169858 03/18/2009 CITY OF CARMEL, INDIANA VENDOR: 060700 Page 1 of 1
0 ONE CIVIC SQUARE CLARK TIRE INC
CARMEL, INDIANA 46032 622 C SOUTH RANGELINE RD CHECK AMOUNT: $47.50
CARMEL IN 46032 CHECK NUMBER: 169858
CHECK DATE: 3/1812009
DEPARTMENT ACCO PO NUMBER INVOICE NUMBER AM OUNT DESCRIP
1110 4350101 123499 47.50 TRASH COLLECTION
I G
9
3 622C S R. geiiiie Road
"YO&ARE RIDING ON OUR REPUTATION LARK.. Carmel,.IN 46032
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I, 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 EVEN` OF DEFAUL T,YE PAYMENT OF ANY AMOUNT DUE, AND
It, THIS ACCOUNT IS PLACED IN THE HANDS OF AN AGENCY OR ATTORNEY FOR COLLECTION OR LEGAL ACTION TO PAY AN ADDITIONAL CHARGE EQU,4E ET THE COST OF COLLECTION INCLUDING
AGENCY AND ATTORNEY FEES AND COURT COSTS INCURRED AND PERMITTED BYLAWS 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) RECEIVED B�'
SOLD TO: SHIP TO
CARREL POLICE DEPT. 64 0!€11 SAVE IN9 123499
THREE CIVIC SQUARE
CARMEL IN 46032
CUST RO. MAKE -MODEL ID# MILEAGE TELEPHONE ROUTE SUM SHIP VIA ORDER PAGE' REMARKS
571 -2500 0 5 NIA 121650 1
INVOICE DATE INVOICE PREVIOUS SHIPPED TERMS
NUMBER INVOICE NUMBER
Opened by Operator 8
03/0912009 123499 NET 10TH 03109109 12:15:27 7
STOCK NUMBER SIZE DESCRIPTION ORDERS SHIPPE SHIPPE D PREV. SHIP UNIT PRICE T F.E. EXTENSION
SCRAP SCRAP TIRE 19 19 2.50 .00 47.50
14£THOD OF PAYMENT:
CHARGE: 47.50
CM46E: .00
Thank you fo your business
PARTS LABOR TAX TAXABLE TAX F.E.T. misc. INVOICE TOTAL
AMOUNT AMOUNT
M •t F._
47.50 47.50
"You're Riding On Our Reputation"
Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No. 201 (Rev. 1995)
y
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 Rangeline Road Terms
Carmel, IN 46c,032 Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
319109 123499 a ment for scrap tires 47.50
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.
;f ALLOWED 20
Clar Tire
IN SUM OF
622 S. Rangeline Road
Carmel, IN 46032
47.50
ON ACCOUNT OF APPROPRIATION FOR
police general fund
Board Members
PO# or INVOICE NO. ACCT #/TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
1110 123499 501 -01 47.50 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
March 12 20 09
O ignature
Assistant Chief of Polic
Cost distribution ledger classification if
Title
claim paid motor vehicle highway fund