HomeMy WebLinkAbout159452 05/14/2008 CITY OF CARMEN, INDIANA VENDOR: 182450 Page 1 of 1
ONE CIVIC SQUARE LEBANON TIRE AUTO SVC CHECK AMOUNT: $1,521.64
CARMEL, INDIANA 46032
1310 W SOUTH ST
:s -a LEBANON IN 46052 CHECK NUMBER: 159452
CHECK DATE: 511412008
DEPARTMENT ACCOU PO NUMBER IN VOICE NUMB AMOUNT DESCRIPTION
1120 4351000 105069 1,521.64 AUTO REPAIR MAINTEN
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11'31() W SOUTH S 11 E E
LEBANON. IN 46052
FEDERAL TAX I D# r I I 5`7 53
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1 �5 F C. F M
1 a 1 7E 1[)5i) I F' F!. 7`7 PS
F A f .'.1 N 0 1`d I G 17 1
BILL TO: CITY OF CAr?ME:L E'(,)5)
I CIVIC SQUARIF
CAFJIEL. IN 4bC.
(3 1 `7 }5' 1 2 634 V'E' I A Y E A F. M A :J
PHL)NE 2 ;31'? 1 31 2 1 t HICLE" M
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RET11IRN FAF.J'(*.-). NO O1)()MF.'1 IN/OUT NA
SAL EStIAN 0f)2 1 Cr 1 FT;'.10R I'NVOICE. 10' 46
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RF- DEF"T'
ACCOUNT COB TC CUST# TYPE /STATE
779800169 4 01 00162 4 IN
SLSM TECH PRODUCT CODE SC QTY DESCRIPTION PARTS LBRIEXCISE LINE TOTAL
002 1 6 4 128 H G287 MSA TL 326.91 100 130
65 NUMBER, G0730q29 QTY. 4 NO, MC3X42WR01
002 9.2 046-120 R 1 ROAD SERVICE PER HRIPER MAN (REG TIMEi .00 75, 00 '15.00
(102 002 040-141 R 4 MT/DISMT 17.5" RIM DIAM LGR OUTSIDE .00 3 120.
002 002 041-263 R 4 NEW VALVE STEM 4.511 .00 18.00
902 002 00-000 R I PER SCOTT OSBORNE .00 .00 .00
REMEMBER TO SERVICE YOUR TRANSMISSION EVERY 15006 TO 30000 MILES! WE THANK YOU FOR YOUR BUSINESS WITH US.
PARTS TOTAL 1
CHARGED AMOUNT 1521.64 LABOR TOTAL 195.00
STATE TIRE FEE 1.00 SUP TOTAL 1520.64
TAXABLE AMOUNT 00 SALES TAX 100
EUST ER AUTHORIZATION FOR TOTAL 1 r 4 0 1
3. C- C T C. "T" IF h-.- 1 1 1 1 5 1 4:!E:P -e*
BUYING PLAN... A OF PAYMENTS. I PAV START DATE 05fI0108 DISCOUNT...... *NET*
E I 1 11 la F I A :0 E�. F- C .119 ;Z -1 F- cil:4l N4 T !E:: 4c% 9 Ne
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A L -J fi:�N A ION'DOR'PROBLENIT"l F: C.".) F Imi df4
Please tell our store manager. We value your opinion as much as your
business. Should you need additional assistance, call our
CUSTOMER ASSISTANCE LINE
1-800-321-2136
FORM GBMS-027 04102
OK Maintenance Yes No VIN
Review Work -order Inspection
Record vehicle information Engine Size 2WD 4WD
Tire Rotation Yes No
Install interior protection Trans Type Auto Man.
Test drive (if applicable) Good Recommend
Insp Wipers ABS Frt Rear N/A
Review maintenance schedule p
and tire fitment Inspect Headlights A/C P/S 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 G�TY Registration
Uniform Inspection Guidelines Inspect Test Battery 1
Return w/o to appropriate individual Inspect Tires
Perfo service requested 2
Inspect Wheel Bearing
Test drive if ap plicable) 3
pp Looseness
Exterior Condition Notes: Inspect Shocks 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 'Pest
RR Coolant/Anti- Freeze Spec.
LR Diff erential
SP Transmission Actual
Brake
SIZE Oil Assoc.
TYPE Signature
Tech Qty Description Comments Map Service
Categories
1 2 3 4
r
a c c
Map Service Categories
t❑ Parts System Failure Service /replacement is required now ❑3 improved System Performance Service /replacement is suggested
2 Preventative Maintenance Servicelreplacement is suggested 4 Diagnostic Procedures Determines condition
performance of parts system Service is suggested
FORM ri GBMS -027 04/02
VOUCHER NO. WARRANT NO.
ALLOWED 20
Lebanon Tire
IN SUM OF
1310 West South Street
Lebanon, IN 46052
$1,
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO Dept. INVOICE NO. ACCT #(TITLE AMOUNT Board Members
1120 105069 43- 510.00 $1,521.64 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
d
r
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))
04/04/08 105069 Tires E41 $1,521.64
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