219456 04/24/2013 CITY OF CARMEL, INDIANA VENDOR: 366394 Page 1 of 1
ONE CIVIC SQUARE POMPS TIRE-LAFAYETTE
i CHECK AMOUNT: $2,137.21
CARMEL, INDIANA 46032 2700 SCHUYLER AVENUE
LAFAYETTE IN 46905 CHECK NUMBER: 219456
CHECK DATE: 4124/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2201 4232000 830011413 804 . 22 TIRES & TUBES
2201 4232000 910007271 381 .25 TIRES & TUBES
2201 4232000 910007894 951 . 74 TIRES & TUBES
POMP' S TIRE-LAFAYETTE INVOICE # : 910007271
2700 SCHUYLER AVE
PAGE: 1
LAFAYETTE, IN 47905
765/742-4000
CUSTOMER: CITY OF CARMEL STREET DEP SHIP TO: LOOSE WHEEL
3400 W 131ST STREET
2264
CARMEL, IN
46074
CREATED BY TIM
REF NUMBER: DR497723
FAX NUMBER: 3177332005
WORK: 317/733-2001 0 PO NUMBER: GOV
SALESMAN: MICHAEL S RUMMEL
INVOICE DATE: 02/01/13 TERMS : 1 PMT DUE 10TH OF MON AFTR INV
-------------------------------- -- -- - - ----------------- - -----------------------
PRODUCT MECHANIC QUANTITY PRICE F.E.T. EXTENSION
------ ---------- ---------------------------------------------------------------
TRUCK DISMOUNT/MOUNT-LOOSE-SHP 9115 1 . 00 25 . 00 25 . 00
TDMLS
STANDARD BRASS TRUCK VALVE 1 6 . 00 6 . 00
TVALV
FLAT REPAIR OFF UNIT IN SHOP 9101 1 . 00 30 . 00 30 . 00
TFLS
11R22 . 5/16 GOODYEAR G182 RSD 1 320 . 00 320 . 00
138G803185
TIRE USER FEE - IN 1 . 25 0 . 25
950L13
CM#73107390 DJS
MERCHANDISE: 326 . 00
LABOR: 55 . 010
OTHER: 0 . 25
INVOICE TOTAL: 381. 25
GOVERNMENT 381 . 25
LUG NUTS SHOULD BE RETORQUED AFTER 50 TO 100 MILES
Signature Printed Name
POMP' S TIRE-LEBANON INVOICE # : 830011413
1316 WEST SOUTH STREET
PAGE: 1
LEBANON, IN 46052
765/482-4359
CUSTOMER: CITY OF CARMEL STREET DEP
3400 W 131ST STREET
2264
CARMEL, IN
46074
CREATED BY SBR
REF NUMBER: DR0794943
FAX NUMBER: 3177332005
WORK: 317/733-2001 0 PO NUMBER: GOV
SALESMAN: MICHAEL S RUMMEL
INVOICE DATE: 01/28/13 TERMS: 1 PMT DUE 10TH OF MON AFTR INV
----------------------- --------------------------------------------------------
PRODUCT MECHANIC QUANTITY PRICE F.E.T. EXTENSION
---------------- --------------------------------------- ------------------------
16X6 . 5 8 HOLE GM WHEEL 2 95 . 00 190 . 00
141L
LT215/85R16/10 TRANSFRC AT BL 6 102 . 12 612 . 72
189F565
TIRE USER FEE - IN 6 .25 1.50
950L13
CM#6410648569 DJS
MERCHANDISE: 802 . 72
OTHER: 1 . 50
INVOICE TOTAL: 804 . 22
GOVERNMENT 804 .22
THANK YOU FOR YOUR BUSINESS ! ! ! !
LUG NUTS SHOULD BE RE-TORQUED AFTER 50-100 MILES
Signature Printed Name
lam" IN
POMP' S TIRE—LAFAYETTE INVOICE # : 910007894
2700 SCHUYLER AVE
PAGE: 1
LAFAYETTE, IN 47905
765/742-4000
CUSTOMER: CITY OF CARMEL STREET DEP SHIP TO: DELIVERED VIA SHANE R.
3400 W 131ST STREET
2264
CARMEL, IN
46074
CREATED BY DBL
REF NUMBER: DR497776
FAX NUMBER: 3177332005
WORK: 317/733-2001 0 PO NUMBER: GOV
SALESMAN: MICHAEL S RUMMEL
INVOICE DATE: 02/27/13 TERMS : 1 PMT DUE 10TH OF MON AFTR INV
-------------------------------------------------------------------------------
PRODUCT MECHANIC QUANTITY PRICE F.E.T. EXTENSION
----—--------------------------------------------------------------------------
11R22 . 5/16 GY G622 RSD 2 385 . 12 770 .24
138G307265
TIRE USER FEE — IN 2 . 25 0.50
950L13
GOV GY G0001643
TRUCK MOUNT — SHOP 9113 2 . 00 16 . 00 32 . 00
TMS
STANDARD BRASS TRUCK VALVE 2 7 . 50 15 .00
TVALV
10 OZ BAG COUNTERACT 2 20 . 00 40 . 00
OlOC
POWDER COAT RIM/WHL RECONDITON 2 32 . 00 64 . 00
RECON
USED WHEEL 1 25 . 00 25 . 00
UWHL
SHOP SUPPLIES 1 5 . 00 5 . 00
SUPL
CM#73748537 DJS
MERCHANDISE: 919 . 24
LABOR: 32 . 00
OTHER: 0 . 50
INVOICE TOTAL: 951. 74
GOVERNMENT 951. 74
VOUCHER NO. WARRANT NO.
ALLOWED 20
Pomp's Tire Service, Inc.
A/R Department IN SUM OF $
p. O. Box 1630
Green Bay, WI 54305-1630
$2,137.21
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
2201 830011413 42-320.00 $804.22 1 hereby certify that the attached invoice(s), or
2201 910007271 42-320.00 $381.25 bill(s) is (are) true and correct and that the
2201 910007894 42-320.00 $951.74
materials or services itemized thereon for
which charge is made were ordered and
received except
°
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qvr/)
& t&ww4ww
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))
01/28/13 830011413 $804.22
02/01/13 910007271 $381.25
02/27/13 910007894 $951.74
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
20
Clerk-Treasurer