216474 01/15/2013 CITY OF CARMEL, INDIANA VENDOR: 366480
ONE CIVIC SQUARE
CARMEL. INDIANA 46032 POMP'S TIRE Page 9 1 of 1
O ATTN:AR DEPARTMENT
PO BOX 1630 CHECK AMOUNT: $177.50
GREEN BAY WI 54305-1630 CHECK NUMBER: 216474
DEPARTMENT T A CCOUNT p0 N CHECK DATE:
1/15/2013
UMBER INVOICE AM
2201
4232100 OUNT DESCRIPTION I
830011128
177. 50 GARAGE & MOTOR SUPPIE
I
SHPN577061302
POMP'S TIRE-LEBANON INVOICE #: 830011128
1316 WEST SOUTH STREET
PAGE: 1
LEBANON, IN 46052
765/482-4359
CUSTOMER: CITY OF CARMEL STREET DEP SHIP TO: REPAIR RF ON LOADER
3400 W 131ST STREET
2264
CARMEL, IN
46074
CREATED BY SBR
FAX NUMBER: 3177332005
WORK: 317/733-2001 0
SALESMAN: MICHAEL S RUMMEL
INVOICE DATE: 01/08/13 TERMS: 1 PMT DUE 10TH OF MON AFTR INV
-------------------------------------------------------------------------------
PRODUCT MECHANIC QUANTITY PRICE F.E.T. EXTENSION
-------------------------------------------------------------------------------
ROAD SERVICE - REGULAR 8317 1.00 75.00 75.00
RS
INDUSTRIAL DISMOUNT/MOUNT ROAD 8317 1.00 75.00 75.00
IDMR
0 RING 1 20.00 20.00
640L
AIR WATER VALVE 1 7. 50 7. 50
TVALV
MERCHANDISE: 27. 50
LABOR: 150.00
INVOICE TOTAL: 177. 50
ON ACCOUNT A/R 177. 50
THANK YOU FOR YOUR BUSINESS M !
LUG NUTS SHOULD BE RE-TORQUED AFTER 50-100 MILES
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))
01/08/13 830011128 $177.50
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 Service, Inc.
A/R Department IN SUM OF $
p. O. Box 1630
Green Bay, WI 54305-1630
$177.50
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO#/Dept. INVOICE NO. ACCT#(TITLE F AMOUNT Board Members
2201 I 830011128 I 42-320.001 $177.50 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
a.
n n % Friday,,',Januay-11-, 2013
� n
StrStreetCommissioner
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund