164320 09/30/2008 CITY OF CARMEL, INDIANA VENDOR: 182450 Page 1 of 1
ONE CIVIC SQUARE LEBANON TIRE AUTO SVC CHECK AMOUNT: $673.95
s._ CARMEL, INDIANA 46032 1310 w SOUTH ST
LEBANON IN 46052 CHECK NUMBER: 164320
CHECK DATE: 9/30/2008
DEPARTMENT ACCOUN PO NUMBER INVO NUMBER A DESCRIPTION
651 5023990 511291 L108794 673.95 TIRES
r
s.
1S1i W SOUTH STREET
LE ANON, IN 46052
765 4Ow2 -5172 7
FEDERAL. TAX IP,# 55114F575S: �em►r9i i
PAGE. 01
P ILL TO: CITY OF CARMEL (E05)
1 CIVIC SQUARE
CARMEL IN 46032
PHONE=, I C 17 5'71 -26 e+ VE H DEAF; ill lAt :'E oC! i'[-!F VY TF,
PHONE E" e (W1' ?1i"' -2321 VL:HICL.E MODEL. t: 500 3. TON 4WD PI
DATE REQUECTED 0? fi =!9 JC:!"�{-• VEHICLE COLOR. RED
TIME REQLJE'STED LICENSE /STATE= 6t_! 14'7 1 N
RETLJRN PARTS. w ND 0I1-0ME-Tt IN,/CUT' 0"2791
AL-E jMAN n iE 171 i 2 �.'EJ J :i: CI.._E 11 16 t ?St::E=�+R `'R 19 fsil! t
PRIOR INVOICE. 1086E38
ACCOUNT 9 GOB TC CU5T4 TYPE /STATE
779000168 4 01 00168 4 IN
SLSM TECH PRODUCT CODE BC QTY DESCRIPTION PARTS LBR!E%CISE LINE TOTAL
006 7`2 -353 -812 -0 G 4 LT245!75R16E WKHSE XGRCBSL TL 143.15 .00 572.60
GS NUMBER. G0730929 QTY. 4 NO. P311PFLR1808
006 017 020 044 -263 R 4 WHEEL BALANCE COMPUTER SPIN 100 8100 32.I00
006 017 020 041 -263 R 4 NEW VALVE STEM 2.00 .00 S.00
002 017 020 040 -101 R 4 AUTO< TRK INSTALL -NOT PURCH IN STORE CIO 5.00 20.00
002 017 (120 093 -002 R 4 TIRE DISPOSAL .00 3.110. .'•12.00
002 017 020 046 -200 R 1 RIF WHEEL STUD AND LUGS 8.78 .00 8.88
006 t 117 020 046 -100 R I PfR WHEEL STUD LABOR .0 15,06 15.00
REMEMBER TO SERVICE YOUR TRANSMISSION EVERY 15000 TO 30000 FILES! WE THANK YOU FOR YOUR BUSINESS WITH US.
1 UNDERSTAND THAT ALL CUSTOM WHEEL LUG NUTS MUST BE RE- TORQUED AFTER 25 MILES AND CHECKED PERIODICALLY.
PARTS TOTAL........ 589:48
LABOR TOTAL........ 79.00
95
CHARGED AMOUNT 673, MISC SHOP SUPPLIES.
4.47
STATE TIRE FEE 1.00 SUB TOTAL.......... 672.95
TAXABLE AMOUNT .00 SALES TAY.......... .00
STOt1ER AUTHORIZATION FOR TOTAL lC ICS JJ d °h B' E� i N_ 2. !E
TREAD L /F..... 11!32 TREAD R /F..... 11!.2 R a R/R 11132 TREAD LIR..... 11132
Please tell u a ag Swe "'4 to as much as your
BUYING PLAN... A OF PAS' business. Should you need additior�l�assls Dance, pour lU DISCOUNT. +NETS
CUSTOMER ASSISI'ANCI= LINE
n- n_ 4 v i n. d ic= r n n k.'8U0.191 2136 tr,xn n `h e r r n n` �^a t 1
7 w_...
l i FORM 36m�giff d=:Z O\.0 �tl- 1A ID 44 u—u F"� T #fN NO _F N' 1 (H M i� 71 1 I3 �'''.•O...
y
OK Maintenance Yes No VIN
Review Work -order Inspection
Record vehicle information Tire flotation Yes No Engine Size 2WD 4WD
Install interior protection Trans Type Auto Man.
Test drive (if applicable) Good Recommend
Inspect Wipers
ABS Frt L] Rear NlA
ers
Review maintenance schedule p p
and tire fitment Inspect Headlights A/C F] P/S F] A/P
Perform inspection indicated Inspect Bulbs
Record findings /review history Inspect Air Filter(s) Tire Registration #'s (NEW TIRES)
Make recommendations er MAP Inspect Belts
p inspect Hoses QTY Registration
Uniform Inspection Guidelines Inspect &Test Battery 1
Return w/o to appropriate individual .Inspect Tires 2
Perform service requested Inspect Wheel Bearing
Test drive (if applicable) El Looseness 3
Exterior Condition Notes: Inspect Shocks 0 4
Struts Drum Rotor Specifications
Inspect Suspension LF RF RR LR
Inspect Exhaust
PSI Inspect Brakes Spec.
32ND IN OUT CONDITION Fluids Good Add Recom. Actual
LF Washer(s)
RF Power Steering Battery Load Test
RR Coolant /Anti Freeze Spec.
LR Differential
SP Transmission Actual
Brake
SIZE Oil Assoc.
TYPE Signature
Tech Qty Description Comments Map Service
Categories
1 2 3 4
P P I B
S t
u
t i
e s,
fiE C Y
f EE J V
7 C
a d
u t n c
r e C
rE
C
I
Map Service Categories
71 1 Parts System Failure Service /replacement is required now Blmproved System Performance Service /replacement is suggested
2 Preventative Maintenance Service /replacement is suggested 4 Diagnostic Procedures Determines condition
performance of parts system Service is suggested
FORM GHMS -027 04/02
VOUCHER 086325 WARRANT ALLOWED
-182450 IN SUM OF
LEBANON TIRE AUTO SVC
1310 W SOUTH ST
LEBANON, IN 46052
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
L108794 01- 7500 -02 $673.95
�a
Voucher Total $673.95
Cost distribution ledger classification if
claim paid under 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 of service rendered, by whom, rates per day, number of units,
price per unit, etc.
l
Payee
182450
LEBANON TIRE AUTO SVC Purchase Order No.
1310 W SOUTH ST Terms
LEBANON, IN 46052 Due Date 9/23/2008
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
9/23/2008 L108794 $673.95
hereby certify that the attached invoice(s), or bill(s) is (are) true and
:orrect and I have audited same in accordance with IC 5- 11- 10 -1.6
g,/iL 2 Cam -�p�
Date Officer