164197 09/30/2008 CITY OF CARMEL, INDIANA VENDOR: 060700 Page 1 of 1
ONE CIVIC SQUARE CLARK TIRE INC
iq 0 CHECK AMOUNT: $36.00
CARMEL, INDIANA 46032 622 C SOUTH RANGELINE RD
CARMEL IN 46032 CHECK NUMBER: 164197
CHECK DATE: 9/30/2008
D EPARTMENT ACC O UNT PO NU MBER INVOI NUMB AMOUNT DESCRIPTION
1110 4350101 -21.50 TRASH COLLECTION
1110 4350101 121277 57.50 TRASH COLLECTION
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t
LIMA Elliott's Mohawk Place
622C S. Rangeline Road
Carmel, Indiana 46032
(317)844 -4839
CARMEL POLICE DEPT.
DBER
THREE CIVIC SQUARE SQUARE ATE ACCOUNT NUM
CARMEL IN 48032 08/31/0 1 800 PAGE:
AMOUNT PAID
PLEASE RETURN THIS PORTION WITH YOUR REMITTANCE
DATE REFERENCE CUST.P.O.NO. CHARGES CREDITS BALANCE
12/27/07 PMT 154894
c;1. 50 c i 50
08/22/08 INV 131277 57. 38.00
TOTAL PAYMENTS 2 1. 50— NEW 36.00
I
4
FUTURE CURRENT 31 -60 DAYS 61 -90 DAYS 91 D OVER. e
.00 57.50 :1710 0LA I 21.5 36.00
Seprrt3 08 07:03a Ron Booth 317 844 -6561 p.1
r^
ARE RIDING GL A *R KK 622 S. Rangelzne Roo
NG ON OUR REFUTATION Carmel, IN 4603
A
IRE (317) 844 -483
m otional PEN pIL
Q
m ot o
L TIME UNDERSIGNED, II S AID A GREE
GOODS TO UN
SEC U UCH TIME AS THIS ACCDUNT IS PAID CV FULL 13Y ME- THE SELLER SHALL RETAIN TITLE TO THE GOODS HEREBY PURCHASED AND SELLER SHALL HAVE
A SECURITY ENTERESi 1N SAID GOODS TO SECRE THE PAYMENT UNT[L MYACCOUNT IS FULLY PAID. I FURTHER AGREE THAT III THE EVE,N7 F D- FAULT TN TH �iF OF ANY AMOUNT DVL•. AN:
TF THIS ACCOUNT IS PLACED IN THE HANDS OF AN AGENCY OR ATTORNEY FOR COLLECTION OR LEGAL ACTION TO PAY AN ADDITIONAL CII GE
AGENCYANDAT 7
TORNEYFEESAN' DCOURTCOSTSTNCURRE D, ANDPERh llTTEDBYLA WSGOVERNWGTHESETR EQUAL TO ANSACTIONS. F OLLECTION INCLUDING
A finance charge oP 13.''4% Per Nionlh will he chr gtd ou all Ac ums 3U days Pam Dae. AnnuaL Percentage Raie is 2I%. (Minimum 75) RECEIVED BY
SOLD TO: CA!EL POLICE W. 6RR@f181 SHIP TO:
TREE CIYIC SUM IWICE4 121277
CRAWL IN 46032
=OATEINVOIC MILEAGE TE E RouiE '31-M SHIP VIA ORDER 4 PAGE REMAR
571- 22518f f 5 NIA 116873 1
US SHIPPED TERMS
CE NUMBER
80 1221 2M 121277 NET 16M 88122Jf9 12:23:RW 8
STOCK NUMBER SIZE DESCRIPTION QUANTITY N
ioROeaS SHiPPEO PRUt SRI` PRICE T F.E.T. EXTENSION
SCRIP SCRAP TIRE 23 23 2.58 ff 57, 5f
iElll[)0 OF PIA17EIrT:
DRIVE: E: 57.58
CIRGE: .fB
Thank you for your business
ml
PARTS LABOR TAX 30 A TAX F.E.T_ OUNT
M
57. 50 A
1 57.50
a
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 S. Rangeline Road Terms
Carmel, 1 46032 Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
8/22/08 121277 payment for scrap tires 57.50
9/26/08 less credit —21.50
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
C lark Tire
IN SUM OF
622 S. Rangleine road
Carmel, IN 46032
36.00
ON ACCOUNT OF APPROPRIATION FOR
police general fund
Board Members
PO4 or INVOICE NO. ACCT #/TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
1110 121277 501 01 g0 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
September 26 20 08
�lJ
Signature
Chief of Police
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund