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Home My WebLink About200821 08/30/2011 CITY OF CARMEL, INDIANA VENDOR: 00351640 Page 1 of 1 ONE CIVIC SQUARE CLARK TIRE FISHERS 0 iI CHECK AMOUNT: $301.00 CARMEL, INDIANA 46032 Po sox iss FISHERS IN 46038 CHECK NUMBER: 200821 CHECK DATE: 8/30/2011 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1207 4350000 IN00122489 301.00 EQUIPMENT REPAIRS M 126TH REYNOLDS ROAD (HWY 37 NO.) P.O. BOX 195 FAST. Service at your Farm, FISHERS, INDIANA 46038 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 ADDRESS ACCOUNT NO. HOME PHONE 'REFERENCE NO.. BROOK"' (s 17) 571--2-4 I N00122489 BROOKSHIRE GOLF CLUB P.O. NO. WORK PHONE DATE TIME 12120 BROOKSHIRE PARKWAY t 3171 08/12"111 11.02 RESALE NO. VIN NO. WO ES NO. CARMEL, IN 46033 W000081 510 YEAR MAKE MODEL LICENSE NO. TAG NO. NEXT INSP. DATE BAR NO. SAVE PARTS ALL PARTS NEW UNLESS PROMISED DATE TIME MILEAGE WHITTEN BY Y N OTHERWISE SPECIFIED �,Ic AM OUNT ESTIMATE DATE TIME EMPLOYEE CUSTO ORIGINAL FREE ROTATION REVISED 1 (EVERY 5,000 MILES) REVISED 2 I acknowledge notice and oral approval of an increase in the original estimate price. F1 ROAD HAZARD WARRANTY X PARTS OTHERS LABOR DESCRIPTION EACH DESCRIPTION 4 511257 20X12.00 -10/4 TURFt1ASTER 75,00 308.00 4.00 INDIANA TIRE FEE 1.80 Reason for original estimate: Any warranties on the iterMtems sold hereby are those made by the manufacturer. The seller, CLARK TfRE,hereby expressly disclaims all warranties either express or implied, including any implied warranty of merchantability or fitness for a particular purse, and CLARK TIRE neither assumes nor authorizes any other person to assume for it any liability In connection with the sale of the itemrtems. A SERVICE CHARGE OF 1;4% PER MONTH (21% ANNUALLY) WILL BE CHARGED ON ALL ACCOUNT PAST DUE 30 DAYS- NET 10th PROX. I THE UNDERSIGNED HEREBY AGREE THAT IN THE EVENT OF DEFAULT IN THE PAYMENT OF ANY AMOUNT DUE AND IF THIS ACCOUNT IS PLACED IN PART ,7, 1 hereby authori COLLECTION INCLUDING AGENCY AND ATTORN EE AND IO URT OR LEGAL ACTION TO PAY AN COSTS INCURRED AND PERMITTED 13Y GOVERNING THESE SACTIONS 300 Q 710 LABOR 1 00 ze the repa ork to bone ortg w' the cessary materials. You and your employees may operate vehicle for purposes of testing OTHER inspection, or delivery at risk. An a fes mechani. s lie Wledged on vehicle to secure the amount of repairs thereto. It is also understood that you will not beheld res Bible for la amage t oar articles left in cars in case of fire, theft or any other cause beyond your control. SUBLET Signature X SUBTOTAL 301. 00 TAX 0. 00 Rec By TOTAL 301 00 CASH AMOUNT CHECK AMOUNT CHECK NO. C.C. AMOUNT C C TYPE t I,% C.C. APPROVAL CODE ON ACCOUNT THANK j 381.00 YOU! V NO. WARRANT NO. ALLOWED 20 Clark Tire Fishers IN SUM OF P.O. Box 195 Fishers, IN 46038 $301.00 ON ACCOUNT OF APPROPRIATION FOR Brookshire Golf Club PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members 1207 IN00122489 43- 500.00 $301.00 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, August 22, 2011 Director, Brooks ire Golf 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)) 08/12/11 IN00122489 Repair Parts $301.0 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