168096 01/21/2009 CITY OF CARMEL, INDIANA VENDOR 182450 Page 1 of 1
0 ONE CIVIC SQUARE LEBANON TIRE AUTO SVC CHECK AMOUNT: $156.05
CARMEL, INDIANA 46032 1310 W SOUTH ST
LEBANON IN 46052 CHECK NUMBER: 168096
CHECK DATE: 1/21/2009
DEPARTMENT ACCOUNT:.:. PO NUMBER IN VOICE NUMBER AMOUNT DESCRIPTION
651 5023990 111044 156.05 OTHER EXPENSES
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L E BA N ON T I R E AUTO S V C
1310 W SOUTH STREET
LEBANON, IN 46052 EA Q
(765) 482 -5027 0000i/
FEDERAL TAX ID# 351145753
Ll 0 7 044 11 :11 O A� B yI 07:35 AM
TERR: 7798
PAGE: 01 COPY: 01 NONSIG: 173531
BILL TO: CITY OF CARMEL (E05)
1 CIVIC SQUARE
CARMEL, IN 46032
PHONE 1....... (317)571 -2634 VEH YEAR /MAKE.
PHONE 2....... (317)710 -2321 VEHICLE MODEL.
DATE REQUESTED 12/19/08 VEHICLE COLOR.
TIME REQUESTED LICENSE /STATE.
RETURN PARTS.. NO ODOMETR IN /OUT NA
SALESMAN...... 002 002 PRIOR INVOICE. 110205
P O NUMBER.... FAUCETT
ACCOUNT COB TC CUST# TYPE /STATE
779800168 4 01 00168 3 IN
SLSM TECH PRODUCT CODE BC QTY DESCRIPTION PARTS LBR /EXCISE LINE TOTAL
002 002 046 -120 R 1 ROAD SERVICE PER HR /PER MAN (REG TIME) .00 75.00 75.00
002 002 046 -100 R 1 REPAIR PAY LOADER TIRE .00 68.50 68.50
002 002 046 -100 R 1 317 571 -2634 96TH HAZELDALE .00 .00 .00
002 002 046 -200 R 1 O /RING LOADER 12.55 .00 12.55
REMEMBER TO SERVICE YOUR TRANSMISSION EVERY 15000 TO 30000 MILES! WE THANK YOU FOR YOUR BUSINESS WITH US.
PARTS TOTAL........ 12.55
LABOR TOTAL........ 143.50
CHARGED AMOUNT 156.05 SUB TOTAL.......... 156.05
X TAXABLE AMOUNT .00 SALES TAX.......... .00
CUSTOMER AUTHORIZATION FOR TOTAL N V O C E T O TA L '1 5 6 0 5
BUYING PLAN... A OF PAYMENTS. 1 PAY START DATE 01/10/09 DISCOUNT...... *NET*
S E E REVERS E S Y 0 E F O R M P O RTA N T S A F E TY
WARN=NG ANO WARRANTY INFOF2MAT=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
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
182450
LEBANON TIRE AUTO SVC Purchase Order No. E
1310 W SOUTH ST Terms
LEBANON, IN 46052 Due Date 12/29/2008
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
12/29/2001 111044 $156.05
)t
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 087039 WARRANT ALLOWED
182450 IN SUM OF
LEBANON TIRE AUTO SVC
1310 W SOUTH ST
LEBANON, IN 46052
Carmel Wastewater Utility
N ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
111044 01- 7502 -06 $156.05
Voucher Total $156.05
Cost distribution ledger classification if
claim pWRV7y fund