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219064 04/09/2013 *F 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: $69.00 FISHERS IL 46038 CHECK NUMBER: 219064 CHECK DATE: 4/9/2013 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 651 5023990 191249 69 . 00 OTHER EXPENSES V TARE CE�TF2A� � �SHEE9aS ,�GVC _ OWNED AND OPERATED BY A PROUD GOODYEAR INDEPENDENT DEALER 7285 EAST 116TH ST Ton;I 604!-t E N T RA L FISHERS, IN 46038 '°'_i AND SERVICE (317) 577-0111 '00 TETE kyw`&At14'OMOTIVE;SERVICE 03/18/13 03/18/13 Ara.9 12 :38 PM 12 :38 PM 'A;IrE TERR: 5625 PAGE: 01 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. F250 3/4 TON SUPER D DATE REQUESTED 03/18/13 VEHICLE COLOR. TIME REQUESTED LICENSE/STATE. RETURN PARTS. . NO ODOMETR IN/OUT 052688 / 52688 SALESMAN. . . . . . 012 / 012 PRIOR INVOICE. 191200 P 0 NUMBER. . . . JEFF COOPER ACCOUNT # COB TC CUST# TYPE/STATE 562502567 1 01 02567 1 IN SLSM TECH PRODUCT CODE BC QTY DESCRIPTION PARTS LBR/EXCISE LINE TOTAL 012 120 078-162 R 1 COMPUTERIZED 4 WHL ALIGN (INCL REAR ADJ) .00 79.00 79.00 012 120 047-100 R 1- 10.00 OFF FLEET DISCOUNT .00 10.00 10.00- 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 NOLT,E WE ARE VERY HAPPY TO HAVE SERVED YOU AND WOULD LIKE TO THANK YOU ONCE AGAIN FOR YOUR BUSINESS. . . . . E 08TOTL MAR 2 6 2013 By 01. '750Z. 06 PARTS TOTAL.. .. .... .00 LABOR TOTAL...... .. 69.00 CHARGED AMOUNT 69.00 SUB TOTAL. . .... .. .. 69.00 --------------------------------- TAXABLE AMOUNT .00 SALES TAX. . .. . . .. .. .00 CUSTOMER AUTHORIZATION FOR TOTAL JE N V® 31 C E T®T'A L X 6 9 _ TREAD L/F.. . .-. 16/32 TREAD R/F. . . . . 16/32 TREAD R/R. . . .. 16/32 TREAD L/R.... . 16132 BUYING PLAN... A # OF PAYMENTS. 1 PAY START DATE 04/10/13 DISCOUNT.. .... *NET* S E WARM tF2 E OO E R S E S g®E f��ryF�C 3 FF2yR-��a��X�M FD C3 Fz-r^ ���I-r ^F a-r)r w A R o ®tl tl ®Please a ours ore. `man�ag�er�We�vaPlue your opinion asnmu s your �— ^ Y ®IV tl business.Should you need additional assistance,Call our CUSTOMER ASSISTANCE LINE 1-800-321-2136 VOUCHER # 135217 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 191249 01-7502-06 $69.00 Voucher Total $69.00 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 4/1/2013 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) Amount 4/1/2013 191249 $69.00 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 Date Officer