HomeMy WebLinkAbout206833 02/28/2012 CITY OF CARMEL, INDIANA VENDOR: 366044 Page 1 of 1
ONE CIVIC SQUARE TIRE CENTRAL FISHERS INC
O CHECK AMOUNT: $1,236.88
CARMEL, INDIANA 46032 7285E 116TH ST
FISHERS IL 46038 CHECK NUMBER: 206833
CHECK DATE: 2/2812012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 182046 252.40 OTHER EXPENSES
651 5023990 182047 380.80 OTHER EXPENSES
651 5023990 182048 553.68 OTHER EXPENSES
651 5023990 182049 50.00 OTHER EXPENSES
T I R E C E N T R AL F I S H E R S a N C_
OWNED AND OPERATED BY A PROUD GOODYEAR INDEPENDENT DEALER w-
7285 EAST 116TH STS'
FISHERS, IN 46038
(317)577 -0111 FOODrYY
I NWCO Z C E 01/27/12 01/27/12 (�)-DlT1VL 'aP
8Z ®49 02:37 PM 02:37 PM KELLYIIgTIRES
TERR: 5625
PAGE: 01 COPY: 01 NONSIG: 905625
BILL TO: CARMEL WASTE WATER TREATMENT
760 THIRD AVE SW
SUITE 110
CARMEL, IN 46032
PHONE 1....... (317)716 -3905 EXT. VEH YEAR /MAKE. 01 CHEVY TRUCK
PHONE 2....... VEHICLE MODEL. SILVERADO 250OHD 3/4
DATE REQUESTED 01/27/12 VEHICLE COLOR.
TIME REQUESTED LICENSE /STATE.
RETURN PARTS.. NO ODOMETR IN /OUT 012712 012712
SALESMAN...... 012 012 VEHICLE INFO.. UNIT #65
PRIOR INVOICE. 182048 P 0 NUMBER.... 512972
ACCOUNT COB TC CUST# TYPE /STATE
562502567 1 01 02567 1 IN
SLSM TECH PRODUCT CODE BC QTY DESCRIPTION PARTS LBR /EXCISE LINE TOTAL
012 067 007 044 -263 R 4 WHEEL BALANCE COMPUTER SPIN 1.50 7.00 34.00
012 067 007 047 -200 R 4 TR600 SNAP IN HIGH PRESSURE VALVE STEMS 2.50 .00 10.00
012 012 040 -223 R 4 TIRE DISPOSAL CHARGE 1.50 .00 6.00
012 012 047 -100 R 1 PO#S12972 .00 .00 .00
012 012 047 -100 R 1 INV FOR INSTALLING NEW TIRES REF #182048 .00 .00 .00
VISIT OUR WEB SITE: WWW.TIRECENTRALANDSERVICE.COM FOR GREAT DEALS COUPONS AND /OR ADD US ON FACEBOOK
COME IN AND MEET YOUR NEW MANAGEMENT TEAM, ERIK BURGESS AND TONY NOLTE
WE ARE VERY HAPPY TO HAVE SERVED YOU AND WOULD LIKE TO THANK YOU ONCE AGAIN FOR YOUR BUSINESS.....
Fin
FEB 0 3 2012
sy
PARTS TOTAL........ 22.00
LABOR TOTAL........ 28.00
CHARGED AMOUNT 50.00 SUB TOTAL.......... 50.00
X-- TAXABLE AMOUNT 00 SALES TAX.......... .00
CUSTOMER AUTHORIZATION FOR TOTAL I N V O I C E T O F A L !S S O_ OO
BUYING PLAN... A OF PAYMENTS. 1 PAY START DATE 03/10/12 DISCOUNT...... *NET*
SEE FZEVERSE S =DE FOR =MPOF2TANT SAFETY
WAFZN I NG AND WARRANTY X N F OFZMAT Z ON
HAVE A QUESTION OR PROBLEM?
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
T I R E C E N TR AL F a S H E R S I N C
OWNED AND OPERATED BY A PROUD GOODYEAR INDEPENDENT DEALER
7285 'EAST 116TH ST'
nww
FISHERS, IN 46038'
(317) 577 -0111 G00J#fVEAA
I NN/O I C E 01/27/12 01/27/12 ��lIJiTLOP u
1 1 8 048 02:29 PM 02 :35 PM KELLYNgflRS 3
5625 027737 182048 TERR: 5625
PAGE: 01 COPY: 01 NONSIG: 905625
BILL TO: CARMEL WASTE WATER TREATMENT
760 THIRD AVE SW
SUITE 110
CARMEL, IN 46032
PHONE 1....... (317)716 -3905 EXT. VEH YEAR /MAKE. 01 CHEVY TRUCK
PHONE 2....... VEHICLE MODEL. SILVERADO 250OHD 3/4
DATE REQUESTED 01/27/12 VEHICLE COLOR.
TIME REQUESTED LICENSE /STATE.
RETURN PARTS.. NO ODOMETR IN /OUT 012712 012712
SALESMAN...... 012 012 GS /AN NUMBER G0001644
VEHICLE INFO.. UNIT#65 PRIOR INVOICE. 182047
P 0 NUMBER.... 512972
ACCOUNT COB TC CUST# TYPE /STATE
562502567 1 01 02567 1 IN
SLSM TECH PRODUCT CODE BC QTY DESCRIPTION PARTS LBR /EXCISE LINE TOTAL
006 312 -249 -027 -0 G 4 LT245/75R16 120/1164 E WRL DURATRAC OWL 138.42 .00 553.68
006 012 047 -100 R 1 UNIT #65 .00 .00 .00
VISIT OUR WEB SITE: WWW.TIRECENTRALANDSERVICE.COM FOR GREAT DEALS COUPONS AND /OR ADD US ON FACEBOOK
COME IN AND MEET YOUR NEW MANAGEMENT TEAM, ERIK BURGESS AND TONY NOLTE
WE ARE VERY HAPPY TO HAVE SERVED YOU AND WOULD LIKE TO THANK YOU ONCE AGAIN FOR YOUR BUSINESS.....
F50 0 a 211$
P 3M
PARTS TOTAL........ 553.68
LABOR TOTAL........ .00
CHARGED AMOUNT 553.68 SUB TOTAL.......... 553.68
X--------------------------- TAXABLE AMOUNT .00 SALES TAX.......... .00
CUSTOMER AUTHORIZATION FOR TOTAL Y N 1/ D I C E T O T A L 5 S:3 68
TREAD L /F..... 14/32 TREAD R %F...., 14/32 TREAD R /R..... 14/32 TREAD L /R..... 14/32
BUYING PLAN... A OF PAYMENTS. I PAY START DATE'03 /10/12 DISCOUNT...... *NET*
SEE REVERSE f S=DE FO T I MPORTANT SAFETY
W^RA N Z NC& AN D W AST 17R IDN RdBLEM1= N F OFZMAT Z ON
Please tell our store manager. We value your opinion as much as your
l„ Gusiness. Should you need additional assistance, call our
1C,USTOMER ASSISTANCE LINE 1- 800 -321 -2136
x I 'I
TARE CENTRAL F aSHEFZS INC
OWNED AND OPERATED BY A PROUD GOODYEAR INDEPENDENT DEALER 7
7285 EAST 116TH ST
FISHERS, IN 46038
(317)577-0111 GOOD YiEASP
I NV ®I C E 01/27/12 01/27/12 0. "zTjw Z ap
7 SZC) 4- 6 02:20 PM 02:20 PM KEL Y1qr1REs
TERR: 5625
PAGE: 01 NONSIG: 905625
BILL TO: CARMEL WASTE WATER TREATMENT
760 THIRD AVE SW
SUITE 110
CARMEL, IN 46032
PHONE 1....... (317)716 -3905 EXT. VEH YEAR /MAKE.
PHONE 2....... VEHICLE MODEL.
DATE REQUESTED 01/27/12 VEHICLE COLOR.
TIME REQUESTED LICENSE /STATE.
RETURN PARTS.. NO ODOMETR IN /OUT f NA
SALESMAN...... 012 012 PRIOR INVOICE. 180285
P O NUMBER.... S12972
ACCOUNT COB TC CUST# TYPE /STATE
562502567 1 01 02567 1 IN
SLSM TECH PRODUCT CODE BC QTY DESCRIPTION PARTS LBR /EXCISE LINE TOTAL
012 012 047 -100 R 1 ATTN JEFF COOPER PO#S12972 .00 .00 .00
012 347 000 -050 -0 R 2 600 -9 lOPLY BKTPL801 IND LUG TUBE TYPE 82.70 .00 165.40
347 007 -500 -0
012 347 000 -010 -0 R 2 600 /6.96R9 RADIAL TUBE TR -87 15.00 .00 30.00
347 000 -100 -0
012 347- 000 -010 -0 R 2 6.7X9 RADIAL FLAP 10.00 .00 20.00
347 005 -000 -0
012 347 000 -010 -0 R 2 MOUNTS AND DISMOUNTS AT OUR LOCATION 15.00 .00 30.00
347 -006 -000 -0
012 012 040 -223 R 2 TIRE DISPOSAL CHARGE 3.50 .00 7.00
VISIT OUR WEB SITE: WWW.TIRECENTRALANDSERVICE.COM FOR GREAT DEALS COUPONS AND /OR ADD US ON FACEBOOK
COME IN AND MEET YOUR NEW MANAGEMENT TEAM, ERIK BURGESS AND TONY NOLTE
WE ARE VERY HAPPY TO HAVE SERVED YOU AND WOULD LIKE TO THANK YOU ONCE AGAIN FOR YOUR BUSINESS.....
Q
FEB 0 3 2012
PARTS TOTAL........ 252.40
LABOR TOTAL........ .00
CHARGED AMOUNT 252.40 SUB TOTAL.......... 252.40
X TAXABLE AMOUNT .00 SALES TAX.......... .00
CUSTOMER AUTHORIZATION FOR TOTAL I "N/0' 11 C E TOTAL !S 2 S Z 4O
BUYING'PLAN... A OF PAYMENTS. 1 PAY START DATE 03/10/12 DISCOUNT...... *NET*
S E E R Ei/E R S E S I D E F O R I MPORTANT S A F E T Y
WAFZN Z NG AN D WARRANTY 2 N F ORMAT" Y ON
HAVE A QUESTION OR PROBLEM?
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
SAFETY WARNING
SERIOUS INJURY MAY RESULT FROM:
Tire failure due to under inflation 1 overloading follow owner's manual or tire placard in vehicle.
Explosion of tire rim assembly due to improper mounting only specially trained persons should mount tires.
All custom wheel lug nuts must be retorqued after 25 miles and checked periodically.
TIRE SERVICE NETWORK NATIONWIDE LIMITED WARRANTY
These limited warranties apply only to parts and labor
shown on your invoice there may be other components in a system that are not covered.
AIR CONDITIONING SERVICES EXHAUST COMPONENTS (EXCLUDING MUFFLER)
COOLING SYSTEM SERVICES STEERING AND SUSPENSION PARTS (EXCLUDING DRIVE TRAIN
Parts: 12 months or 12,000 miles, whichever comes first. COMPONENTS)
Labor: 12 months or 12,000 miles, whichever comes first. Parts: 12 months or 12,000 miles, whichever comes first.
Labor: 12 months or 12,000 miles, whichever comes first.
ALIGNMENT
Parts: 6 months or 6,000 miles, whichever comes first. MACPHERSON STRUTS CARTRIDGES, SHOCKS AND ASSEMBLIES
Labor 6 months or 6,000 miles, whichever comes first. Standard Limited Warranty on Parts: 12 months or 12,000 miles, whichever
NOTE: Steering or suspension parts installed after the alignment voids comes first.
the limited warranty. *Lifetime Limited Warranty on Parts: lifetime to the original purchaser.
Labor: 12 months or 12,000 miles, whichever comes first.
ENGINE TUNE -UP
Parts: 12 months or 12,000 miles, whichever comes first. MUFFLER
Labor: 12 months or 12,000 miles, whichever comes first. Standard Limited Warranty on Parts: 12 months or 12,000 miles, whichever
comes first.
BELTS AND HOSES (COOLING SYSTEM) *Lifetime Limited Warranty on Parts: lifetime to the original purchaser.
Parts: Lifetime, to the original purchaser. Labor: 12 months or 12,000 miles, whichever comes first.
Labor: 12 months or 12,000 miles, whichever comes first.
LIFETIME TIRE ROTATION
FRONT BRAKE SPECIAL 2 WHEEL DISC Lifetime Tire Rotation on new tire purchases of Goodyear, Dunlop, Kelly
Parts: 6 months or 6,000 miles, whichever comes first. product.
Labor: 6 months or 6,000 miles, whichever comes first. Good for the life of the usable tire tread (2/32
Present this folder at any Tire Service Network location for a free tire rotation
BRAKE SERVICES (EXCLUDING FRONT BRAKE SPECIAL every 6 months or 6,000 miles.
OVERHAUL) (Vehicles requiring mounting or dismounting of tires to perform rotation
Parts: 12 months or 12,000 miles, whichever comes first. excluded.)
Labor: 12 months or 12,000 miles, whichever comes first.
WHEEL BALANCE
BRAKE OVERHAUL (BRAKE SHOES AND /OR DISC PADS Standard Limited Warranty: 12 months or 12,000 miles, whichever comes first.
WARRANTED LIFETIME) *Lifetime Limited Warranty: Good for the life of the usable tire tread (2/32
Parts: 24 months or 24,000 miles, whichever comes first. balanced.
Labor: 24 months or 24,000 miles, whichever comes first.
Brake Overhaul: Disc and /or drum performed as a package includes: TPMS reset procedure not included in lifetime limited warranty.
Disc disc pads, resurface rotors, rebuild or replace hydraulic
calipers, grease seals (if equipped), associated hardware. *Lifetime Limited Warranty available on these parts. See your Sales
Drum brake shoes, resurface drums; new wheel cylinders, grease Representative for complete details. 'Lifetime Limited Warranty" must be listed
seals (if equipped), associated hardware. Any and all other brake service on invoice.
or repair is covered under the "Brake Service" warranty.
"ALL PARTS ARE NEW UNLESS OTHERWISE DESIGNATED. AUTOMOTIVE REPAIRS AND PARTS, EXCLUDING TIRES,
ARE WARRANTED FOR A MINIMUM OF 12 MONTHS OR 12,000 MILES. FOR COMPLETE WARRANTY DETAILS, SEE THE
SPECIFIC WARRANTY FOR TIRES AND THE SPECIFIC WARRANTY FOR AUTOMOTIVE REPAIRS AND PARTS."
WHO MAKES THIS WARRANTY
This limited warranty is made and will be serviced by the Tire Service Network provider who performed the repairs identified on the face of your repair invoice.
This limited warranty will also be honored by any participating Tire Service Network outlet nationwide if you require warranty service 25 or more miles from the
location where the warranted original service was performed.
This limited warranty extends only to you, the original purchaser, and the motor vehicle identified on the original repair invoice. It applies only during the warranty
periods stated above.
Warranty authorization must be obtained from the Warranty Administrator prior to any warranty repair being performed. Phone 1- 800 426 -0733.
Warranty repair costs are covered up to the cost of the original repair.
This limited warranty does not apply to vehicles used commercially.
Not all Network providers are owned and operated by Goodyear. Ask provider for details.
*Not all services are provided by all Tire Service Network locations.
TIRE CIENTReQ►IL FISH -QERS =NC
OWNED AND OPERATED BY A PROUD GOODYEAR INDEPENDENT DEALER
7285 EAST 116TH ST
FISHERS, IN 46038
(317) 577 -0111 GOODrYEAR
NVO I C E 01/27/12 01/27/12
82047 02:23 PM 02 :23 PM KELLYNgTIRES
TERR: 5625
PAGE: 01 NONSIG: 905625
BILL TO: CARMEL WASTE WATER TREATMENT
760 THIRD AVE SW
SUITE 110
CARMEL, IN 46032
PHONE 1....... (317)716 -3905 EXT. VEH YEAR /MAKE.
PHONE 2....... VEHICLE MODEL.
DATE REQUESTED 01/27/12 VEHICLE COLOR.
TIME REQUESTED LICENSE /STATE.
