211841 08/14/2012 a CITY OF CARMEL, INDIANA VENDOR: 182450 Page 1 of 1
0 ONE CIVIC SQUARE LEBANON TIRE&AUTO SVC CHECK AMOUNT: $1,853.19
`(o CARMEL, INDIANA 46032 1310 W SOUTH ST
LEBANON IN 46052 CHECK NUMBER: 211841
CHECK DATE: 8/14/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4351000 L00902 1, 358 . 74 AUTO REPAIR & MAINTEN
1120 4351000 L00903 48 . 50 AUTO REPAIR & MAINTEN
2201 4232000 L00946 212 . 95 TIRES & TUBES
1120 4351000 L009BJ 233 . 00 AUTO REPAIR & MAINTEN
LEBANON TIRE & AUTO SERVICE
1310 W. SOUTH STREET
LEBANON, IN 46052
Store Location Store Phn Date Time
R & T Tire/Auto - LEB (765) 482-5027 07/16/12 11:44 AM
1310 W. SOUTH STREET Page 1
LEBANON, IN 46052
Your P/O # A/R Acct# Terms Ship Via
Inv: L00946 L05634 1 ST 10TH
Sold-To: Ship-To: Type - Payment
CARMEL STREET DEPT $
3400 W 131 ST $
WESTFIELD, IN 46074 =------------
Total $ 0.00
REP 317-417-5053
317-733-2001
!R! SCU;UNIT C;BOX 21, .59,B;RPU;EXIT;
Qty Shp B/O Item Number Description S/W FET Price Amount Init's
1 1 046120000 ROAD SERVICE PER HR/PER MAN (R 85.00 85.00 202,220
1 1 046100000 FLAT REPAIR 67.50 67.50 202, 220
1 1 GY197493962 158195 R HB TUBE 44 .68 44 .68 202
1 1 046100000 JEFF STEWART-CALLED IN 0. 00 0.00 202,220
SHOP SUPPLIES 15.77
--------------------
V/Info: 2000 GOODYEAR TEMPORARY
Lic# GDYR0000 IN Mil: 1 Trq: 80 ft#
------------------------------------------------------------------------------------------------
Sub-Total
$212.95
IN GOV'T, 0.000%
$0 .00
Total: $212 .95
NewPymt: $0. 00
Total Due: $212 . 95
Received By: SP:Terry Millikan
VOUCHER NO. WARRANT NO.
ALLOWED 20
Lebanon Tire and Auto Svc
IN SUM OF $
//l
$212.95
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO#/Dept. INVOICE NO. I ACCT#/TITLE AMOUNT
Board Members
r
2201 I L00946 I 42-320.001 $212.95 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
Thursday, Arugust 09, 2012
jo
Street Commissioner
i V
Street CcT;tlenissio-ne-
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))
07/16/12 L00946 $212.95
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
20
Clerk-Treasurer
LEBANON TIRE & AUTO SERVICE
1310 W. SOUTH STREET
LEBANON, IN 46052
Store Location Store Phn Date Time
R & T Tire/Auto - LEB (765) 482-5027 07/10/12 01: 00 PM
1310 W. SOUTH STREET Page 1
LEBANON, IN 46052
Your P/O # A/R Acct# Terms Ship Via
Inv: L00902 L00259 1 ST 10TH
Sold-To: Ship-To: Type - Payment
CARMEL FIRE DEPT $
2 CIVIC SQUARE $
CARMEL, IN 46032
Total $ 0.00
REP 317-664-0958
317-571-2615
!R! SCU;UNIT C;BOX 21, .59,B;RPU;EXIT;
Qty Shp B/O Item Number Description S/W PET Price Amount Init' s
1 1 046100000 SERVICE CALL 85 .00 85.00 202,220
2 2 046100000 MT- DISMOUNT 425/65R225 STEERA 32 .00 64 .00 202,220
2 2 GY756160365 425/65R225 L G296 MSA T 590. 12 1180 .24 202
dot# MC9M6PEW4611, MC9M6PEW4811
2 2 EPA STATE TIRE FEE (INDIANA) 0.25 0.50 202
2 2 041263000 NEW VALVE STEM 4 .50 9.00 202
2 2 093002000 TIRE DISPOSAL 10 .00 20.00 202,220
APPROVAL G0001644
--------------------
V/Info: 2010 SEAGRAVES LADDER TRUCK RED
Lic# NA IN Unt# L41 Mil: 13082 Trq: 81 ft#
------------------------------------------------------------------------------------------------
Sub-Total
$1358.74
IN GOV'T, 0. 000'
$0 .00
Total: . $1358.74
NewPymt: $0.00
Total Due: $1358 . 74
Received By: SP:Terry Millikan
LEBANON TIRE & AUTO SERVICE
1310 W. SOUTH STREET
LEBANON, IN 46052
Store Location Store Phn Date Time
R & T Tire/Auto - LEB (765) 482-5027 07/10/12 01: 03 PM
1310 W. SOUTH STREET Page 1
LEBANON, IN 46052
Your P/O # A/R Acct# Terms Ship Via
Inv: L00903 L00259 1 ST 10TH
Sold-To: Ship-To: Type - Payment
CARMEL FIRE DEPT $
2 CIVIC SQUARE $
CARMEL, IN 46032
Total $ 0.00
REP 317-664-0958
317-571-2615
!R! SCU;UNIT C;BOX 21, .59,B;RPU;EXIT;
Qty Shp B/O Item Number Description S/W FET Price Amount Init' s
1 1 046100000 REPAIR TRAINING FORKLIFT TIRE 48 .50 48 .50 202,220
1 1 046100000 BOB VANVORST 0 .00 0 .00 202, 220
--------------------
V/Info:
Sub-Total
$48.50
IN GOV'T, 0.000%
$0.00
Total: $48.50
NewPymt: $0.00
Total Due: $48 . 50
Received By: SP:Terry Millikan
LEBANON TIRE & AUTO SERVICE
1310 W. SOUTH STREET
LEBANON, IN 46052
Store Location Store Phn Date Time
R & T Tire/Auto - LEB (765) 482-5027 07/25/12 04 : 09 PM
1310 W. SOUTH STREET Page 1
LEBANON, IN 46052
Your P/O # A/R Acct# Terms Ship Via
Inv: L009BJ L00259 1 ST 10TH
Sold-To: Ship-To: Type - Payment
CARMEL FIRE DEPT $
2 CIVIC SQUARE $
CARMEL, IN 46032 -------------
Total $ 0.00
REP 317-664-0958
317-571-2615
!R! SCU;UNIT C;BOX 21, .59,B;RPU;EXIT;
Qty Shp B/O Item Number Description S/W FET Price Amount Init' s
1 1 046120000 ROAD SERVICE PER HR/PER MAN (R 85. 00 85.00 202, 220
4 4 046100000 MT- DISMOUNT CUST OWN TIRES 28 . 00 112 .00 202, 220
4 4 046100000 SCRAP OLD TIRES 9. 00 36.00 202,220
1 1 046100000 ENGINE #49 -BOB VANVORST 0. 00 0 .00 202,220
--------------------
V/Info:
------------------------------------------------------------------------------------------------
Sub-Total
$233 .00
IN GOV'T, 0.000%
$0.00
Total: $233 .00
NewPymt: $0 .00
Total Due: $233 . 00
Received By: SP:Terry Millikan
VOUCHER NO. WARRANT NO.
ALLOWED 20
Lebanon Tire
IN SUM OF $
1310 West South Street
Lebanon, IN 46052
$1,640.24
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1120 L00902 43-510.00 $1,358.74 1 hereby certify that the attached invoice(s), or
1120 L00903 43-510.00 $48.50 bill(s) is (are) true and correct and that the
1120 I L009BJ I 43-510.00 I $233.00 materials or services itemized thereon for
which charge is made were ordered and
received except
AUG 13 `2of'2
/ (N
7
Fire Chief
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
Drescribed by State Board of Accounts City Form No.201 (Rev.1995)
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
4n invoice or bill to be properly itemized must show: kind of service,where performed, dates service rendered, by
Nhom, 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))
L00902 L41 $1,358.74
L00903 Forklift Tire $48.50
L009BJ I E49 I $233.00
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