HomeMy WebLinkAbout193463 01/05/2011 CITY OF CARMEL, INDIANA VENDOR: 182450 Page 1 of 1
ONE CIVIC SQUARE LEBANON TIRE AUTO SVC CHECK AMOUNT: $1,003.52
CARMEL, INDIANA 46032 1310 W SOUTH ST
LEBANON IN 46052
CHECK NUMBER: 193463
CHECK DATE: 1/5/2011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4351000 126818 1,003.52 AUTO REPAIR MAINTEN
Dec 23 10 03:12p P,1
L_ EES AF*4aN TIL RE AUT0 ZVC
1310 W SOUTH STREET rrl�SfRUic
LEBANON, IN 46052
(765) 482 -5027 rvrrtx
FEDERAL TAX ID# 351145753 EAR
INVQ X C R 12/22/10 12/23/10 �"UA?ZOP
L '1 Z 45 $'A S 09:31 AM 02:16 PM KELLY TIRES
7798 017112 126818 TERR: 7798
PAGE: 01 NONSIG: 173531
BILL TO: CARMEL FIRE DEPT
BOB VANVOORST
2 CIVIC SQUARE
CP -RMEL, IN 46032
PHONE 1....... (317)664 -0958 EXT. VEH YEAR /MAKE.
PHONE 2....... (317)571--2615 EXT. FAX VEHICLE MODEL,.
DATE REQUESTED 12/22/10 VEHICLE COLOR.
TIME REQUESTED LICENSE /STATE.
RETURN PARTS.. NO ODOMETR IN /OUT NA
SALESMAN...... 002 002 GS /AN NUMBER G0000733
PRIOR INVOICE. 126015 P O NUMBER.... VANVOORST
ACCOUNT COB TC CUST# TYPE /STATE
779800259 2 01 00259 4 IN
SLSM TECH PRODUCT CDDE 3C CITY DESCRIPTION PARTS LBR /EXCISE LINE TOTAL
002 756- 256 -427 -C G 2 315/80R22E 6291 LP TL 406.63 52.83 919.02
QTY. 2 NCI. MC725VHR1110
102 Q17 041 -253 R 2 NEW VALUE STEM 4.50 .00 5.00
002 E17 043 -12C R 1 ROAD SERVICE PER H2 /P_R MAN ;REG TIME) .00 75.00 75.00
REMEMBER TO SERVICE YOUR TRANSMISSION EVERY 15000 TO 30000 VILES! lE THANK vOU FOR YOUR BUSINESS W'TH US.
i
EXCISE TAX......... 105.66 PARTS TOTAL........ 928.02
CHA,RCED AMOUNT :003.52 LA503 TOTAL........ 75.00
X__ STATE TITRE FEE .50 SUE TOTAL.......... 1003.02
CUSTCMER AUTHORIZATION FCR TOTAL YNNJ(3XCF j 0 s�aL� 0:3 5;_> .00
BUYING PLAN... A OF PAYMENTS, 1 PAY START DATE 01/10/11 DISCOUNT...... *NET*
SEE REVERSE S =CIE FQR YMF FA SAF ETY
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HAVE A QUESTION OR PROBLEM?
Please lei our store manager. We value wur opinion as much as your
business. Shoup you need additional ass. stanco. 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
$1,003.52
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO# Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Members
1120 126818 43- 510.00 $1,003.52 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
1�
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))
126818 E45 $1,003.52
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
2a
Clerk- Treasurer