218252 03/13/2013 CITY OF CARMEL, INDIANA VENDOR: 366044 Page 1 of 1
ONE CIVIC SQUARE TIRE CENTRAL FISHERS INC
CARMEL, INDIANA 46032 7285 E 116TH ST CHECK AMOUNT: $500.37
4 off�o FISHERS IL 46038 CHECK NUMBER: 218252
CHECK DATE: 3113/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 190835 500 . 37 OTHER EXPENSES
. � �RE CENTRAL F X59-HERS �N� _
OWNED AND OPERATED BY A PROUD GOODYEAR INDEPENDENT DEALER
7285 EAST 116TH ST � ENTRAL
FISHERS, IN 46038 ° i AND SERVICE
(317) 577-0111
COMPLETE TIRE 8'AU7UMOTIVE SERVICE
JE N W® J:C E 02/26/13 02/26/13
19®835 08 :42 AM 09: 17 AM Goo" am
562S-028601-190835 5625-028601-190835 TERR: 5625
PAGE: 01 COPY: 04 NONSIG: 905625
BILL TO: CARMEL WASTE WATER TREATMENT
760 THIRD AVE SW
SUITE 110
CARMEL, IN 46032
PHONE 1 . . . . . . . (317) 716-3905 EXT. VEH YEAR/MAKE. 07 FORD TRUCK
PHONE 2 . . . . . . . VEHICLE MODEL. F150 1/2 TON PICKUP
DATE REQUESTED 02/26/13 VEHICLE COLOR.
TIME REQUESTED LICENSE/STATE. 72597 / IN
RETURN PARTS. . NO ODOMETR IN/OUT 089199 / 89199
SALESMAN. . . . . . 012 / 012 GS/AN NUMBER G0001644
VEHICLE INFO. . #25 VEHICLE ID #. . 1FTRX14747FB28885
PRIOR INVOICE. 189755 P 0 NUMBER. . . . JEFFCOOPER
ACCOUNT # COB TC CUST# TYPE/STATE
562502567 1 01 02567 1 IN
SLSM TECH PRODUCT CODE BC QTY DESCRIPTION PARTS LBR/EXCISE LINE TOTAL
012 012 093-502 R 1 HAZARDOUS WASTE DISPOSAL .13 .00 .13
008 183-539-418-0 G 4 P235/75R17 1085 SL WRL SR-A OWL TL 108.42 .00 433.68
012 005 093-303 R 4 TIRE INSTALLATION IN STORE PURCHASE 1.00 15.00 64.00
MOUNT,BALANCE,VALVE OR TPMS RESET, AND DISPOSAL
012 012 047-100 R 1 CALL DRIVER CELL WHEN TIRES HERE 716-3935 .00 .00 .00
VISIT OUR WEB SITE: WWW.TIRECENTRALANDSERVICE.COM FOR GREAT DEALS & COUPONS AND/OR ADD US ON FACEBOOK
COME IN AND MEET YOUR NEW MANAGEMENT TEAM, ERIK BURGESS AND TONY NOLTE
WE ARE VERY HAPPY TO HAVE SERVED YOU AND WOULD LIKE TO THANK YOU ONCE AGAIN FOR YOUR BUSINESS.. . ..
�� MAR 0 4 2013
50Z•
By V✓ /��
ORIGINAL
PARTS TOTAL. .. . ... . 437.81
LABOR TOTAL. ... . . .. 60.00
MISC SHOP SUPPLIES. 2.56
CHARGED AMOUNT 500.37 SUB TOTAL...... . . .. 500.37
--------------------------------- TAXABLE AMOUNT .00 SALES TAX. . . ... . ... .00
CUSTOMER AUTHORIZATION FOR TOTAL 31 mx/a S C E T®T A L -9s!5®® _ 3 7
BUYING PLAN.. . A # OF PAYMENTS. 1 PAY START DATE 04/10/13 DISCOUNT.. ... . *NET*
SEE REi/ERSE SJCDE FOR gNIP®RTANT SAFETY
WARNgNG AND WARRANTY YNF®FP,M^TZON
HAVE A QUESTION OR PROBLEM?
Please tell our store manager.We value your opinion as much as your
business.Should you need additional assistance,call our
CUSTOMER ASSISTANCE LINE 1-800-321-2136
VOUCHER # 135036 WARRANT # ALLOWED
366044 IN SUM OF $
TIRE CENTRAL FISHERS INC
7285 EAST 116TH ST
FISHERS, IN 46038
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO# INV# ACCT# AMOUNT Audit Trail Code
190835 01-7502-06 $500.37
Voucher Total $500.37
z
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
366044
TIRE CENTRAL FISHERS INC Purchase Order No.
7285 EAST 116TH ST Terms
FISHERS, IN 46038 Due Date 3/6/2013
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
3/6/2013 190835 $500.37
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
Date Officer