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Home My WebLink About214048 10/23/2012 CITY OF CARMEL, INDIANA VENDOR: 366394 Page 1 of 1 ` t ONE CIVIC SQUARE POMPS TIRE-LAFAYETTE CARMEL, INDIANA 46032 2700 SCHUYLER AVENUE CHECK AMOUNT: $737.82 LAFAYETTE IN 46905 CHECK NUMBER: 214048 CHECK DATE: 10/23/2012 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 2201 4232000 910004654 549 . 84 TIRES & TUBES 2201 4232000 910004692 75 . 00 TIRES & TUBES 2201 4232000 910004863 112 . 98 TIRES & TUBES SHPN577034060 POMP'S TIRE-LAFAYETTE INVOICE #: 910004863 2700 SCHUYLER AVE PAGE: 1 LAFAYETTE, IN 47905 765/742-4000 CUSTOMER: CITY OF CARMEL STREET DEP 3400 W 131ST STREET 2264 CARMEL, IN 46074 CREATED BY TIM FAX NUMBER: 3177332005 WORK: 317/733-2001 0 SALESMAN: MICHAEL S RUMMEL INVOICE DATE: 10/16/12 TERMS: NET 30 DAYS ------------------------------------------------------------------------------- PRODUCT MECHANIC QUANTITY PRICE F.E.T. EXTENSION ------------------------------------------------------------------------------- 9-17. 5 HIGHWAY (HWA) 1 112.98 112.98 274HWA MERCHANDISE: 112.98 INVOICE TOTAL: 112.98 ON ACCOUNT A/R 112.98 signature Printed Name Page 1 CUSTOMER COPY a � 2 REMITTANCE ADDRESS: [P MPS T 11 E SEI��/]R V ME9 MCI. POMP'S TIRE SERVICE, INC. ATTN:AR DEPARTMENT �e P.O. BOX 1630 eunesnaisuennssuun� ,ie`srinm GREEN BAY,WI 54305-1630 a POMP' S TIRE-LAFAYETTE INVOICE # : 910004692 2700 SCHUYLER AVE PAGE: 1 LAFAYETTE, IN 47905 765/742-4000 CUSTOMER: CITY OF CARMEL STREET DEP 3400 W 131ST STREET 2264 CARMEL, IN 46074 CREATED_BY _TIM_ FAX NUMBER: 3177332005 WORK: 317/733-2001 0 SALESMAN: MICHAEL S RUMMEL INVOICE DATE: 10/05/12 TERMS : NET 30 DAYS ------------------------------------------------------------------------------- PRODUCT MECHANIC QUANTITY PRICE F.E.T. EXTENSION ------------------------------------------------------------------------------- TRUCK DISMOUNT - SHOP 9105 1 . 00 15 . 00 15. 00 TDS TRUCK SPIN BALANCE 9105 2 . 00 30 . 00 60 . 00 TBAL LABOR.: 75 . 00 INVOICE TOTAL: 75 . 00 ON ACCOUNT A/R 75 . 00 Signature Printed Name • t , A finance chafge of 1 5/o peg month 08/'APR)will be'added to&'u'•npaid balance after 30 days: ,CUSTOMER ESTIMATE SELECTION• I hereby"authorize the below repair work to be done along with necessary materials.You and . You are entitled to.a price estimate for the repairs you have authorized..The repair price may be less your employees may operate vehicle for purposes of testing,inspection or delivery at my risk: than the estimate but will not exceed the estimate without your permission. Your signature will An express mechanic's lien is acknowledged on vehicle to secure the amount of repairs indicate your estimate selection. thereto.You will not be held responsible for loss or damage to vehicle or articles left in vehicle in case of fire,theft,accident,damage from freezing due to lack of anti-freeze or any other 1.I request an estimate in writing before you begin repairs. causes beyond your control. 2.Please proceed with repairs but call me before CUSTOMER SIGNATURE X. continuing if price will exceed $ 3.1 do not want an estimate. Do you want the replaced parts you are entitled to? ❑YES ❑NO ESTIMATED PRICE OF REPAIRS ADDITIONAL WORK AUTHORIZED BY: ❑This vehicle received without face to face customer contact. A.M. NAME DATE TIME P.M. NO.CALLED NEW ESTIMATE SHPN577032591 POMP'S TIRE-LAFAYETTE INVOICE #: 910004654 2700 SCHUYLER AVE PAGE: 1 LAFAYETTE, IN 47905 765/742-4000 CUSTOMER: CITY OF CARMEL STREET DEP SHIP TO: DELIVERED VIA SHANE R. 3400 W 131ST STREET 2264 CARMEL, IN 46074 CREATED BY DBL REF NUMBER: DR497287 FAX NUMBER: 3177332005 WORK: 317/733-2001 0 PO NUMBER: GOV SALESMAN: MICHAEL S RUMMEL INVOICE DATE: 10110112 TERMS: NET 30 DAYS ------------------------------------------------------------------------------- PRODUCT MECHANIC QUANTITY PRICE F.E.T. EXTENSION ------------------------------------------------------------------------------- TRUCK DISMOUNT/MOUNT-LOOSE-SHP 9113 1.00 28.00 28.00 TDMLS STANDARD BRASS TRUCK VALVE 1 7. 50 7. 50 TVALV POWDER COAT RIM/WHL RECONDITON 1 32.00 32.00 RECON SHOP SUPPLIES 1 5.00 5.00 SUPL TRUCK SPIN BALANCE 9113 1.00 30.00 30.00 TBAL 315/80R22.5/20 GDYR G291 1 447.34 447.34 7566256420 CM#70090571 DJS MERCHANDISE: 491.84 LABOR: 58.00 INVOICE TOTAL: 549.84 GOVERNMENT 549.84 Signature Printed Name Page 1 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)) 10/05/12 910004692 $75.00 10/10/12 910004654 $549.84 10/16/12 9100004863 $112.98 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 Pomp's Tire- Lafayette IN SUM OF $ 2700 Schuyler Avenue Lafayette, IN 46905 $737.82 ON ACCOUNT OF APPROPRIATION FOR Carmel Street Department PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members 2201 910004692 42-320.00 $75.00 1 hereby certify that the attached invoice(s), or 2201 910004654 42-320.00 $549.84 bill(s) is (are) true and correct and that the 2201 9100004863 42-320.00 $112.98 materials or services itemized thereon for which charge is made were ordered and received except %,/Thursday, Octob�eJr 18,2012 �VV V T-/.Y Street;Com m issionere; Title Cost distribution ledger classification if claim paid motor vehicle highway fund