212548 09/12/2012 CITY OF CARMEL, INDIANA VENDOR: 060700 Page 1 of 1
ONE CIVIC SQUARE CLARK TIRE INC
CARMEL, INDIANA 46032 622 C SOUTH RANGELINE RD CHECK AMOUNT: $127.86
'r CARMEL IN 46032
<.o. CHECK NUMBER: 212548
CHECK DATE: 9/12/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
601 5023990 136209 83 . 00 OTHER EXPENSES
1110 4232000 136300 44 . 86 TIRES & TUBES
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
60700
CLARK TIRE INC CARMEL Purchase Order No.
622 C SOUTH RANGELINE RD Terms
CARMEL, IN 46032 Due Date 9/6/2012
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
9/6/2012 136209 $83.00
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 ice
VOUCHER # 122062 WARRANT # ALLOWED
60700 IN SUM OF $
CLARK TIRE INC CARMEL
622 C SOUTH RANGELINE RD
CARMEL, IN 46032
Carmel Water Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO# INV# ACCT# AMOUNT Audit Trail Code
i
! 136209 01-6500-05 $83.00
Voucher Total $83.00
Cost distribution ledger classification if
claim paid under vehicle highway fund
CRK 622C S. Rangeline Road
"YOU ARE RIDING ON OUR REPUTATION" Carmel, N 46032
4w (317) 844-4839
RE
mational PENS IL
1,THE UNDERSIGNED,HEREBY AGREE UNTIL SUCH TIME AS THIS ACCOUNT IS PAID IN FULL BY ME,THE SELLER SHALL RETAIN TITLE TO THE GOODS HEREBY PURCHASED AND SELLER SHALL HAVE
A SECURITY INTEREST IN SAID GOODS TO SECURE THE PAYMENT UNTIL MY ACCOUNT IS FULLY PAID.I FURTI IER AGREE THAT IN THE EVENT OF DEFAULT IN THE PAYMENT OF ANY AMOUNT DUE,AND
IF THIS ACCOUNT IS PLACED IN THE HANDS OF AN AGENCY OR ATTORNEY FOR COLLECTION OR LEGAL ACTION TO PAY AN ADDITIONAL CHARGE EQUAL TO THE COST OF COLLECTION INCLUDING
AGENCY AND ATTORNEY FEES AND COURT COSTS INCURRED AND PERMITTED BY LAWS GOVERNING THESE TRANSACTIONS.
A finance charge of 13/4%Per Month will be charged on all Accounts 30 days Past Due.Annual Percentage Rate is 21%.(Minimum 75) RECEIVED BY
SOLD TO: SHIP TO:
CARMEL WATER DISTRIAUTIOIN 11-::00/01 SAME INVOICE## 136209
3450 W. 131ST ST.
CARMEL IN 46074
CUST.P.O.# MAKE-MODEL ID# MILEAGE TELEPHONE ROUTE SLM SHIP VIA ORDER# ' PAGE REMARKS
EQ 716-3939 0 1 N/A 149595 i
INVOICE DATE INVOICE PREVIOUS SHIPPED TERMS
NUMBER INVOICE NUMBER
Opened by Operator 4
08/21;2312 13K19 NET 10TH 08/21/12 14:38:58 8
STOCK NUMBER SIZE DESCRIPTION _ QUANTITY UNIT T F.E.T. EXTENSION
...ORDERS SHIPPED PREV.S4 PRICE
SC EACH SERVICE CALL 1 1 55.00 ,00 55.00
MI PER MILE MILEAGE 2- 2 1.50 .00 3.00 -
05 EACH, CLEAN & RESEAL TIRE BEADS 1 1 25.00 .00 25.00
BAC HOE RIGHT FRONT
METHOD OF PAYMENT:
CHARGE. 83.00
CNIGE: .00
Thank you for ynur business Mech: Nike
PARTS LABOR TAX% TAXABLE TAX F.E.T. AMOUNT INVOICE TOTAL
�[ I v
83.00 I I I I r 83.00
"You're Riding On Our Reputation"
i
CLARK 622C S. Rangeline Road
"YOU ARE RIDING ON OUR REPUTATION" Carmel, IN 46032
4w r (317) 844-4839
RE
PENv IL
National Q
],THE UNDERSIGNED.HEREBY AGREE UNTIL SUCK TIME AS THIS ACCOUNT IS PAID IN FULL BY ME,THE SELLER SHALL RETAIN TITLE TO THE GOODS HEREBY PURCHASED AND SELLER SHALL HAVE
A SECURITY INTEREST IN SAID GOODS TO SECURE THE PAYMENT UNTIL MY ACCOUNT IS FULLY PAID.I FURTHER AGREE THAT IN THE EVENT OF DEFAULT IN THE PAYMENT OF ANY AMOUNT DUE,AND
IF THIS ACCOUNT IS PLACED IN THE HANDS OF AN AGENCY OR ATTORNEY FOR COLLECTION iOR LEGAL ACTION TO PAY AN ADDITIONAL CHARGE EQUAL TO THE COST OF COLLECTION INCLUDING
AGENCY AND ATTORNEY FEES AND COURT COSTS INCURRED AND PERMITTED BYLAWS GOVERNING THESE TRANSACTIONS.
A finance charge of 13/4%Per Month will be charged on all Accounts 30 days Past Due.Annual Percentage RI to is 21%.(Minimum 75) RECEIVED BY
I
SOLD TO: SHIP TO:
CARREL POLICE DEPT. 6000/01 SAME INVOICE# 136300
THREE CIVIC SQUARE
CARREL IN 46032
I
CLIST.P.O.# MAKE-MODEL ID# MILEAGE TELEPHONE ROUTE SLM SHIP VIA ORDER# PACE REMARKS
T3 571-2500 0 5 N/A 14974E 1
INVOICE DATE INVOICE PREVIOUS SHIPPED TERMS
NUMBER INVOICE NUMBER
Opened by Operator
08/30/2012 136300 NET 10TH 08/30/12 13:57:57 7
STOCK NUMBER SIZE DESCRIPTION QHIPP r_ UNIT F.E.T. EXTENSION
S T
ORDERS SHIPPED PREY.SHIP; PRICE z
OUTSIDE 10037620 15/500-6 CARL TURFMASTER 1 1 44,61 02 .00 44.6i
TF INDIANA TIRE FEE 1 1 .25 .00 .25
METHOD OF PAYMENT: _
~ ' RGE; /'�' 44,86
CHA' ' : / �J" .00
t
iha0 you for your business
PARTS LABOR TAX% fA OUNT TAX F.E.T. AMOUNT INVOICE TOTAL
HY tHIS ANMNT
44.86 44.86
"You're Riding On Our Reputation"
J
/i
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))
08/30/12 136300 T3 tire $44.86
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.
ALLOWED 20
Clark Tire
IN SUM OF $
622 C South Rangeline Road
Carmel, IN 46032
$44.86
ON ACCOUNT OF APPROPRIATION FOR
Carmel Police Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1110 I 136300 I 42-320.00 I $44.86 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
Wednesday, September 05, 2012
Chief of Police
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund