218417 03/25/2013 CITY OF CARMEL, INDIANA VENDOR: 060700 Page 1 of 1
ONE CIVIC SQUARE CLARK TIRE INC CHECK AMOUNT: $63.00
CARMEL, INDIANA 46032 622 C SOUTH RANGELINE RD
CARMEL IN 46032 CHECK NUMBER: 218417
CHECK DATE: 3/25/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4350101 137931 63 . 00 TRASH COLLECTION
"YOUARERIDINGONOURREPUTAT/ON,, LARK 6220 S. Rangeline Road
4
Carmel, IN 46032
I RE (317) 844-4839
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oval PEA►L
1,THE UNDERSIGNED,HEREBY AGREE UNTIL SUCH TIME AS THIS ACCOUNT IS PAID IN FULL BY ME,THE SELLER SHALL RETAIN TITLE TO THE GOODS HEREBY PURCHASED AND SE:AMOUNT R SIIALL HAVE
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SHE
INTEREST 1N SAID GOODS TO SECURE THE PAYMENT UNTIL MY ACCOUNT IS FULLY PAID.I FURTHER AGREE THAT IN THE EVENT OF DEFAULT IN THE PAYMENT OF ANY DUE,AND A THIS ACCOUNT IS PLACED IN THE HANDS OFAN AGENCY OR ATTORNEY FOR COLLECTION OR LEGAL ACTION TO PAY AN ADDITIONAL CHARGE EQUAL TO THE COST OF COLLECT INCLUDING
AGENCY AND ATTORNEY FEES AND COURT COSTS INCURRED AND PERMITTED BYLAWS ION OR EG THESE TRANSACTIONS.
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) RECE WED BY
SOLD TO:CARMEL POLICE DEPT, 6000/01
THREE CIVIC 5(ILkjP,E SHIP TONE INVOICE# 137931
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CARMEL IN 46032
CUST P.O.# MAKE-MODEL ID# MILEAGE I1!?11) i "
TELEPMONE ROUTE SLM SHIP VIA
J 11_ ORDER# PAGE REMARKS
1 !H
INVOICE DATE INVOICE PREVIOUS SHIPPED I
NUMBER INVOICE NUMBER TERMS
03/15/2013 137531 O ened b Operator # g
NtT iOTH 03;15/13 10:16:54 $
STOCK NUMBER SIZE DESCRIPTION ouANrlrY. ----_
ORDERS SHIPPED PREY SHIP, PRICE T F.E.T. EXTENSION
METHOD OF PAYMENT:
CHARGE: 63.00
D ANGE: ,00
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PARTS LABOR TAX% TAXABLE
AFAOISNZ TAX F.E.T. MIsC. ,
63,60 AMOUNT INVOICE TOTAL
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"You're Riding On Our Reputation" II
- - I
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))
03/15/13 137931 21 scrap tires $63.00
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
20
Clerk-Treasurer
VOUCHER NO. WARRANT NO.
ALLOWED 20
Clark Tire
IN SUM OF $
622 C South Rangeline Road
Carmel, IN 46032
$63.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel Police Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1110 I 137931 I 43-501.01 -1. $63.00 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
Wednesday, March 20, 2013
Chief of Police
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund