178893 10/28/2009 CITY OF CARMEL, INDIANA VENDOR: 360940 Page 1 of 1
ONE CIVIC SQUARE TRIPLE S TIRE CO INC CHECK AMOUNT: $469.18
CARMEL, INDIANA 46032 405 S 9TH ST
ELWOOD IN 46036 CHECK NUMBER: 178893
CHECK DATE: 10128/2009
"DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2201 4232000 5321 170.00 TIRES TUBES
2201 4232000 5337 299.18 TIRES TUBES
Printed: 912912009 3:37:28 PM INVOICE Sales Receipt #5321
Slore:
9117/2009
Cashier: User10
Page 1
TRIPLES TIRE ELWOOD
405 S 4th Street
u 'Wood, IN 46036
FAX: (765) 552 -6(b'l
REMIT PAYMENT ABOVE
Bill To:
Carmel Street Dept,
Carmel, 11\1 46032
D escription 1 Description 2 Ply Size Qty Price Ext Pricera)
ZSRVICE CALL TRAVEL AND HOURLY FEES 1 $150.00 $150.00
r; psJGS:SMALL PLUGS 1 $20.00 $20.00 T
y Subtotal: $170.00
Exempt 0 Tax: +$0.00
RECEIPT TOTAL: $170.00
Account: $170.00
Signature
Previous Account Balance: $0.00
161429 bobcat
t t PLEASE PAY FROM THIS INVOICE SALES RECEIPT. TERMS NET 30
WITH BILLING QUESTIONS CALL 765 -552 -5765 THANK YOU
11111111111111111 IIIIIIIIIIIIIIIII
5321
Printed: 101912009 8:35:23 AM INVOICE Sales Receipt #5337
Store: EL
9/17/200-9
Cashier Useri o
Page i
TRIPLE S TIRE ELWOOD
405 So. 9th Street
ELWOOD, IN 46036
(765) 552 -5765
FAX: (765) 552 -5761
REMIT PAYMENT ABOVE
Bill To:
Carmel Street Dept,
Carmel, IN 46032
Description 1 Description 2 Ply Size Qty Price Ext Pricera)
LABOR TIRE CHANGE LAIR CHECK/ REPAIR 1 $75.00 $75.00
CONDITIONER 1 $29.18 $29.18 T
PLU_GS,5MALL P LUGS 1 $20.00 $20.00 T
17.5125 ALUTURA 27132 23269 23270 17.5125 1 $175.00 $175.00 T
Subtotal: $299.18
Exempt 0 Tax: +$0.00
RECEIPT TOTAL: $299.18
Account: $299.18
Signature
Previous Account Balance: $170.00
161430 TIRE OFF STAYS
PLEASE PAY FROM THIS INVOICE SALES RECEIPT. TERMS NET 30
WITH BILLING QUESTIONS CALL 765 552 -5765 THANK YOU
5337
_e
W
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))
09/17/09 5337 $299.18
09/17/09 5321 $170.00
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
VOU N WARRANT N O_
ALLOWED 20
Triple S. of Indy, Inc_
IN SUM OF
405 S. 9th Street
Elwood, IN 46036
$469.18
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO# Dept. INVOICE NO. ACCT /TITLE AMOUNT
Board Members
2201 5337 42- 320.00 $299.18 1 hereby certify that the attached invoice(s), or
2201 5321 42- 320.00 $170.00
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
hursday,,Octode 22, 2009
Street Commissioner
ree t missioner
Cost distribution ledger classification if
claim paid motor vehicle highway fund