213882 10/23/2012 wee 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: $149.71
CARMEL IN 46032 CHECK NUMBER: 213882
CHECK DATE: 10/23/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1125 4350000 136596 68 . 71 EQUIPMENT REPAIRS & M
1110 4350101 136695 81 . 00 TRASH COLLECTION
22C S. Rangelin�d
"YOU ARE RIDING ON OUR REPUTATION" LARK Carmel, IN 46032
(317) 844-48
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I,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 FURTHER AGREE THAT IN THE EVENT OF DEFAULT IN THE PAYMENT OF ANY AMOUNT DUE,AND
IF THIS ACCOUNT IS PLACED M 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:
CARREL CLAY PARKS AND REC 63501'01 SAME INVOICE# 13659E
1411 E. 116TH STREET
CARREL I 46032
CUST P.O.# MAKE-MODEL ID# MILEAGE TELEPHONE 'ROUTE SLM SHIP VIA ORDER# PAGE REMARKS
(317)573-4044
(317)571°4144 0 1 NIA 150368 1
INVOICE DATE INVOICE PREVIOUS SHIPPED ' TERMS
NUMBER INVOICE NUMBER
Opened by Operator # 7
STOCK NUMB r SIZE DESCRIPTION QUANTITY,-,- _- U IT T F.E.T. EXTENSION
---- :ORDERS SHIPPED PREY.SHIP, PRICE'
i
REPAIR 3 TIRES
CH EACH TIRE CHANGE 3 3 15.00 100 45.00
STEM EACH` VALUE STEM 1 1 2.50 02 .00 2.50
2010 290!256-4 DEL-NAT TUBE 1 1 6.77 02 .00 6.77
1825 18/8.5-9.5-108 COOPER TUBE TR13 1 1 14.44 0i? .00 14.44
METHOD OF PAYMENT:
CHARGE: 68,71
CHANGE: ;00
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OCT 0 4 2W q-D� 'u�35�a�
Bung �� ( 10
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Approval
/ M nl,. Mike
PARTS LABOR TAX% TAXABLE M ri TAX F.E.T. AMOUNT INVOICE TOTAL4
P_EACr al AMOUNT
68,71 65.71
"You're Riding On Our Reputation"
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice of 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.
060700 Clark Tire Terms
622C S Rangeline Rd
Carmel, IN 46032
Invoice Invoice Description
Date Number (or note attached invoice(s)or bill(s)) PO# Amount
1011112 136596 Tire repairs $ 68.71
Total $ 68.71
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.
060700 Clark Tire Allowed 20
622C S Rangeline Rd
Carmel, IN 46032
In Sum of$
$ 68.71
ON ACCOUNT OF APPROPRIATION FOR
101 -General Fund
PO#or INVOICE NO. ACCT#!TITLE AMOUNT Board Members
Dept#
1125 136596 4350000 $ 68.71 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
18-Oct 2012
Signature
$ 68.71 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund
622C S. Rangeline Road
"YOU ARE RIDING ON OUR REPUTATION" LARK Carmel, IN 46032
4w (317) 844-4839
FIRE
t rational PEA 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 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 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 ,,, POLICE DEPT. 6000101 SHIP TO
HF4E INVDICE# 13665
THREE CIIIC SQUARE
CARMEL IN 46T-32
CLIST. P.O.# MAKE-MODEL ID# MILEAGE _1 TELEPHONE ROUTE SLM SHIP VIA ORDER# PAGE REMARKS
571-2500 0 5 N/A 150575 1
INVOICE DATE INVOICE PREVIOUS SHIPPED TERMS
NUMBER INVOICE NUMBER
Opked T Operator
10/12/2012 136695 NET 10TH 10/12112 10:08:28 8
STOCK NUMBER SIZE DESCRIPTION DR .__.QUANTITY. ,,_ v UNIT T F.E.T. EXTENSION '
DERS SHIPPED PREV.SHIP- PRICE''
5CRAP SCRAP TIRE 27 27 3.00 .00 81.00
I
I THOD DE PAYMENT: _--
CHARGE: 81.00
CHANGE: .00
a 1 [
:iank you for your business
PARTS LABOR TAX% AMOUNT TAX F.E.T: AMOUNT INIUOICE TOTAL
81.00 81.00. _ . .
"You're Riding On Our Reputation"
VOUCHER NO. WARRANT NO.
ALLOWED 20
Clark Tire
IN SUM OF $
622 C South Rangeline Road
Carmel, IN 46032
$81.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel Police Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1110 136695 43-501.01 $81.00
I hereby certify that the attached invoice(s), or
I I
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, October 18, 2012
Chief of Police
Title
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))
10/12/12 136695 27 scrap tires $81.00
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