RETURN PARTS.. NO ODOMETR IN /OUT NA
SALESMAN...... 012 012 PRIOR INVOICE. 182046
P O NUMBER.... 512972
ACCOUNT COB TC CUST# TYPE /STATE
562502567 1 01 02567 1 IN
SLSM TECH PRODUCT CODE BC QTY DESCRIPTION PARTS LBR /EXCISE LINE TOTAL
012 012 047 -100 R 1 ATTN JEFF COOPER PO #512972 .00 .00 .00
012 347 000 -120 -0 R 2 7.00 -12 12PLY CARLISLE IND DEEP TRAC TT 152.00 .00 304.00
347 000 -210 -0
012 347 -000 -010 -0 R 2 7.00R12 RADIAL TUBE TR -440 19.90 .00 39.80
347 -000 -100 -0
012 012 047 -100 R 1 NOTE RADIAL FLAPS INCLUDED IN TIRE PRICE .00 .00 .00
012 347 000 -010 -0 R 2 MOUNTS AND DISMOUNTS OUR LOCATION 15.00 .00 30.00
347 006 -000 -0
012 012 040 -223 R 2 TIRE DISPOSAL CHARGE 3.50 .00 7.00
VISIT OUR WEB SITE: WWW.TIRECENTRALANDSERVICE.COM FOR GREAT DEALS COUPONS AND /OR ADD US ON FACEBOOK
COME IN AND MEET YOUR NEW MANAGEMENT TEAM, ERIK BURGESS AND TONY NOLTE
WE ARE VERY HAPPY TO HAVE SERVED YOU AND WOULD LIKE TO THANK YOU ONCE AGAIN FOR YOUR BUSINESS.....
FEB 0 3 2012
PARTS TOTAL........ 380.80
LABOR TOTAL........ .00
CHARGED AMOUNT 380.80 SUB TOTAL.......... 380.80
X- TAXABLE AMOUNT .00 SALES TAX. .00
CUSTOMER AUTHORIZATION FOR TOTAL I N VO I C E T C► T A L. 3�0 80
BUYING PLAN... A OF PAYMENTS. 1 PAY START DATE 03110112 DISCOUNT...... *NET*
S E E R EVE R S E S I D E F OR I MPOR TANT SA F E TY
WAR N= N G AN D WARRANTY N F oR MAT I O N
HAVE A QUESTION OR PROBLEM?
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
SAFETY WARNING
SERIOUS INJURY MAY RESULT FROM:
Tire failure due to under inflation overloading follow owner's manual or tire placard in vehicle.
Explosion of tire rim assembly due to improper mounting only specially trained persons should mount tires.
All custom wheel lug nuts must be retorqued after 25 miles and checked periodically.
TIRE SERVICE NETWORK NATIONWIDE LIMITED WARRANTY
These limited warranties apply only to parts and labor
shown on your invoice— there may be other components in a system that are not covered.
AIR CONDITIONING SERVICES EXHAUST COMPONENTS (EXCLUDING MUFFLER)
COOLING SYSTEM SERVICES STEERING AND SUSPENSION PARTS (EXCLUDING DRIVE TRAIN
Parts: 12 months or 12,000 miles, whichever comes first, COMPONENTS)
Labor: 12 months or 12,000 miles, whichever comes first. Parts: 12 months or 12,000 miles, whichever comes first,
Labor: 12 months or 12,000 miles, whichever comes first.
ALIGNMENT
Parts: 6 months or 6,000 miles, whichever comes first. MACPHERSON STRUTS CARTRIDGES, SHOCKS AND ASSEMBLIES
Labor: 6 months or 6,000 miles, whichever comes first. Standard Limited Warranty on Parts: 12 months or 12,000 miles, whichever
NOTE: Steering or suspension parts installed after the alignment voids comes first.
the limited warranty, *Lifetime Limited Warranty on Parts: lifetime to the original purchaser.
Labor: 12 months or 12,000 miles, whichever comes first,
ENGINE TUNE -UP
Parts: 12 months or 12,000 miles, whichever comes first. MUFFLER
Labor 12 months or 12,000 miles, whichever comes first. Standard Limited Warranty on Parts: 12 months or 12,000 miles, whichever
comes first.
