010 CITY OF CARMEL, INDIANA VENDOR: 060700 Page 1 of 1
ONE CIVIC SQUARE CLARK TIRE INC
CHECK AMOUNT: $64.00
CARMEL, INDIANA 46032 622 C SOUTH RANGELINE RD
CARMEL IN 46032 CHECK NUMBER: 192788
CHECK DATE: 12/15/2010
DEPARTMENT ACCOUNT PO N INVOICE NUMBER AMOUNT DESCRIPTION
601 5023990 130381 21.50 TRANSPORTATION EXPENS
1120 4351000 130424 42.50 AUTO REPAIR MAINTEN
LARK 622C S. Rangeline Road
"YOUARE RIDING ON OUR REPUTATION" Carmel, 1N 46032
44 IRE (317) 844 -4839
mational PEA
I. THE UNDERSIGNED, I IEREBYAGREE UNTIL SUCH TIME AS THIS ACCOUNT IS PAID IN FULL BY ME, THE SELLER SHALL RETAIN TITLE TO THE GOODS HEREBY PURCHASED AND SELLER SHALL HAVE
A SECURITY INTEREST IN SAID GOODS TO SECURE THE PAYMENT UNTIL MY ACCOUNT IS FULLY PAID, I FURTHER AGREE THAT IN THE EVENT OF DEFAULT IN THE PAYMENT OF ANY AMOUNT DUE, AND
IF THIS ACCOUNT IS PLACED IN THE HANDS OF AN AGENCY OR ATTORNEY FOR COLLECTION OR LEGAL ACTION TO PAY AN ADDITIONAL CHARGE EQUAL TO THE COST OF COLLECTION INCLUDING
AGENCY AND ATTORNEY FEES AND COURT COSTS INCURRED AND PERMITTED BY LAWS GOVERNING THESE TRANSACTIONS.
A finance charge of 13/4% Per Month will be charged on all Accounts 30 days Past Due. Annual Percentage Rate is 21 (Minimum 75) RECEIVED BY
t
SOLD TO: SHIP TO:
CARVIEL FIRE DEPT. 5300(01 SAME INVOICH 130424
TWO C!'01C SQUARE
CAMEL IN 46032
CLIST. P.O. MAKE- MODEL ID# MILEAGE TELEPHONE ROUTr='sLM SHIP VIA` "ORDER PAGE' REMARKS
63731 571- 2609 0 1 NIA I36912 1
INVOICE PREVIOUS SHIPPED
TERMS
INVOICE DATE
NUMBER INVOICE NUMBER
upellea ay uperator
1109/2010 130404 NET 10TH 12109110 13:46:49 8
STOCK NUMBER SIZE DESCRIPTION QUANTITY T FE T
ORDERS SHIPPED PREV.SHIPt I .UNIT -F EXTENSION
PRICE
CAR 4599
CK ALL TIRES,
RF WAS FLAT AND DRIVEN ON �t�r
508 5777 GARY
16 t6" DISMOUNT A MOUNT PASS96ER 2 2 12.00 .00 24.
STEM EACH VALVE 'STEPS 1 1 2.50 02 .00 2:50
CS EACH CLEAN RESEAL TIRE BEADS 2 2 8.00 .00 16.00
METHOD OF PAYMENT:
G�IRCE:
CHWK: 00
I--
�De
Thank you for your business Meeh: Bill ft Jon
PARTS LABOR- TAX TAXABLE TAX F.E.T. MISC INVOICE TOTAL
TAX -MOUNT
I. us peer N esale o. Lt t I'Ky
42.50 03120;•155 °002 0 42.50
"You're Riding On Our Reputation"
VOUCHER NO. WARRANT NO.
ALLOWED 20
Clark Tire
IN SUM OF
622 South Rangeiine Road
Carmel, IN 46032
$42.50
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO# I Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Members
1120 130424 43- 510.00 $42.50 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
VEG 13 2010
r
4-77
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 bill(s))
130424 $42.50
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
SARK 622C S. Rangeline Road
"YOU ARE RIDING ON OUR REPUTATION" Camel, IN 46032
4w (317) 844 -4839
IRE
Jational
?ENS 14
L THE UNDERSIGNED, HEREBY AGRFE UNTIL SUCH TIME AS THIS ACCOUNT IS PAID IN FULL BY ME, THE SELLER SHALL RETAIN TITLE TO THE GOODS HEREBY PURCHASED AND SELLER SHALL HAVE
A SECURITY INTEREST IN SAID GOODS TO SECURE THE PAYMENT UNTIL MY ACCOUNT IS FULLY PAID. 1 FURTHER AGRFE THAT IN THE EVENT OF DEFAULT IN THE PAYMENT OF ANY AMOUNT DUE, AND
IF THIS ACCOUNT IS PLACED IN THE HANDS OF AN AGENCY OR ATTORNEY FOR COLLECTION OR LEGAL ACTION TO PAY AN ADDITIONAL CHARGE EQUAL TO THE COST OF COLLECTION INCLUDING
AGENCY AND ATTORNEY FEES AND COURT COSTS INCURRED AND PER1,41TTED BY LAWS GOVERNING THESE TRANSACTIONS.
A finance charge of IV4% PerMonth will be charged on all Accounts 30 days Past Due. Annual Percentage Rate is 21%. (Minimum 75) RECEIVED BY
SOLD TO: SHIP TO:
CARPEL WATER DISTRIBUTION 6390101 SAME INVOICE.# 130381
760+ ZRAD AVENUE SId
CARME-L IN 46032
CUST. P.O. MAKE- MODEL ID# MILEAGE TELEPHONE ROUTE` S1_ n "SHIP VIA ORDER`# PAGt" REMARKS``
s
r w
#130 715-3939 0 1 N/A 136754 1
INVOICE DATE INVOICE PREvlbus WPPED TERMS
NUMBER INVOICE NUMBER
Upened by Operator
2196i2ol0 M 7 81 NET 10TH lc" 06J10 14:40:26 8
OuANTITY UNIT EXTENSION;
STOCK NUMBER SIZE DESCRIPTION T F.E.T.
..ORDERS SHIPPED PREV. SHIPI PRICE L
REPAIR LOOSE TIRE
LTCH EACH LIGHT TRUCK DISNOUNTfPiOUNT 1 1 15.00 .00 15.00
REP EACH INSIDE TIRE REPAIR I 1 6.50 6.50
METHOD OF PAYP'IENT
CHARGE: 2- 1.50
CHANGE: ,00
I I
Thad you for your business Mech: WE
PARTS LABOR 'TAX 0 q oUNT TAX: F E.T.AMOUNf INVOICE TOTAL
t t N 419 UN
21.50
"You're Riding On Our Reputation"
VOUCHER 103532 WARRANT ALLOWED
60700 IN SUM OF
CLARK TIRE INC CARMEL 0 A ?bq j
622 C SOUTH RANGELINE RD CMS
CARMEL, IN 46032
i
Carmel Water Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
130381 01- 6500 -05 $21.50
Voucher Total $21.50
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
60700
CLARK TIRE INC CARMEL Purchase Order No.
622 C SOUTH RANGELINE RD Terms
CARMEL, IN 46032 Due Date 12/7/2010
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
12/7/2010 130381 $21.50
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
X.
Date Officer