HomeMy WebLinkAbout216250 01/10/2013 CITY OF CARMEL, INDIANA VENDOR: 182450 Page 1 of 1
� J� ONE CIVIC SQUARE LEBANON TIRE&AUTO SVC CHECK AMOUNT: $1,989.48
s®'° CARMEL, INDIANA 46032 1310 W SOUTH ST
LEBANON IN 46052 CHECK NUMBER: 216250
CHECK DATE: 1/10/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4351000 LOOCD7 1, 876 . 08 AUTO REPAIR & MAINTEN
1120 4351000 LOOCGB 113 . 40 AUTO REPAIR & MAINTEN
LEBANON TIRE & AUTO SERVICE
1310 W. SOUTH STREET
LEBANON, IN 46052
Store Location Store Phn Date Time
R & T Tire/Auto - LEB (765) 482-5027 12/21/12 07 :22 AM
1310 W. SOUTH STREET file id: LEB-16139 Page 1
LEBANON, IN 46052
Your P/O # A/R Acct# Terms Ship via
Inv: LOOCGB L00259 1 ST 10TH
Sold-To: Ship-To: Type - Payment
CARMEL FIRE DEPT $
2 CIVIC SQUARE $
CAR_MEL, IN 46032 --------
Total $ 0.00
REP 317-664-0958
317-571-2615
!R! SCU;UNIT C;BOX 21, .59,B;RPU;EXIT;
Qty Shp B/O Item Number Description S/W FET Price Amount Init's
1 046120000 ROAD SERVICE PER HR/PER MAN (R 85.00 85.00 202,220
1 046100000 engin 41-ambulance 1670 0.00 0.00 202,220
1 046100000 dismount 2-==mount 1 on unit 20.00 20.00 202,220
1 046100000 unit 41 RRI loose valve stem 0.00 0.00 202,220
SHOP SUPPLIES 8.40
--------------------
V/Info:
------------------------------------------------------------------------------------------------
Sub-Total
$113.40
IN GOV'T,0.000%
$0.00
Total: $113.40
NewPymt: $0.00
Total Due: $113 . 40
Received By: SP:Terry Millikan
LEBANON TIRE & AUTO SERVICE
1310 W. SOUTH STREET
LEBANON, IN 46052
Store Location Store Phn Date Time
R & T Tire/Auto - LEB (765) 482-5027 12/21/12 07:24 AM
1310 W. SOUTH STREET file id: LEB-16027 Page 1
LEBANON, IN 46052
Your P/O # A/R Acct# Terms Ship Via
Inv: LOOCD7 L00259 1 ST 10TH
Sold-To: Ship-To: Type - Payment
CARMEL FIRE DEPT $
2 CIVIC SQUARE $
CARMEL, IN 46032 _____________
Total $ 0.00
REP 317-664-0958
317-571-2615
!R! SCU;UNIT C;BOX 21, .59,B;RPU;EXIT;
Qty Shp B/O Item Number Description S/W FET Price Amount Init's
4 GY138799665 11R225 H G288 MSA T 415.27 1661.08 202
dot# MC3TL7OW1912, MC3TL7OW1912, MC3TL7OW1912, MC3TL7OW1912
4 041263000 NEW VALVE STEM 4 .50 18.00 202
1 046120000 ROAD SERVICE PER HR/PER MAN (R 85.00 85.00 202,220
4 046100000 MT- DISMOUNT 28.00 112.00 202,220
G000164'4 STATE OF INDIANA POL SUB
1 046100000 unit 42 replace frt drives 0.00 0.00 202,220
1 046100000 rotate frts to rear 0.00 0.00 202,220
1 046100000 mileage 68875 0.00 0 .00 202,220
--------------------
V/Info:
------------------------------------------------------------------------------------------------
Sub-Total
$1876. 08
IN GOV'T,0.000%
$0.00
Total: $1876.08
NewPymt: $0.00
Total Due: $1876 . 08
Received By: SP:Terry Millikan
Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No.201(Rev.1995)
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))
Total
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.
20
Clerk-Treasurer
VOUCHER NO. WARRANT NO.
l/� ALLOWED 20
ine- y /" IN SUM OF $
tj
ON ACCOUNT OF APPROPRIATION FOR
rte, G76
Board Members
Po#or INVOICE NO. ACCT#/TITLE AMOUNT
DEPT.# I hereby certify that the attached invoice(s), or
//U 7 ����, �'�' 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
20
Signature
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund