207416 03/26/2012 CITY OF CARMEL, INDIANA VENDOR: 060700 Page 1 of 1
ONE CIVIC SQUARE CLARK TIRE INC
CARMEL, INDIANA 46032 622 C SOUTH RANGELINE RD CHECK AMOUNT: $89.95
CARMEL IN 46032 CHECK NUMBER: 207416
CHECK DATE: 3/26/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
601 5023990 134721 89.95 TRANS EXPENSES -CUST A
LARK 622C S. Rangeline Road
"YOU ARE RIDING ON OUR REPUTATION" Carmel, IN 46032
4w (317) 844 -4839
ri RE
mational PE,:°I`
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
A SECURITY INTEREST IN SAID GOODS TO SECURE THE PAYMENT UNTIL MY ACCOUNT IS FULLY PAID. 1 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 ZCOL INCLUDING
AGENCY AND ATTORNEY FEES AND COURT COSTS INCURRED AND PERMITTED BY LAWS GOVERNING THESE TRANSACTIONS. JAj
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 BY j
O IV
SOLD TO: SHIP TO: b
CARi4EL UTILITIES 6100/01 SAME INUt7ICE'tt' 134721
761 3RD AVE SIB!
CARMEL IN 46032
CUST. P.O. MAKE -MODEL ID# MILEAGE TELEPHONE ROUTE SLM SHIP VIA ORDER PAGE REMARKS
139 9053 (317)571 -2634 0 1 N!A 146539 1
INVOICE DATE INVOICE PREVIOUS SHIPPED TERMS
NUMBER INVOICE NUMBER Opefied by n
03/2'0/2012 134721 NET 10TH 03/20/12 08:37:22 7
QUANTITY, UNIT
STOCK NUMBER SIZE DESCRIPTION ORDERS SHIPPED PREV. SHIP PRICE T F.E.T. EXTENSION
AL1 EACH PASSENGER FRONT END ALIGNIENT 1 1 89.95 .00 89.95
14ETHOD OF PAYMENT:
CHARGE: 89.95
CHANGE: .00
Thank you far your buyinese mech. D ug
PARTS LABOR TAX AMOUNT TAX F.E.T. AMOUNT r SINUOICETOTAL -I
89.9 85.95
"You're Riding On Our Reputation"
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
60700
CLARK TIRE INC CARMEL Purchase Order No.
622 C SOUTH RANGELINE RD Terms
CARMEL, IN 46032 Due Date 3/22/2012
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
3/22/2012 134721 $89.95
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
Date Officer
VOUCHER 114082 WARRANT ALLOWED
60700 IN SUM OF
CLARK TIRE INC CARMEL
622 C SOUTH RANGELINE RD
CARMEL, IN 46032
Carmel Water Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
134721 01- 6500 -07 $89.95
Voucher Total $89.95
Cost distribution ledger classification if
claim paid under vehicle highway fund