167046 12/17/2008 -u% CITY OF CARMEL, INDIANA VENDOR: 060700 Page 1 of 1
ONE CIVIC SQUARE CLARK TIRE INC
0 CHECK AMOUNT: $45.43
CARMEL, INDIANA 46032 622 C SOUTH RANGELINE RD
6ri Z� CARMEL IN 46032 CHECK NUMBER: 167046.
CHECK DATE: 12/1712008
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUM A MOUNT DESCRIPTION
'1.110 4350101 122612 22.50 TRASH COLLECTION
2201 4232000 122651 22.93 TIRES TUBES
r
CARMEL All Claims and Returns MUST Be Accompanied By THIS INVOICE
L ARK 622 C. South Rangeline Road TERMS: NET 10TH FOLLOWING DATE OF PURCHASE. A SERVICE CHARGE
Carmel IN 46032 OF 1 PER MONTH WILL BE ADDED TO PAST DUE BALANCE (MINIMUM
(317) 844 -4839 CHARGE .75). THE ANNUAL PERCENTAGE RATE IS 21
FAX (317) 844.6561 AGRICULTURAL EXEMPTION CERTIFICATE
STATE DEPARTMENT OF REVENUE —SALES TAX DIVISION
I HEREBY CERTIFY UNDER THE PENALTIES OF PERJURY THAT THE PERSONAL
PROPERTY PURCHASED BY THE USE OF THIS EXEMPTION CERTIFICATE WILL BE
DIRECTLY USED IN THE DIRECT PRODUCTION OF AGRICULTURAL PRODUCTS FOR
TWO RESALE.
CUSTQMEF('S SIGNATURE
UNI®
CARMEL POLICE DEPT. 6000/01 SAME INVOICE# 122612
SOLD TO: THREE CIVIC SQUARE SHIP TO:
CARMEL IN 46032
CUST. P.O. MAKE -MODEL ID MILEAGE TELEPHO E ROUTE SLM SHIP VIA ORDER PAGE REMARKS
571 -2560 �0 �5 IN /A 119804 1
INVOICE DATE INVOICE PREVIOUS SHIPPED TERMS
n NUMBER. II INVOICE NUMBER r�
12/11/2008 122612 NET 10TH 12/11/08 12:14:55 7
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r ounNTm_�___' UNIT...
STOCK NUMBER SIZE DESCRIPTION ,'".oROeas '-SHiPPED aae1j_.SH PRICE T F.E.T. EXTENSION
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SCRAP j SCRAP TIRE 9 9 2.50 .00 22.5�D
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METHOD OF PAYMENT:
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CHARGE: 22.501
CHANGE: .00
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Thank you for your business
PARTS LABOR TAX AMOUNT TAX F.E.T AMOUNT INVOICE TOTAL
22.50 .22.50.
"Ours Is A Reputation You Can Ride On"
CUST COPY
Now
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
Clark Tire Purchase Order No.
622 C South Rangelien Road Terms
Carmel, IN 46032 Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
12/11/08 122612 payment for scrap tires 22.50
Total
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
VOUCHER NO. WARRANT NO.
ALLOWED 20
G1Rrk—Tire IN SUM OF
i
622 C. SOuth Rangeline Road
Carmel, IN 46032
22.50
ON ACCOUNT OF APPROPRIATION FOR
police general fund
Board Members
PO# or INVOICE NO. ACCT #/TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
2 2 50 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
December: -12 20 08
Signature
Chief of P lice
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund
J�
'a
622 S. Rangeline Road
YOU ARE RIDING ON OUR REPUTATION" LARK Carmel, IN 46032
4w (317) 844 -4839
IRE
tJational PENS IL
L THE UNDERSIGNED, HEREBY AGREE UNTIL SUCH TIME AS THIS ACCOUNT IS PAID IN FULL BY ME, THE SELLER SHALL RETAIN TITLE TO THE GOODS HER PURCHASED AND SELLER SHALL I LAVE
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 TI IESE 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
SOLD TO: CARla STREET DEPT. 6200/01 SHIP TO: SANE INVOICE# 122561
34#0 W 131ST
WESTFIELD IN 46074
CUST P.O. MAKE- MODEL" ID# MILEAGE TEL -E .HO E ROUTE SLM SHIP VIA ORDER PAGE REMARKS
733 -2091 0 5 N/A 119687 1
INVOICE DATE" INVOICE l PREVIOUS SHIPPED I' TERMS
NUMBER INVOICE NUMBER
O
12/66/2008 122561 NET 10TH 12/06/08 10:54:52 8
STOCK NUMBER SIZE DESCRIPTION QUANTITY UNIT T F.E.T. EXTENSION
a
ORDER SHIPPED SHIPPED PREY. SHIP PRICE
j TIRE REPAIR
1949 15/600X6 COOPER TUBE 1 1 7.93 02 .06 7.93
CH EACH 'TIRE CHANGE 1 1 15.00 .00 15.00
VIIETHOD OF PAY MT
CHARGE: 22.93
CHPXGE: .00
Thank you for your business Nech: Steven
't
TAXABLE ,l MISC.
PARTS LABOR TAX gMOUNT TAX F.E.T. AMOUNT A JNVOIGE•1OTALpI
22.93 22.93
"You're Riding On Our Reputation"
VOUCHER NO. WARRANT NO.
ALLOWED 20
Clark Tire
IN SUM OF
622 S. Rangeline Road
Carmel, IN 46032
$22.93
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO# dept. INVOICE NO, ACCT #!TITLE AMOUNT Board Member:
2201 122651 42- 320.00 $2293 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
Friday, December 12, 2008
Street Cory( sinner
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))
12/06/08 122651 $22.93
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