207143 03/13/2012 CITY OF CARMEL, INDIANA VENDOR: 182450 Page 1 of 1
ONE CIVIC SQUARE LEBANON TIRE AUTO SVC
CARMEL, INDIANA 46032 1310 W SOUTH ST CHECK AMOUNT: $1,049.68
ho„ c
LEBANON IN 46052 CHECK NUMBER: 207143
CHECK DATE: 3/13/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4351000 L0059K 1,049.68 AUTO REPAIR MAINTEN
LEBANON TIRE AUTO SERVICE
1310 W. SOUTH STREET
LEBANON, IN 46052
Store Location Store Phn Date Time
R T Tire /Auto LEB (765) 482 -5027 02/06/12 01:08 PM Reprint
1310 W. SOUTH STREET Page 1
LEBANON, IN 46052
Your P/0 A/R Acct# Terms Ship Via
Inv: L0059K L00259 1 ST 10TH
Sold -To: Ship -To: Type Payment
CARMEL FIRE DEPT
2 CIVIC SQUARE
CARMEL, IN 46032
Total 0.00` Y
REP 317 664 -0958
317 571 -2615
!R! SCU;UNIT C;BOX 21,.59,B;RPU;EXIT;
Qty Shp B/0 Item Number Description S/W FET Price Amount Init's
2 2 GY756256420 315/80R225 L 0291 LP T 447.34 894.68 222
dot# MJ725VAW4511, MJ725VAW4511
1 1 046120000 ROAD SERVICE PER HR /PER MAN (R 85.00 85.00 222,217
2 2 046100000 MT- DISMOUNT 25.00 50.00 222,217
2 2 093002000 TIRE DISPOSAL 10.00 20.00 222,217
1 1 046100000 GS00001644 STATE OF INDIANA GO 0.00 0.00 222,217
V /Info: 2000 FIRE ENGINE E45
Lic# E45 IN Unt# E45 Mil: 5971
Sub -Total
$1049.68
IN GOV'T,0.000%
$0.00
Total: $1049.68
NewPymt: $0.00
Total Due: $1049.68
Received By: SP:JEFF HOGG
VOUCHER NO. WARRANT NO.
Lebanon Tire ALLOWED 20
IN SUM OF
1310 West South Street
Lebanon, IN 46052
$1,049.68
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO# Dept. INVOICE NO. I ACCT /TITLE I AMOUNT Board Members
1120 I L0059K I 43- 510.00 j $1,049.68 I hereby certify that the attached invoice(s), or
l 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
MAR 12 2012
Fire Chief
Title
Cost distribution ledger classification if
claim paid motor 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 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
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
L0059 K E45 $1,049.68
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