219514 04/24/2013 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: $786.89
FISHERS IL 46038
CHECK NUMBER: 219514
CHECK DATE: 4/2412013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 191200 786 . 89 OTHER EXPENSES
TgF2E CEIVT�2A� F MSHaaS ZNC
OWNED AND OPERATED BY A PROUD GOODYEAR INDEPENDENT DEALER
7285 EAST 116TH ST ---o-'CENTRAL
FISHERS, IN 46038 >°' AND SERVICE
(317) 577-0111
COMpLE7E TIRE;B;'AUTOM071VE,SERVICE
xNvaxca 03/15/13 03/15/13
1Sol 2!00 02 :29 PM 02 :29 PM ® i
5625-028634-191200 TERR: 5625
PAGE: 01 NONSIG: 905625
BILL TO: CARMEL WASTE WATER TREATMENT
760 THIRD AVE SW
SUITE 110
CARMEL, IN 46032
PHONE 1. . . . . . . (317) 716-3905 EXT. VEH YEAR/MAKE. 07 FORD TRUCK
PHONE 2 . . . . . . . VEHICLE MODEL. F250 3/4 TON SUPER D
DATE REQUESTED 03/15/13 VEHICLE COLOR.
TIME REQUESTED LICENSE/STATE.
RETURN PARTS. . NO ODOMETR IN/OUT 031513 / 031513
SALESMAN. . . . . . 012 / 012 GS/AN NUMBER G0001644
PRIOR INVOICE. 190835 P 0 NUMBER. . . . PO- cqi�
ACCOUNT # COB TC CUST# TYPE/STATE Cs
562502567 1 01 02567 1 IN
SLSM TECH PRODUCT CODE BC QTY DESCRIPTION PARTS LBR/EXCISE LINE TOTAL
006 748-535-189-0 G 4 LT265/70R17 WRL SILARMR PROGRD E OWLTL 180.05 .00 720.20
012 120 007 093-303 R 4 TIRE INSTALLATION IN STORE PURCHASE 1.00 15.00 64.00
MOUNT,BALANCE.VALVE OR TPMS RESET, AND DISPOSAL
012 012 047-100 R 1 P.O. JEFF COOPER .00 .00 .00
012 012 093-502 R 1 HAZARDOUS WASTE DISPOSAL .13 .00 .13
VISIT OUR WEB SITE: WWW.TIRECENTRALANDSERVICE.COM FOR GREAT DEALS & COUPONS AND/OR ADD US ON FACEBOOK
COME IN AND MEET YOUR NEW MANAGEMENT TEAM, ERIK BURGESS AND TONY NOLTE
WE ARE VERY HAPPY TO HAVE SERVED YOU AND WOULD LIKE TO THANK YOU ONCE AGAIN FOR YOUR BUSINESS. . ...
o � (19 d �
C�
PARTS TOTAL.... .. .. 724.33
LABOR TOTAL. ... .. .. 60.00
MISC SHOP SUPPLIES. 2.56
CHARGED AMOUNT 786.89 SUB TOTAL. .... . . . . . 786.89
�---'------""----""--""----------- TAXABLE AMOUNT .00 SALES TAX... . . . .. .. 00
CUSTOMER AUTHORIZATION FOR TOTAL 31 N V® ]C C E T®T A S;7$gs o as
TREAD L/F.... . 14132 TREAD R/F. .. . . 14/32 TREAD R/R. . . . . 14/32 TREAD L/R. . ... 14/32
BUYING PLAN... A # OF PAYMENTS. 1 PAY START DATE 04/10/13 DISCOUNT...... *NET*
SEE F2eEp\/wEnF2SE ®S z®E FGC)R-1i7•�ra•n�av�MPC)R2-F^E9�VpT� sAIF®ETV
• y•Y ■ ®Please IeII our sTore manager,Wee value your opinion as much as yo ur F ® _®�-® U o■r
business.Should you need additional assistance,call our
CUSTOMER ASSISTANCE LINE 1-800-321-2136
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 4/16/2013
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
4/16/2013 191200 $786.89
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
///9//3 C,//1'-- —
Date Officer
VOUCHER # 135334 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
191200 01-7502-06 $786.89
Voucher Total $786.89
Cost distribution ledger classification if
claim paid under vehicle highway fund