HomeMy WebLinkAbout213621 10/09/2012 CITY OF CARMEL, INDIANA VENDOR: 366394 Page 1 of 1
i 0 ONE CIVIC SQUARE POMPS TIRE-LAFAYETTE
•' CARMEL, INDIANA 46032 2700 SCHUYLER AVENUE CHECK AMOUNT: $420.48
LAFAYETTE IN 46905 CHECK NUMBER: 213621
CHECK DATE: 10/9/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
601 5023990 910004260 420 . 48 OTHER EXPENSES
SHPN577027750.TXT
POMP'S TIRE-LAFAYETTE INVOICE #: 910004260
2700 SCHUYLER AVE
PAGE: 1
LAFAYETTE, IN 47905
765/742-4000
CUSTOMER: CITY OF CARMEL WATER OPER SHIP TO: DELIVERED VIA SHANE R.
3450 W 131ST STREET
2266
CARMEL, IN 46074
CREATED BY DBL
REF NUMBER: 0694262
FAX NUMBER: 3177332053
WORK: 317/733-2855 0 PO NUMBER: GOV
SALESMAN: MICHAEL S RUMMEL
INVOICE DATE: 09/28/12 TERMS: NET 30 DAYS
-------------------------------------------------------------------------------
PRODUCT MECHANIC QUANTITY PRICE F.E.T. EXTENSION
-------------------------------------------------------------------------------
LT245/75R16/10 TRANSFRC AT BL 4 103.87 415.48
189F582
GOV F/S 7130
TIRE USER FEE - IN 4 .25 1.00
950L13
DELIVERY FUEL SURCHARGE 1 4.00 4.00
DFS
CM#6407343110 D]S
MERCHANDISE: 415.48
LABOR: 4.00
OTHER: 1.00
INVOICE TOTAL: 420.48
GOVERNMENT 420.48
signature Printed Name
V
Page 1
VOUCHER # 122255 WARRANT # ALLOWED
366480 IN SUM OF $
Pomp's Tire
1316 West South Street
Lebanon, IN 46052
Carmel Water Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO# INV# ACCT# AMOUNT Audit Trail Code
910004260 01-6500-05 $420.48
Voucher Total $420.48
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
366480
Pomp's Tire Purchase Order No.
1316 West South Street Terms
Lebanon, IN 46052 Due Date 10/2/2012
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
10/2/2012 910004260 $420.48
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