211684 08/14/2012 »., CITY OF CARMEL, INDIANA VENDOR: 00351640 Page 1 of 1
ONE CIVIC SQUARE CLARK TIRE FISHERS
CARMEL, INDIANA 46032 Po BOX 195 CHECK AMOUNT: $326.50
FISHERS IN 46038 CHECK NUMBER: 211684
CHECK DATE: 8/14/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1207 4350000 IN00128643 166 . 00 EQUIPMENT REPAIRS & M
1207 4350000 IN00128762 160 . 50 EQUIPMENT REPAIRS & M
126TH & REYNOLDS ROAD (HWY 37 NO.) FAST! Service at our Farm,
FISHERS, INDIANA 46038
P.O. BOX 195 Commercial Site or on the Road.
TIRE FISHERS 317-842-0544 OR 1-800-444-5985 All Major Brands Available
Fax 317-577-3956
NAME/ADDRESS ACCOUNT NO. HOME PHONE REFERENCE NO.
BROOKSH (317) 5-171--.-2427 I N001 28762
BRUUKSHIRE GULF CLUB
12120 BRUUKSHIRE PARKWAY P.O.NO. WOR}tJi JO0 _ D�Tg/AM91'1 9: 44
CAMEL, IN 46033 RESALE NO. VIN NO. WOt-iES NO.
YEAR/MAKE/MODEL LICENSE NO. TAG NO. NEXT INSP.DATE BAR NO.
SAVE PARTS ALL PARTS NEW UNLESS PROMISED DATE/TIME MILEAGE WRITTEN BY
Y N OTHERWISE SPECIFIED
L ❑ FREE ROTATION
(EVERY 5,000 MILES)
notice and oral approval of an increase in the original estimate price. ❑ ROAD HAZARD WARRANTY
PARTS & ®TMERS .N.* LABOR
2 511257 20XI2.00-1014 TURFNASTER 80.80 160.00 2.00 INDIANA TIRE FEE 0.50
Reason for original estimate:
Any warranties on the item/items sold hereby are those made by the manufacturer.The seller,CLARK TIRE,hereby expressly
disclaims all warranties either express or implied,including any implied warranty of merchantability or fitness for a particular
purpose and CLARK TIRE neither assumes nor authorizes any other person to assume for it any liability in connection with the sale
of this it'emfitems.
A SERVICE CHARGE OF 1N%PER MONTH(21%ANNUALLY)WILL BE CHARGED ON ALL ACCOUNT PAST DUE 30 DAYS.NET 10th PROX.
I,THE UNDERSIGNED HEREBY AGREE THAT IN THE EVENT OF DEFAU TIN THE PAYMENT OF ANY AMOUNT DUE AND IF THIS ACCOUNT IS PLACED IN • G
THE HANDS OF AN AGENCY OR ATTORNEY FOR COLLECTIP{�N O EGAL ACTION TO PAY AN ADDITIONAL CHARGE EQUAL TO THE COST OF PARTS
COLLECTION INCLUDING AGENCY AND ATTOR EY F S AND CCU COSTS INCURREb AND PERMITTED BY LAW GOVERNING THESE TRANSACTIONS 0. 50
LABOR
1 hereby authorize the repair wo to be do Ion R4 th ec s ry materials.You and your employees may operate vehicle for purposes of testing, OTHER
inspection,or delivery at my ri An expre ec ic's Ii i>� ed on vehicle to secure the amount of repairs thereto.It is also understood that
you will not be held respons' for loss a to r c s left in cars in case of fire,theft or any other cause beyond your control. SUBLET
SUBTOTAL 1 Go. 50
' Signature X 0. 00
TAX
Rec'd By
I Flo. 50
TOTAL
CASH AMOUNT CHECK AMOUNT CHECK NO. C.C.AMOUNT i=;,`,tfHC.G:TY,PE C.C.APPROVAL CODE ON ACCOtt?u
Ib !A -THANK- --
€q', YOU!
<t':.
120TH & REYNOLDS ROAD (HVVY37NO)
� FAST! Somioe � yourF�m
P.O. BOX 195 'Commercial Site or on.the Road.
FISHERS, INDIANA 46038
317-842-0544 OR 1-800-444-5985 All Major Brandsk"A41Able.
TIRE FISHERS Fax 317-577-3956
�-NAME/ADDRESS ACC06NT NO. HOME PHONE REFERENCE NO:'
P.O.NO. WORK PHONE DATE/TIME
CARMEi, IN 4W33 W000085903
YEAR/MAKE/MODEL LICENSE NO. TAG NO. NEXTINSP.DATE BAR NO.
SAVE PARTS ALL PARTS NEW UNLESS PROMISED DATE TIME MILEAGE WRITTEN BY
Y N OTHERWISE SPECIFIED WS
LORIGINAL FREE ROTATION
REVISED 1 (EVERY 5,000 MILES)
REVISED 2
1 acknowledge notice and oral approval of an increase in the original estimate price. El ROAD HAZA`RD WARRANTY
PARTS & OTHERS LABOR
2 CA510981 CAR 18-950-8/4 SMOOTHY 78.50 157.00 2.00 INDIANA TIRE FE" 0.50
1.N DISMOUNT & MOUNT 5.00
1.00 TIRE DISPOSAL PAS. 3.50
Reason for original estioate:
dgy war anties on the item/items sold hereby are those made by the manufacturer.The seller,CLARK TIRE,hereby exprpssly
sc[a Ims all warrantiesgither express or implied,including any implied warranty of merchantability or fitness for a particular
purpose,and CLARK TIR neither assumes nor authorizes any other person to assume for it any liability in connection with the sale
'A SERVICE CHARGE or 1Y,%PER MONTH(21%ANNUALLY)WILL BE CHARGED ON ALL ACCOUNT PAST DUE 30 DAYS-NET 10th PROX. TOTALS
THE UNDERSIGNED HEREBY AGREE THAT IN�11EfIENT EFAULT IN THE PAYMENT OF ANY AMOUNT DUE AND,F THIS ACCOUNT IS PLACED IN
.01 OLLE
01 OL
WE HANDS OF AN AGENCytOR ATTORNEY F LEC R LEGAL ACTION TO PAY AN ADDITIONAL CHARGE EQUAL TO THE COST OF PARTS
COLLECTION INCLUDING A NCYANDA ORN EES A COUR COSTS INCURREb AND PERMITTED BY LAW GOVERNING THESE TRANSACTIONS LABOR 9. 00
1 hereby authoril t e re a! work to b on ng wit a eery materials.You and your employees may operate vehicle for purposes of testing, OTHER
inspection,or de I 7y risk.An e 's echan' ie ck 4.Qn.Kehicle to secure the amount of repairs thereto.It is also understood that
you will not be It I r risible for r ma r 'Icles left in cars in case of fire,theft or any other cause beyond your control. SUBLET
TAX 0. 00
Rec'd By TOTAL 1615. 00
CASH AMOUNT CHECK AMOUNT CHECK NO. C.C.AMOUNT C.C.TYPE C.C.APPROVAL CODE ON ACCOUNT
THANK
VOUCHER NO. WARRANT NO.
ALLOWED 20
Clark Tire Fishers
IN SUM OF $
P.O. Box 195
Fishers, IN 46038
$326.50
ON ACCOUNT OF APPROPRIATION FOR
Brookshire Golf Club
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1207 IN00128643 43-500.00 $166.00 1 hereby certify that the attached invoice(s), or
1207 IN00128762 43-500.00 $160.50 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
Friday, August 10, 2012
Director, Brookshir olf Club
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))
08/03/12 IN00128643 Repair Parts $166.00
08/09/12 IN00128762 Repair Parts $160.50
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
CITY OF CARMEL, INDIANA VENDOR: 364677 Page 1 of 1
ONE CIVIC SQUARE CLEAN EARTH SYSTEMS INC
CARMEL, INDIANA 46032 15245 AMBERLY DRIVE
CHECK AMOUNT: $2,809.00
TAMPA FL 33647 CHECK NUMBER: 211685
CHECK DATE: 8/14/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 37703 2, 809 . 00 OTHER EXPENSES
Voice: (813) 930-6688 Invoice
i(� Fax: (813) 930-2530 Invoice Number:
Y' � U 37703
00000000000000000000 oa0000000 Invoice Date:
S Y S T E M S, I N C.
Jul 30, g
15245 AMBERLY DRIVE
Page:
Tampa, FL 33647-2155 1
USA
Sold To: Ship to:
City of Carmel HHW City of Carmel HHW
760 3rd Avenue 901 N. Rangeline Rd
Attn: Bill Kelam Carmel, IN 46032
Carmel, IN 46032
Customer 1D Customer PO Payment Terms
CITY0019 WILLIAM 071912 2% 15, Net 30 Days
Sales Rep ID Shipping Method Ship Date Due Date
MW AVERITT 7/26/12 I 8/29/12
Quantity Item Description Unit Price Extension
100.00ID-30GOHPOLY ID 30 GAL OH POLY PLAIN COVER 24.75 2,475.00
Subtotal 2,475.00
Sales Tax
Freight 334.00
Total Invoice Amount 2,809.00
Check/Credit Memo No: Payment/Credit Applied
TOTAL 2,809.00
VOUCHER # 125444 WARRANT# ALLOWED
364677 ' IN SUM OF $
CLEAN EARTH SYSTEMS INC
15245 AMBERLY DRIVE
TAMPA, FL 33647
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO# INV# ACCT# AMOUNT Audit Trail Code
37703 01-720H-08 $2,809.00
Voucher Total $2,809.00
Cost distribution ledger classification if
claim paid under 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 of service rendered, by whom, rates per day, number of units,
price per unit, etc.
Payee
364677
CLEAN EARTH SYSTEMS INC Purchase Order No.
15245 AMBERLY DRIVE Terms
TAMPA, FL 33647 Due Date 8/7/2012
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
8/7/2012 37703 $2,809.00
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
Date Officer