180780 12/30/2009 CITY OF CARMEL, INDIANA VENDOR: 060700 Page 1 of 1
ONE CIVIC SQUARE CLARK TIRE INC
CARMEL, INDIANA 46032 622 C SOUTH RANGELINE RD CHECK AMOUNT: $152.45
CARMEL IN 46032
CHECK NUMBER: 180780
CHECK DATE: 12/30/2009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
601 5023990 126636 89.95 TRANSPORTATION EXPENS
1110 4350101 126645 62.50 TRASH COLLECTION
622C S. Rangelme Road
"YOU ARE RIDING ON OUR REPUTATION" LARK Carmel, IN 46032
`w (317) 844 -4839
t
ri RE
Jational PE0
I, THE UNDERSIGNED, HEREBY AGREE UNTIL SUCH TIME AS THIS ACCOUNT IS PAID IN FULL BY ME, THE SELLER SHALL RETAIN TITLE TO E GOODS HEREBY PURCHASED•AND SELLER SHALL HAVE
A SECURITY INTEREST IN SAID GOODS TO SECURE THE PAYMENT UNTIL MY ACCOUNT IS FULLY PAID. I FURTHER AGREE THAT IN THE EV T OF DEFAULT IN THE AYMENT OF�NY 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 CI-I GE EQUAL TO COh F COLLECTION INCLUDING
AGENCY AND ATTORNEY FEES AND COURT COSTS INCURRED AND PERMITTED BYLAWS GOVERNING THESE TRANSACTIONS. \'R \l /J J
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) RECEI BY
1
SOLD TO: CRRrEL PaucE FPT. 6000101 SHIP TOs;AME ICE# 126645
THREE CIVIC <SQUARE
CARMEL IN 4E..032
CUST. P:O. MAKE -MODEL ID# MILEAGE t3 TELEPH;ONE ROUTE SLM SHIP VIA ORDER PACE REMARKS
571 -250@ 5 NIA 128548 1.
INVOICE PREVIOUS SHIPPED
INVOICE BATE NUMBER INVOICE NUMBER TERMS
fippnpd by npqr
12/16/2009 126645 NET 10TH 12116/09 13:55:31 6
Y
STOCK NUMBER SIZE DESCRIPTION QUANTm UNIT T F.E.T. EXTENSION
ORDERS SHIPPED PREV SHIP, ..PRICE
SCRAP SCRAP TIRE ?5 25 2.50 .00 62.50
METHOD OF PAYMENT:_
CHARGE: 62.50
CHANGE: .00
5 1 H{
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Irani: you for your busines
PARTS LABOR TAX 62.50 AMOUNT TAX F.E.T. _AMO NT ,':PLEAS EINUQICE�TOT a _T t
62.50 y
"You're Riding On Our Reputation"
Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No. 201 (Rev. 1995)
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 Rangeline road Terms
Carmel, IN 46032 Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
12/16/09 126645 payment for scrap tires 62.50
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
Clark Tire IN SUM OF
622 C South Rangeline Road
Carmel, IN 46032
62.50
ON ACCOUNT OF APPROPRIATION FOR
p olice genera lfund
Board Members
Po# or INVOICE NO. ACCT #/TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
1110 126645 501 -01 62.50 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 17 20 09
Signature
Chief of POlice
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund
f
LARK 6220 S. Rangeline Road
"YOU ARE RIDING ON OUR REPUTATION" Carmel, IN 46032
4w (317) 844 -4839 IRE
Jational PENv I
1, THE UNDERSIGNED, HEREBY AGREE UNTIL SUCH TIME AS THIS ACCOUNT IS PAID IN FULL BY ME, THE SELLER SHALL RETAIN TITLE TO THE GOODS HEREBY PURCHASED AND SELLER SHALL HAVE
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 THESE 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) RECEIVE BY
SOLD TO: C#1RMEL WATER DISTRIBUTION 6300/01 SHIP TO -SAME INVOICE# 126635
760 3RD AVENUE Std
CARMEL iN.N41032
CLIST. P.O. MAKE -MODEL ID# MILEAGE TELEPHONE 'ROUTE SAM SHIP VIA ORDER PAGE REMARKS
TRUCK #26 #26 59932 716 -3939 0 1 N/A 128520 1
INVOICE DATE INVOICE PREVIOUS SHIPPED TERMS
NUMBER INVOICE NUMBER o pen ed Fu Operato a A
12/1512009 126636 NET 10TH 12/15109 16:26 :58 8
STOCK NUMBER SIZE DESCRIPTION DUANTITY T F.E.T. EXTENSION
O
RDER$ SHIPPED PRE UNIT Y. SHIP PRICE
AL2 EACH PASSENGER ,4 WHEEL ALIGNMENT 1 1 89.95 .00 89.95
--CELL 7#6-3939
METHOD OF PAYMENT:
CHARGE: 89.95
CHANGE: .00
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O
I11aH l 1 or r' S ries,; S' Em1. '1. ?Neff
PARTS LABOR TAX AMOUNT TAX F.E.T. anaourir PLEASEINUOICE TOTALJj
E �J
89.95 89.95
"You're Riding On Our Reputation"
r
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.
Payee
60700
CLARK TIRE INC CARMEL Purchase Order No.
622 C SOUTH RANGELINE RD Terms
CARMEL, IN 46032 Due Date 12/21/2009
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
12/21/200i 126636 $89.95
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
z X. .31; 5 C,--. anti
Date Officer
VOUCHER 093940 WARRANT ALLOWED
60700 IN SUM OF
CLARK TIRE INC CARMEL
622 C SOUTH RANGELINE RD.*
CARMEL, IN 46032
Carmel Water Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
126636 01- 6500 -04 $89.95
Voucher Total $89.95
Cost distribution ledger classification if
claim paid under vehicle highway fund