177151 09/15/2009 CITY OF CARMEL, INDIANA VENDOR: 060700 Page 1 of 1
ONE CIVIC SQUARE CLARK TIRE INC CHECK AMOUNT: $14.50
CARMEL, INDIANA 46032 622 C SOUTH RANGELINE RD
CARMEL IN 46032 CHECK NUMBER: 177151
CHECK DATE: 9/15/2009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1125 4232100 125450 14.50 GARAGE MOTOR SUPPIE
=622C S. Rangeline Road
"YOU ARE RIDING ON OUR REPUTATION C RK Carmel, IN 46032
(317) 844 =:4839
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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
7uSECURITY 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.
finance charge of 13/4 Per Month will be charged on all Accounts 30 days Past Due. Annual Percentage Rate is 21%. (Minimum 75) !RECEIVED BY
SOLD TO: CARMEL CLAY PARKS AND REC f1350 /01 SHIP TO SAfi1E INVOICE# 125450
1411 E. 116TH STREET
CARMEL IN 45032
CLIST. P.O. MAKE -MODEL ID# MILEAGE JELEPH.ONE ROUTE' SUM" SHIP VIA ORDER PAGE REMARKS
22473 (317 )571 -4135 0 1 N/A 125724 1
INVOICE DATE INVOICE PREVIOUS SHIPPED TERMS
NUMBER INVOICE NUMBER
08124/200`�� 125450 NET 10T open r
I H 08l24/0S 07:57:08 7
STOCK NUMBERS SIZE DESCRIPTION QUANTITY UNIT T F.E.T. EXTENSION
ORDERS SHIPPED PREV. SHIP PRICE
13 13115" DISMOUNT 3 MOUNT PASSENGER 1 1 12.00 .00 122.00
STEM EACH VALVE STEM 1; 1 2.50 02 .00 2
METHOD OF PAYMENT.:
CHARGE: 14.50
CHANGE: .00
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AUG 2 7 2009
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Line Deser
?urchaser
aPProval nom.. y
Thank you for your business hecti: Jia Blood
PARTS LABOR TAX AMOUNT MISC.
TAX F.E.T. AMOUNT IN OICE TOTAL
14.50 d 14,50yV
"You're Riding On Our Reputation"
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice of 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
060700 Clark Tire
622C S Rangeline Rd
Carmel, IN 46032
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
8/24/09 125450 Flat tire repair
22473 F 14.50
Total 14.50
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
M
Voucher No. Warrant No.
060700 Clark Tire Allowed 20
622C S Rangeline Rd
Carmel, IN 46032
In Sum of
14.50
ON ACCOUNT OF APPROPRIATION FOR
101 General Fund
PO# or INVOICE NO. ACCT #[TITLE AMOUNT Board Members
Dept
1125 125450 4232100 14.50 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
10 -Sep 2009
Signature
14.50 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund