HomeMy WebLinkAbout178430 10/14/2009 CITY OF CARMEL, INDIANA VENDOR: 363306 Rage 1 of 1
ONE CIVIC SQUARE TRIPLE S OF INDY INC CHECK AMOUNT: $595.33
CARMEL, INDIANA 46032 836 S 22ND STREET
ELWOOD IN 46036
CHECK NUMBER: 178430
CHECK DATE: 10/14/2009
DEPARTMENT ACCO PO NUMBER INV OICE NUMBER AMOUNT DESCRIPTION
2201 4232000 7178 595.33 TIRES TUBES
Printed: 1017/200911:57:32AM INVOICE Sales Receipt #7178
Storey IN
9/28/2009
Cashier: Chris
Page 1
Copy
TRIPLE S TIRE INDIANAPOLIS
836 S. 22ND ST.
ELWOOD, IN 46036
(765) 552 -5765
FAX: (765) 552 -5761
REMIT PAYMENT ABOVE
Bill To: CITY OF CARMEL
CITY OF CARMEL,
3400 WEST 131 ST
WEST FIELD, IN 46074
Description 1 Description 2 Ply S ize Qty Price Ext Pricera)
SERVICE CALL TRAVEL AND HOURLY FEES 1 $150.00 $150.00
17.5125 USED L -2 20412 1 $190.00 $190.00 T
NCH -3 VALVE CORE HOUSING 1 $17.95 $17.95 T
SEALER SEALER PER GALLON 3 $29.96 $89.88 T
Labor retail Mt /DisMt,Repair,On /Off, Inspect 1 $75.00 $75.00
DISPOSAL FEE JUNK TIRE 1 $72.50 $72.50
Subtotal: $595.33
Exempt 0 Tax: +$0.00
Ship 9/18/2009 512223 Shipping:
RECEIPT TOTAL: $595.33
Account: $595.33
Signature
Previous Account Balance: $0.00
EQ# 559807
LF
HRS: 5218
SWO# 512223
PLEASE PAY FROM THIS INVOICE SALES RECEIPT. TERMS NET 30
WITH BILLING QUESTIONS CALL 765- 552 -5765 THANK YOU
111111 11111 11111 11111 11111 1111 1111
7178
SAFETY 1 WORK ORDER NO.
SERVICE e
ISATISFRCTIGN Try i l -e S of INDY, I5122
".a.
INVOICE NO.
REMIT PAYMENT TO:
836 So. 22nd Street IT IS THE CUSTOMER'S RESPONSIBILITY TO CHECK
TIGHTNESS OF WHEELS PRIOR TO USE
Elwood, IN 46036 AFTER SERVICE.
l
ACCOUNTING Phone: (765)552 -5765 Fax: (765) 552 -5761" 24 HR. SERVICE: 317 873 -0900
CUSTOMER t t PH —NO.
ADDRESS, /v WORK DATE —Q
EQUIP. NO: g MAKE SALESMAN
HRS OR MILEAGE: CUST. P.O.
SERVICE DIRECTIONS: C I
P :41
SERVICE MERCHANDISE DELIVERED
EACH
i re
I /25a WVAJS
r z. Jo 7z. E A
TIRES TAKEN IN FOR
RETREAD, REPAIR, TRADE -IN
r)
f 5
BUYER HEREBY ACKNOWLEDGES RECEIPT OF THE MERCHANDISE AND SERVICES SET FORTH HEREON TOGETHER
SERVICEMAN: WITH A COPY OF THIS RETAIL SALE AGREEMENT.
REMARKS: X i -TO (BUYER)
CONDITIONAL SALE AGREEMENT
Under the conditions of this sale or transaction of merchandise listed hereon it is understood that the title to said merchandise remains in the
name of TRIPLE S TIRE CO., Inc. until the last payment is made according to the conditions on the face of this contract. In rase this contract is
not properly and timely taken care of, the buyer agrees to permit the seller or any of their authorized agents to peacefully enter the premises
where the merchandise may be located, or kept and take possession of the same.The buyer also agrees to pay reasonable attorney or collection
fees, if any, and agrees not to sell, dispose of, mutilate, mortgage or remove said merchandise from immediate locality of place of sale until last
payment is made thereon, This merchandise listed hereon is not considered an integral part of the vehicle and is not subject to confiscation by
TIME ON JOB holder of former lien on which Merchandise is installed by the seller.
NOTICE -After the 10th of following month FINANCE CHARGE is computed by a
PERIODIC RATE OF 1 per monthly billing cycle which is an ANNUAL
REG. O.T. PERCENTAGE RATE OF 18 Minimum Finance Charge $.50.
THANK YOU!
5
SAT S CTION ri of I I n C O 5 1 2 2 2 3
ENVOICE NO.
[REMIT PAYMENT TO: So. 22nd Street IT IS THE CUSTOMER'S RESPONSIBILITY TO CHECK
TIGHTNESS OF WHEELS PRIOR TO USE
ood, IN 46636 AFTER SERVICE.
1
ACCOUNTING Phone: (765) 552 =5765 Fax: (765) 552 -5761 24 HR. SERVICE: 317 -873 -0900
CUSTOMER -F PH. N0.
ADDRESS,: WORK DATE
EQUIP. NO: `J MAKE C ALESMAN
HRS OR MILEAGE: tCUST. P.O.
SERVICE DIRECTIONS:
SERVICE.'& MERCHANDISE DELIVERED
150. J0
74
TIRES TAKEN IN FOR
RETREAD, REPAIR, TRADE -IN
7 1
BUYER HEREBY ACKNOWLEDGES RECEIPT OF THE.MERCHANDISE AND SERVICES SET FORTH HEREON TOGETHER
SERVICEMAN: WITH A COPY OF THIS RETAIL SALE AGREEMENT.
REMARKS: X 7� (BUYER)
CONDITIONAL SALE AGREEMENT
Under the conditions of this sale or transaction of merchandise listed hereon it is understood that the title to said merchandise remains in the
name of TRIPLE S TIRE CO., Inc. until the last payment is made according to the conditions on the lace of this contract. In case this contract is
not properly and timely taken care of, the buyer agrees to permit the seller or any of their authorized agents to peacelully enter the premises
where the merchandise may be Iccaled, or kept and take possession of the same.-The buyer also agrees to pay.reasonable attorney or collection
fees, if any, and agrees not to sell, dispose of, mutilate, mortgage or remove said merchandise from immediate locality of place of sale until last
payment is made thereon. This merchandise listed hereon is not considered an integral part of the vehicle and is not subject to confiscation by
TIME ON JOB holder of former lien on which Merchandise is installed by the seller.
NOTICE -After the loth of following month FINANCE CHARGE is computed by a
PERIODIC RATE OF 1 per monthly billing cycle which is an ANNUAL
REG. O.T. PERCENTAGE RATE OF 18 Minimum Finance Charge $.50.
7HANK YOU!
Prescribed by State Board of Accounts City Form No. 201 (Rev. 1995)
ACCOUNTS PAYABLE VOUCHER
CITY OF CARfMEL
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))
09/28/09 7178 $595.33
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
VOUCHER Na WARRANT NO.
ALLOWED 20
Triple S. of Indy, Inc.
IN SUM OF
4.05 S. 9th Street
Elwood, IN 46036
$595.33
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT
Board Members
2201 7178 42- 320.00 $595.33 1 hereby certify that the attached invoice(s), or
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
ii
day ber 09, 2009
i
Street Commi s ner
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund