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219278 04/24/2013 CITY OF CARMEL, INDIANA VENDOR: 060700 Page 1 of 1 ONE CIVIC SQUARE CLARK TIRE INC ` rQ CARMEL, INDIANA 46032 622 C SOUTH RANGELINE RD CHECK AMOUNT: $184.90 ? CARMEL IN 46032 CHECK NUMBER: 219278 «ON� CHECK DATE: 4124/2013 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 601 5023990 138113 89 . 95 OTHER EXPENSES 601 5023990 138147 94 . 95 OTHER EXPENSES 622C S. Rangeline Road "YOU ARE RIDING ON OUR REPUTATION" LARK Carmel, IN 46032 4a (317) 844-4839 � IRE Jational PENd IL I,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 SELLER SHALL HAVE A SECURITY INTEREST IN 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 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 CHARGE EQUAL TO THE COST OF COLLECTION INCLUDING AGENCY AND ATTORNEY FEES AND COURT COSTS INCURRED AND PERMITTED BYLAWS GOVERNING 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) RECEIVED BY SOLD TO:CARMEL WATER DISTRIBUTION c63=0@101 SHIP TO ME INVOICE# 139147 33459 W. 131ST ST. CARMEL IN 46074 l —7� CUST. P.O.# MAKE-MODEL ID# MILEAGE TELEE.P E ROUTE sLM SHIP VIA ORDER# PAGE REMARKS _ #173 1041 716-3,939 0 1 N/A 153730 1 INVOICE 1 PREVIOUS SHIPPED INVOICE DATE NUMBER INVOICE NUMBER TERMS a by Operator 04/0912013 139147 NET 10TH 04/09/13 14:51:17 9 STOCK NUMBER SIZE DESCRIPTION - QUANTITY ,..-,- UNIT T " F.E.T. EXTENSION _ ,ORDERS SHIPPED PREV.SHIPt PRICE AL3 EACH LIGHT TRUCK ALIGNMENT 1 1 99,95 ,00 95.95 S SHOW SUPPLIES 1 1 5,00 ,00 5.00 1 BALL ,7OINT NUT METHOD OF PAYMENT: CHARGE: 94.95 CHANGE: .00 U �^�/ �r V R.vc� 112 (q 1 Ian, you for your business eCn: DO { PARTS LABOR TAX /o TAXABLE TAX F.E.T. MISC. INU©IGE TOTAL '' o AMOUNT AMOUNT 1 ° Ili: r. 94.90 94.95y "You're Riding On Our Reputation" '�,°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 of service rendered, by whom, rates per day, number of units, price per unit, etc. Payee 60700 CLARK TIRE INC CARMEL Purchase Order No. 622 C SOUTH RANGELINE RD Terms CARMEL, IN 46032 Due Date 4/15/2013 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) Amount 4/15/2013 138147 $94.95 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 VOUCHER # 131343 WARRANT # ALLOWED 60700 IN SUM OF $ CLARK TIRE INC CARMEL 622 C SOUTH RANGELINE RD CARMEL, IN 46032 Carmel Water Utility ON ACCOUNT OF APPROPRIATION FOR Board members PO# INV# ACCT# AMOUNT Audit Trail Code 138147 01-6500-04 $94.95 Voucher Total $94.95 Cost distribution ledger classification if claim paid under vehicle highway fund 622C S. Rangeline Road "YOU ARE RIDING ON OUR REPUTATION" LARK Carmel, IN 46032 410 (317) 844-4839 I � Jational PENd 0 0 L 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 SELLER SHALL HAVE A SECURITY INTEREST IN 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 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 CHARGE EQUAL TO THE COST OF COL 9CTION INCLUDING AGENCY AND ATTORNEY FEES AND COURT COSTS INCURRED AND PERMITTED BY LAWS GOVERNING 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) REC C'IVED SOLD TO:C4RMtl UTILITIES 61pp/0i SHIP TOE INVOICE# 138113 760 3RD AUE SW / CARMEL IN 46032 CUST.P.O.# MAKE-MODEL ID# MILEAGE TELEPHONE ROUTE SLM SHIP VIA ORDER# PAGE REMARKS TRK #1139 316-3923 105926 (317)571-2634 0 5 N/A IM4 1 INVOICE DATE INVOICE PREVIOUS SHIPPED TERMS NUMBER INVOICE NUMBER I Opened by Operator 04/05/202 138113 NET 10TH 04/05/13 13:15:50 8 STOCK NUMBER SIZE DESCRIPTION QUANTITY _ UNIT T F.E.T. EXTENSION ORDERS SHIPPED PREV.SHIP PRICE- R12 EACH PASSENGER 4 WHEEL ALIGNMENT i 1 89.95 .00 89.95 TRK #139 METHOD :7F PAYMENTe CHARGE: 89.95 CHANGE: .00 � I -' I hank you for your business PARTS LABOR TAX% AMOUNT TAX F.E.T. AMOUNT PLEASE FINUQI,CE TI,QTAT 89.95 89.95 "You're Riding On Our Reputation" 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 60700 CLARK TIRE INC CARMEL Purchase Order No. 622 C SOUTH RANGELINE RD Terms CARMEL, IN 46032 Due Date 4/16/2013 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) Amount 4/16/2013 138113 $89.95 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 VOUCHER # 131420 WARRANT # ALLOWED 60700 IN SUM OF $ CLARK TIRE INC CARMEL 622 C SOUTH RANGELINE RD CARMEL, IN 46032 Carmel Water Utility ON ACCOUNT OF APPROPRIATION FOR Board members PO# INV# ACCT# AMOUNT Audit Trail Code 138113 01-6500-07 $89.95 Voucher Total $89.95 Cost distribution ledger classification if claim paid under vehicle highway fund