HomeMy WebLinkAbout214048 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
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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