197602 05/26/2011 CITY OF CARMEL, INDIANA VENDOR: 00351640 Page 1 of 1
ONE CIVIC SQUARE CLARK TIRE FISHERS
I r/ CARMEL, INDIANA 46032 PO BOX 195 CHECK AMOUNT: $87.75
FISHERS IN 46038 CHECK NUMBER: 197602
CHECK DATE: 5/26/2011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1207 4350000 IN001206SO 87.75 EQUIPMENT REPAIRS M
126TH REYNOLDS ROAD (HWY 37 NO.) FAST! Service at our Farm,
FISHERS, INDIANA 4603$
P.O. BOX 195 Commercial Site or on the Road.
TIRE FISHERS 317 -842 -0544 OR 1- 800 -444 -5985 All Major Brands Available
Fax 317 577 -3956
NAME 1 ADDRESS ACCOUNT NO. HOME PHONE REFERENCE NO.
BI:tOOKSH E 31 7) 571 —t 7` I h1001 E OED O
BROOKSHIRE GOLF CLUB P.O. NO.
;WORK PHONE DATE !TIME
1 2120 11ROOH5HIRE PARKWAY I (u 17) E II51 17/11 10-
RESALE NO. VIN NO_ WO ES NO,
CARMEL, IN 46033 W000060270
YEAR I MAKE MODEL s r A= LICENSE NO. 'TAG NO. 1 NEXT INSP- DATE BAR NO.
i
,1
ALL PARTS NEW UNL�
SAVE PARTS W PROMISED DATE /TIME
ESS i MILEAGE WRITTEN BY
Y N OTHERWISE SPECIFIED I,JS
ORIGINAL ETOREE. ROTATION
REVISED i (EVERY 5,000 MILES)
REVISED 2
I acknowledge notice and oral approval of an increase in the original estimate price: 0 ROAD. HAZARD WARRANTY
X
ARM, OTHERS LABOR
1 574362 20X10.00X10/4 TURFNASTER, 87.50 87.50 1.00.41 INDIANA TIRE FEE. 0.25
r
t
i
i
Reason` original estiaate:
Any warranties on the item /items sold hereby are those made the manufacturer. The seller, CLARK. TIRE;' hereby expressly,:
disclaims all warranties, either express or implied, including any implie&warranty of merchantability or fitness for a particular:
purpose, and CLARK TIRE neitherassumes nor authorizes anyother person to assume for it anyliability in connection with the sale
of this itemlitems. 7
r
i
A SERVICE CHARGE OF t PER MONTH 12145 ANNUALLY}',WILL BE OWALL ACCOUNT PAST DUE 30 DAYS. NET 10th PROX..; •r I h
1 „THE UNDERSIGNED; HEREBY AGREE THAT IN THE EVE T -'OF DEFAULT IN THE PAYMENT OF ANY AMOUNT DUE, AND IF THIS ACCOUNT IS PLACED IN PARTS y. m
THE HANDS OF AN AGENCY OR, ATTOR EY R CO LECTI OR LEGAL ACTION, .TO 'PAY AN ADDITIONAL CHARGE: EQUAL TO THE COST OF 8 -t 50
COLLECTION INCLUDING AGENCY AN O YFE AND OUR 4 60STS, INCURRED AND PERMITTED BYLAW GOVERNING THESE TRANSACTIONS LABOR 0 25
1 hereby a the re it work to an long th t e ssary' You and your employees may operate vehicle for purposes of'tesfing, OTHER
inspection, ordelivery a y risk. An ss echan 's acknowledged on vehicle' "to secure the amount repairs thereto. It is alsounderstoad that
you will r r not be heId'res Bible fo r d 'e ticles' left in cars in case of Tire, theft or any other Cause beyond your control. SUBLET
left
017. 75.
Signature X TAX O, 0
Rec'd By 97 75
TOTAL
CASH AMOUNT CHECK AMOUNT CHECK NO C.C. AMOUNT C.C- TYPE C.C. APPROVALCCDE ON ACCOUNT
87.75 THANK
YOUI
VOUCHER NO. WARRANT NO.
ALLOWED 20
Clark Tire Fishers
IN SUM OF
P.O. Box 195
Fishers, IN 46038
$87.75
ON ACCOUNT OF APPROPRIATION FOR
Brookshire Golf Club
PO# Dept. INVOICE NO. ACCT #rrITLE AMOUNT Board Members
1207 IN00120650 43- 500.00 $87.75 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
Monday, May 23, 2011
Director, Brookshir olf Club
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
Prescribed by State Board of Accounts City Form No 201 (Rev, 199`
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))
05/17111 IN00120650 Repair Parts $87.7
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