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Home My WebLink About215394 12/11/2012 "+f CITY OF CARMEL, INDIANA VENDOR: 366480 Page 1 of 1 0 ONE CIVIC SQUARE POMP'S TIRE CARMEL, INDIANA 46032 ATTN:AR DEPARTMENT CHECK AMOUNT: $1,473.00 ? PO BOX 1630 CHECK NUMBER: 215394 GREEN BAY WI 54305-1630 CHECK DATE: 12/11/2012 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 601 5023990 830009490 1, 293 . 00 TRANSPORTATION EXPENS 2201 4232000 910006114 180 . 00 TIRES & TUBES n CUSTOMER COPY REMITTANCE ADDRESS: PO MPS T E SEIJ 11 V CE 9 MC. POMP'S TIRE SERVICE, INC. �A ATTN:AR DEPARTMENT �4a• »»»»»»».,»,,..,p�Q�»», P.O. BOX 1630 1R64fil\@5lifll{1[LlflfO� ,llumg GREEN BAY,WI 54305-1630 POMP' S TIRE-LAFAYETTE INVOICE # : 910006114 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: 11/28/12 TERMS : DUE 10TH OF THE MONTH FOLLOWIN ------------------------------------------------------------------------------- PRODUCT MECHANIC QUANTITY PRICE F.E.T. EXTENSION ------------------------------------------------------------------------------- 6 OZ BAG COUNTERACT 24 7 . 50 180 . 00 006C --- MERCHANDISE: 180 . 00 INVOICE TOTAL: 180 . 00 ON ACCOUNT A/R 180 . 00 LUG NUTS SHOULD BE RETORQUED AFTER 50 TO 100 MILES Signature Printed Name A finance charge of 1.5%per month(18%APR)will be added to the unpaid 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: A.M. NAME ❑This vehicle received without face to face customer contact. DATE TIME P.M. NO.CALLED NEW ESTIMATE VOUCHER NO. WARRANT NO. ALLOWED 20 Pomp's Tire Service, Inc. A/R Department IN SUM OF $ p. O. Box 1630 Green Bay, WI 54305-1630 $180.00 ON ACCOUNT OF APPROPRIATION FOR Carmel Street Department PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members 2201 I 910006114 I 42-320.001 $180.00 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 �j •� / ! �/ G Frida;, Dece�ber07�2012 z y' 1r ,,�-V �--� i 9 '�tre�t .mrr. �r Street CommIssIoner 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)) 11/28/12 910006114 $180.00 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 SHPN577046823.TXT POMP'S TIRE-LEBANON INVOICE #: 830009490 1316 WEST SOUTH STREET PAGE: 1 LEBANON, IN 46052 765/482-4359 CUSTOMER: CITY OF CARMEL WATER OPER SHIP TO: C/I REPLACE 3450..W 131ST STREET 2266 CARMEL, IN 46074 CREATED BY SBR REF NUMBER: DR0728837 FAX NUMBER: 3177332053 WORK: 317/733-2855 0 SALESMAN: MICHAEL S RUMMEL INVOICE DATE: 11/29/12 TERMS: DUE 10TH OF THE MONTH FOLLOWIN ------------------------------------------------------------------------------- PRODUCT MECHANIC QUANTITY PRICE F.E.T. EXTENSION ------------------------------------------------------------------------------- 225/70R19.5/14 B/S M729F 4 289.00 1156.00 227B023 TIRE USER FEE - IN 4 .25 1.00 950L13 TRK DISMOUNT&MOUNT ON UNIT/SHP 8304 4.00 18.00 72.00 TDMS TRUCK SPIN BALANCE 8301 4.00 12.00 48.00 TBAL TRUCK REJECT AND SCRAP CHARGE 4 4.00 16.00 TDISP CM#6409117671 DJS MERCHANDISE: 1156.00 LABOR: 120.00 OTHER: 17.00 INVOICE TOTAL: 1293.00 GOVERNMENT 1293.00 THANK YOU FOR YOUR BUSINESS! ! ! ! LUG NUTS SHOULD BE RE-TORQUED AFTER 50-100 MILES Signature Printed Name Page 1 VOUCHER # 122942 WARRANT # ALLOWED 366480 IN SUM OF $ Pomp's Tire PO BOX 1630 GREEN BAY, WI 54305-1630 Carmel Water Utility ON ACCOUNT OF APPROPRIATION FOR Board members PO# INV# ACCT# AMOUNT Audit Trail Code 830009490 01-6500-05 $1,293.00 Voucher Total $1,293.00 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. PO BOX 1630 Terms GREEN BAY, WI 54305-1630 Due Date 12/4/2012 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) Amount 12/4/2012 830009490 $1,293.00 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 /Z A Date Officer