218002 03/13/2013 a +'a CITY OF CARMEL, INDIANA VENDOR: 060700 Page 1 of 1
ONE CIVIC SQUARE CLARK TIRE INC CHECK AMOUNT: $81.00
CARMEL, INDIANA 46032 622 C SOUTH RANGELINE RD
CARMEL IN 46032 CHECK NUMBER: 218002
CHECK DATE: 311312013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4350101 137784 81 . 00 TRASH COLLECTION
LARK 622C S. Rangeline Road
"YOU ARE RIDING ON OUR REPUTATION" Carmel, IN 46032
4w (317) 844-4839
t tJational PENN IL
I,THE UNDERSIGNED,HEREBY AGREE UNTIL SUCH TIME AS THIS ACCOUNT IS PAID IN FULL BY ME,THE SELLER SHALL RETAIN TITLE TO TH`(GOODS HEREBYY[j'R�C'F�{+SE ND SELLER SHALL HAVE
A SECURITY INTEREST IN SAID GOODS TO SECURE THE PAYMENT UNTIL MY ACCOUNT 1S FULLY PAID.I FURTHER AGREE THAT IN THE EVENT(�F DEFAULT IN'I'HE PAYIdE �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 CHA111IIIRGE EQUAL TOT E COSH FF/COLLECTION INCLUDING
AGENCY AND ATTORNEY FEES AND COURT COSTS INCURRED AND PERMITTED BY LAWS GOVERNING THESE TRANSACTIONS. ( / i
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 1
SOLD TO- RMEL POLICE DEPT. £001101 SHIP TO E � QNVOICE# 137784
THREE CIVIC WS RE
CARMEL IN 46132
CLIST.P.O.# MAKE-MODEL ID# MILEAGE (317)TELEPHONE ROUTE SLM SHIP VIA ORDER# PAGE REMARKS
571=2511 0 5 N/A IS 43 1
INVOICE DATE INVOICE PREVIOUS SHIPPED TERMS
NUMBER INVOICE NUMBER
_^1nPnPd hy 1 pY f.l'
'0212512013 137784 NET 10TH 12/25/13 08:51:36 8
STOCK NUMBER SIZE DESCRIPTION QUANTITY-- -,-- -.^ UNIT " T : F.E.T. EXTENSION
_ ORDERS SHIPPED PREV.SHIP' PRICE _
SCRAP SCRAP TIRE 27 27 3.01 .00 81.00
METHOD OF PAYMENT;
CHARGE. 81.00
CHANGE: .W
hank you for your business
PARTS LABOR TAX% q OUNT TAX F.E.T. AnMOUu T PLEASE FCNVOI'C`E TOTA�T
81.00 81.10
"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 137784 43-501.01 $81.00
I hereby certify that the attached invoice(s), or
I 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
Wednesday, March 06, 2013
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))
02/25/13 137784 27 scrap tires $81.00
1 hereby certify that the attached invoice(s), or bill(s), is (are)true and correct and 1 have audited same in accordance
with IC 5-11-10-1.6
20 _
Clerk-Treasurer