170017 03/18/2009 CITY OF CARMEL, INDIANA VENDOR: 357882 Page 1 of 1
ti`,� ONE CIVIC SQUARE MICHEL TIRES PLUS CHECK AMOUNT: $532.96
•�o CARMEL, INDIANA 46032 531 RANGELINE ROAD
CARMEL IN 46032 CHECK NUMBER: 170017
CHECK DATE: 3/18/2009
DEPARTIV,ZNT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4232000 36.64 TIRES TUBES
1110 4232000 19021 496.32 TIRES
WORK ORQER MICHEL TIRES PLUS SERVICE ADVISOR
048 878 531 RANGE LINE ROAD 10 BRIAN
�0122/2009 CARMEL, IN. 46032 31.7. 846. 8203
|CARMELVOLICE DEPT, ED CITY GARAGE 2007 DODGE PICKUP R1500
3 CIVIC SO LIC VIN
�CARMEL, IN 46032-2584 IN 01/22/09 01:10P EST. MILEAGE 1
317.571.2644 xED DUE-. 02.-OOPM 01/22 Waiting APPT: Yes
PO#:
9,Tu,e 0 HooIIc INITIAL ESTIMATE
Pirticl.e Extended Job
'Descri ti Number T# Qtv Part Labor Price Total
TIRE PACKAGE 494.88
208010 TIMBERLINE A/T II OWL 208010 4 110.99 443.96
LT265/70R17 C112R No Mileage
Warranty
DOT# OT#
DO T#
INDIANA TIRE FEE 007095834 4 0.25 1.00
NEW TIRE WHEEL BALANCE PARTS 7018708 4 1.99 7.96
NEW TIRE WHEEL BALANCE LABOR 007018716 4 6.00 24.00
NEW RUBBER VALVE STEM 7007902 4 1.99 7.96
TIRE DISPOSAL FEE (1> 007075078 4 2.50 10.00
INSTALLATION 067015016 4 N/C 14/1 /14/1
�InS'EC/Iun
v
ION
y
Flat rate charged per internal Mitchell labor manuals
P-
�Time In: 01:10PM 01/22/2009 Parts Return: No Mounting Instructions Labor 35.00
�Cust Status: Waiting Appt: Yes Pay Type: Comm/Mr ShopSupply 1.44
�Hub Cap Lock: Sub 496.32
`Pickup 1500 TRX4 Reg. Cab 4WD Tax 0.00
|OE: LT275/70R17/C PSI 35
Torque 135 Total 496.32
I ACKNOWLEDGE THAT I HAVE REVIEWED THIS ESTIMATE OF REPAIR AND SERVICE WORK. I HEREBY AUTHORIZE THE ABOVE WORK TO BE DONE, INCLUDING THE INDICATED,
PARTS AND LABOR, AND PROMISE TO PAY FOR ALL SUCH WORK. I GRANT PERMISSION TO OPERATE THE REFERENCED CAR, TRUCK OR VEHICLE ON STREETS, HIGHWAYS
OR ELSEWHERE FOR THE PURPOSE OF INSPECTION AND/OR TESTING. I UNDERSTAND THAT ALL CLAIMS MUST BE ACCOMPANIED BY AN INVOICE. I UNDERSTAND IF ADDITIONAL
WORK m REQUIRED, YOU WILL OBTAIN m, VERBAL ADDITIONAL WORK /a BEGUN, UNLESS OTHERWISE SPECIFIED ow THIS ESTIMATE.
CUSTOMERIX Please do not leave Cell Phones, CDs, Money, Jewelry, or an other valuables in
SIGNATURE your vehicle. Tires Plus is not and will not be held responsible for missing or
%91.9n't WorkOrder1 080702
Mai, 2. 2009 10: 38AM No. 8146 V P 31 of 1
TIRES PLUS TOTAL. CAR CARE
Customor Invoice CARMEL Service Advisor:
48627 5318 RANGE LINE ROAD Brian Mcclure
1v8J2009 CARMEL, IN 46032 (317)646.6203
Duplicate Invoice
2007 Dodge Pickup R2500
Carmel Police
3 Civic Square tic 93004 IN Vln
Carmel, In 46032 In: 11912009 11:53:00 AM Mireage: 53603
(317)416 -4292 Out: 119/2009 6:19 -29 PM
Store# 260112 COMMERCIAL Reg#
serl p114u Article 14 ,1
M MA Extended 0
Wig! ik& EL 0 Total
UNIT #127 0 0 0.00 0.00
BASIC -TIRE INSTALL IBALfWALVE- PACKAGE 36.92
RUBBER VALVE STEM 7015040 4 1198 7.96
TIRE DISPOSAL FEE (1) 7076078 4 1.99 7.96
TIRE INSTALLATION 7015016 4 0.00 0.00
WHE=EL 9ALANCE PARTS 7005989 4 2.00 8.00
WHEEL BALANCE LABOR 7006010 4 3.00 12.00
COURTESY CHECK 0.00
COURTESY CHECK 7046930 1 0.00 0.00
Technician(s):
JESSE SCHOOLCRAFT
Payment Hlstoty:
Charge Tendered 36.64
summary:
Remit to: Tires Plus, P.O. Box 409726, Atlanta, GA 30384 -3726 Parts 15.96
Labor 19.96
THANK YOU Shop Supp. 0.72
Sub Total 36.64
Visit us at Http:llwww.tlresPlus.com Tax (7,00 0100
Total 36.134
htip:// h. ome/ CtistomerHistoryIngtiiry /PrintBFRCInvoice.aspx ?InvID= 71654010 3/2/2009 capitani
INDIANA RETAIL TAX EXEMPT PAGE
f Carmel CERTIFICATE NO. 003120155 002 0 Q j ty PURCHASE ORDER NUMBER
Police Department FEDERAL EXCISE TAX EXEMPT
35- 60000972 1 QA? 1
3 ftFt.0IVIC SQUARE THIS NUMBER MUST APPEAR ON INVOIC PIP
CARMEL, INDIANA 46032 -2584 VOUCHER DELIVERY MEMO, PAC K
I ES, NG SLIPS,
FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL 1997 SHIPPING LABELS AND ANY CORRESPONDENCE.
PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION
January 8, 200. tires
VENDOR Fires Plus SHIP City of Carmel POlice Department
TO 3 (Civic Square
Carmel., IN 46032
CONFIRMATION BLANKET CONTRACT PAYMENTTERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
8 tires car 126 GVaham car 127 Frost 110.99 887.92
Z.
f
fl
4 I A
Send Invoice To: I
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PR(P ECT PROJECT ACCOUNT AMOUNT
1110 �J tires and tubes PAYMENT
j J A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O.
NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND
VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED.
SHIPPING INSTRUCTIONS I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN
SHIP REPAID.
THIS APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER.
C.O.D. SHIPMENTS CANNOT BE ACCEPTED. f
•PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY �19r�`!_rP
SHIPPING LABELS.
THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945 TITLE Chief 66 Police
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
CLERK- TREASURER
DOCUMENT CONTROL NO.
k COPY SIGN AND RETURN TO CLERK'S OFFICE
VOUCHER NO. WARRANT NO.
ALLOWED 20
IN THE SUM OF
ON ACCOUNT OF APPROPRIATION FOR
Board Members
PO# or INVOICE NO. ACCT #/TITLE AMOUNT
DEPT. I 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_
k
20
Signature
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
I
Prescribedby 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
Michel Tires Plus Purchase Order No. 19021F
531 Rangeline Road Terms
Carmel, IN 46032 Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
1/ 22/09 a ent for tires 496.32
1/9/ Davment for installation 36.64
Total 532.96
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 NO. WARRANT NO.
�s ALLOWED 20
IK ,,ichel,Tires Plus
IN SUM OF
531 Rangeline Road
Carmel, IN 46032
532.96
ON ACCOUNT OF APPROPRIATION FOR
p olice general ufnd
Board Members
Po# or INVOICE NO. ACCT #/TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
19021F 320 496.32 bill(s) is (are) true and correct and that the
1110 320 36.64 materials or services itemized thereon for
f.
which charge is made were ordered and
received except
March 11 20 09
ignature
Assistant Chief of Polic
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund