177614 09/29/2009 CITY OF CARMEL, INDIANA VENDOR: 060700 Page 1 of 1
ONE CIVIC SQUARE CLARK TIRE INC CHECK AMOUNT: $1,104.85
CARMEL, INDIANA 46032 622 C SOUTH RANGELINE RD
CARMEL IN 46032 CHECK NUMBER: 177614
CHECK DATE: 9/29/2009
DEPART ACCOUNT PO NU INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 125663 490.73 OTHER EXPENSES
601 5023990 125713 614.12 OTHER EXPENSES
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d
622C S. Rangeline Road
"YOU ARE RIDING ON OUR REPUTATION" LARK Carmel, IN 46032
4� (317) 844 -4839
IRE
_mational PEA I�
1, THE UNDERSIGNED, HEREBY AGREE UNTIL SUCII 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: SHIP TO:
CARMEL DATER DISTRIBUTION 300/01 SAFE INVOICE# 125713
760 3RD AVEIAK Std
CARMEL IN 46032
CUST. P.O. MAKE -MODEL ID# MILEAGE TELEPHONE ROUTE SLM SHIPVIA ORDER PACE' REMARKS
733 -2853
FORD #140 #140 26807 716 -3939 9 1 N/A 1263% 1
INVOICE DATE INVOICE PREVIOUS SHIPPED TERMS
NUMBER INVOICE NUMBER
Opened by Operator 7
O'?!18/2009 125713 NET 10TH 09118/09 05:22:04 8
STOCK NUMBER SIZE DESCRIPTION QUANTITY UNIT ORDERS SHIPPED PREV. SH PRICE T F.E.T. EXTENSION'
50503 235/70R16 COOPER DISCOVER HIT OWL (T) 4 4 135.78 02 .00 543.12
WBP EACH WHEEL. BALANCE PASSENGER 4 4 1 .00 48.00
STEM EACH VP.LVE STEM 4 4 2.50 02 .00 10.00
SCRAP SCRAP TIRE 4 4 3.00 .00 122.00
TF INDIANA TIRE FEE 4 4 225 .00 1.00
METHOD OF PAYMENT:
CHARGE: 614.12
[MANGE:
Th.3nk v t r uoiir bilcinac5 P 1 1 JiN
TAXAB PARTS LABOR TAX AMOUNT TAX F.E.T. AMOUNT INVOICE TOTAL
PLEASE .PAY THIS AMOUNT
614.12 614.12
"You're Riding On Our Reputation"
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 9/18/2009
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
9/18/2009 1.25713 $614.12
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
Date Officer
VOUCHER 093066 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,
I
Board members
PO INV ACCT AMOUNT Audit Trail Code
125713 01- 6500 -07 $614.12
C
Voucher Total $614.12
Cost distribution ledger classification if
claim paid under vehicle highway fund
Y
l 622C S. Rangeline Road
"YOU ARE RIDING ON OUR REPUTATION" LARK Carmel, IN 46032
4 RE (317) 844 -4839
I
�Jationai PEA
I, THE UNDERSIGNED, HEREBY AGREE UNTIL SUCH TIME AST[ HS 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) RE CE' I VE D BY
SOLD TO: SHIP TO:
CARMEL WASTEWATER (:110010t SAME INVOICE# 125663
9609 HAZELDELL PKW. 1
INDIANAPOLIS IN 46280 I
CUST. P.O. MAKE -MODEL ID# MILEAGE TELEPHONE ROUTE SLM SHIP VIA ORDER PACE REMARKS
TRUCK#80 #80 18406 571 -2634 0 1 N/A 126162 1
INVOICE DATE INVOICE PREVIOUS SHIPPED TERMS
NUMBER INVOICE NUMBER
Opened by Operator 8
09/14/2009 125663 NET 10TH 09/14!09 10:54:01 8
STOCK NUMBER SIZE DESCRIPTION D S H UNIT D PREY SHIP, PRICE
ORDERS SHIPPE T F.E.T. EXTENSION
571 -2645
OUTSIDE 9848334 1022.:, GDY 6164 1 1 430.25 02 25.23 455.48
TF INDIANA TIRE FEE 1 1 .25 .00 .25
TCH EACH LARGE TRUCK DISMiDIfI MOUNT 1 1 330.02 .00 30.00
SCRAP f SCRAP TIRE 1 1 5.00 .00 5.00
METHOD OF PAYMENT:
CHARGE: 490.73
CHANGE: .00
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Thank you for• your business Mech: Steven
PARTS LABOR TAX AMOUNT TAX F.E.T. A INVOICE TOTAL
PLEASE PAY THIS AMOUNT
465.50 25.23 490.73
"You're Riding On Our Reputation"
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
060700
CLARK TIRE CARMEL Purchase Order No.
622C S. Rangeline Road Terms
Carmel, IN 46032 Due Date 9/17/2009
Invoice Invoice Description Q
Date Number (or note attached invoice(s) or bill(s)) Amount
9/17/2009 125663 $490.73
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
Date Officer
VOUCHER 096413 WARRANT ALLOWED
060700 IN SUM OF
CLARK TIRE CARMEL
622C S. Rangeline Road
Carmel, IN 46032
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
J
PO INV ACCT AMOUNT Audit Trail Code
125663 01- 7500 -02 $490.73
Voucher Total $490.73
Cost distribution ledger classification if
claim paid under vehicle highway fund