BELTS AND HOSES (COOLING SYSTEM) *Lifetime Limited Warranty on Parts: lifetime to the original purchaser.
Parts: Lifetime, to the original purchaser. Labor: 12 months or 12,000 miles, whichever comes first.
Labor: 12 months or 12,000 miles, whichever comes first.
LIFETIME TIRE ROTATION
FRONT BRAKE SPECIAL 2 WHEEL DISC Lifetime Tire Rotation on new tire purchases of Goodyear, Dunlop, Kelly
Parts: 6 months or 6,000 miles, whichever comes first. product.
Labor: 6 months or 6,000 miles, whichever comes first. Good for the life of the usable tire tread (2132
Present this folder at any Tire Service Network location for a free tire rotation
BRAKE SERVICES (EXCLUDING FRONT BRAKE SPECIAL every 6 months or 6,000 miles.
OVERHAUL) (Vehicles requiring mounting or dismounting of tires to perform rotation
Parts: 12 months or 12,000 miles, whichever comes first. excluded.)
Labor: 12 months or 12,000 miles, whichever comes first.
WHEEL BALANCE
BRAKE OVERHAUL (BRAKE SHOES AND /OR DISC PADS Standard Limited Warranty: 12 months or 12,000 miles, whichever comes first.
WARRANTED LIFETIME) *Lifetime Limited Warranty: Good for the life of the usable tire tread (2132
Parts: 24 months or 24,000 miles, whichever comes first. balanced.
Labor: 24 months or 24,000 miles, whichever comes first.
Brake Overhaul: Disc and/or drum performed as a package includes: TPMS reset procedure not included in lifetime limited warranty.
Disc disc pads, resurface rotors, rebuild or replace hydraulic
calipers, grease seals (if equipped), associated hardware. *Lifetime Limited Warranty available on these parts. See your Sales
Drum brake shoes, resurface drums; new wheel cylinders, grease Representative for complete details. "Lifetime Limited Warranty' must be listed
seals (if equipped), associated hardware. Any and all other brake service on invoice.
or repair is covered under the `Brake Service" warranty.
"ALL PARTS ARE NEW UNLESS OTHERWISE DESIGNATED. AUTOMOTIVE REPAIRS AND PARTS, EXCLUDING TIRES,
ARE WARRANTED FOR A MINIMUM OF 12 MONTHS OR 12,000 MILES, FOR COMPLETE WARRANTY DETAILS, SEE THE
SPECIFIC WARRANTY FOR TIRES AND THE SPECIFIC WARRANTY FOR AUTOMOTIVE REPAIRS AND PARTS."
WHO MAKES THIS WARRANTY
This limited warranty is made and will be serviced by the Tire Service Network provider who performed the repairs identified on the face of your repair invoice.
This limited warranty will also be honored by any participating Tire Service Network outlet nationwide if you require warranty service 25 or more miles from the
location where the warranted original service was performed.
This limited warranty extends only to you, the original purchaser, and the motor vehicle identified on the original repair invoice. It applies only during the warranty
periods stated above.
Warranty authorization must be obtained from the Warranty Administrator prior to any warranty repair being performed. Phone 1- 800 -426 -0733.
Warranty repair costs are covered up to the cost of the original repair.
This limited warranty does not apply to vehicles used commercially.
Not all Network providers are owned and operated by Goodyear. Ask provider for details.
*Not all services are provided by all Tire Service Network locations.
VOUCHER 116875 WARRANT ALLOWED
366044 IN SUM OF
TIRE CENTRAL FISHERS INC
7285 EAST 116TH ST
FISHERS, IN 46038
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
182047 01- 7502 -06 $380.80
j c6��� rr 252 -y�
�VwA rr 0. CO
Voucher Total 8�
Cost distribution ledger classification if
claim paid under 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 of service rendered, by whom, rates per day, number of units,
price per unit, etc.
Payee
366044
TIRE CENTRAL FISHERS INC Purchase Order No.
7285 EAST 116TH ST Terms
FISHERS, IN 46038 Due Date 2/23/2012
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
2/23/2012 182047 $380.80
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 e&
Date �O icer