219868 05/07/2013 a CITY OF CARMEL, INDIANA VENDOR: 366480 Page 1 of 1
i ONE CIVIC SQUARE POMP'S TIRE
CARMEL, INDIANA 46032 ATTN:AR DEPARTMENT CHECK AMOUNT: $2,179.41
PO BOX 1630 CHECK NUMBER: 219868
GREEN BAY WI 54305-1630
CHECK DATE: 517/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
601 5023990 910007461 471 .44 OTHER EXPENSES
2201 4232000 910008946 738 . 09 TIRES & TUBES
2201 4232000 910009162 480 . 00 TIRES & TUBES
601 5023990 910009163 489 . 88 OTHER EXPENSES
SHPN577099245
POMP'S TIRE-LAFAYETTE INVOICE #: 910007461
2700 SCHUYLER AVE
PAGE: 1
LAFAYETTE, IN 47905
765/742-4000
CUSTOMER: CITY OF CARMEL WATER OPER
3450 W 131ST STREET
2266
CARMEL, IN
46074
CREATED BY TIM
REF NUMBER: DR0775050
FAX NUMBER: 3177332053
WORK: 317/733-2855 0 PO NUMBER: GOV
SALESMAN: MICHAEL S RUMMEL
INVOICE DATE: 04/19/13 TERMS: 1 PMT DUE 10TH OF MON AFTR INV
----------------------- -------------------------------
PRODUCT MECHANIC QUANTITY PRICE F. E.T. EXTENSION
-------------------------------------------------------------------------------
LT235/85R16/10 TRANSFRC AT BL 4 117.61 470.44
189F633
TIRE USER FEE - IN 4 .25 1.00
95OL13
FIRESTONE GOVERNMENT SALE APPROVAL# 7130
CM#6412870250 D7S
MERCHANDISE: 470.44
OTHER: 1.00
INVOICE TOTAL: 471.44
GOVERNMENT 471.44
LUG NUTS SHOULD BE RETORQUED AFTER 50 TO 100 MILES
Signature Printed Name
Page 1
SHPN577102766
POMP'S TIRE-LAFAYETTE INVOICE #: 910009163
2700 SCHUYLER AVE
PAGE: 1
LAFAYETTE, IN 47905
765/742-4000
CUSTOMER: CITY OF CARMEL WATER OPER olq �
2266 3450 W 131ST STREET
�
CARMEL, IN
46074 lX/�
CREATED BY TIM
REF NUMBER: DR0850681
FAX NUMBER: 3177332053
WORK: 317/733-2855 0
SALESMAN: MICHAEL S RUMMEL
INVOICE DATE: 04/29/13 TERMS: 1 PMT DUE 10TH OF MON AFTR INV
-------------------------------------------------------------------------------
PRODUCT MECHANIC QUANTITY PRICE F. E.T. EXTENSION
-------------------------------------------------------------------------------
LT245/75R17/10 TRANSFRC AT WL 4 122.22 488.88
205F222
TIRE USER FEE - IN 4 .25 1.00
950L13
FIRESTONE GOVERNMENT SALE APPROVAL# 7130
CM#6413181169 D3S
MERCHANDISE: 488.88
OTHER: 1.00
INVOICE TOTAL: 489.88
GOVERNMENT 489.88
LUG NUTS SHOULD BE RETORQUED AFTER 50 TO 100 MILES
L
Signatu ` 7 Printed Name
Page 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
366480
Pomp's Tire Purchase Order No.
PO BOX 1630 Terms
GREEN BAY, WI 54305-1630 Due Date 4/30/2013
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
4/30/2013 910007461 $471.44
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 # 131493 WARRANT # ALLOWED
366480 IN SUM OF $
Pomp's Tire
PO BOX 1630
GREEN BAY, WI 54305-1630
Carmel Water Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO# INV# ACCT# AMOUNT Audit Trail Code
910007461 01-6500-05 $471.44
9 I00CP/I vs 11 14$949
Voucher Total Q
Cost distribution ledger classification if
claim paid under vehicle highway fund
SHPN577102278
POMP'S TIRE-LAFAYETTE INVOICE #: 910009162
2700 SCHUYLER AVE
PAGE: 1
LAFAYETTE, IN 47905
765/742-4000
CUSTOMER: CITY OF CARMEL STREET DEP SHIP TO: DELIVER VIA SHANE
3400 W 131ST STREET
2264
CARMEL, IN
46074
CREATED BY TIM
FAX NUMBER: 3177332005
WORK: 317/733-2001 0
SALESMAN: MICHAEL S RUMMEL
INVOICE DATE: 04/26/13 TERMS: 1 PMT DUE 10TH OF MON AFTR INV
-------------------------------------------------------------------------------
PRODUCT MECHANIC QUANTITY PRICE F.E.T. EXTENSION
-------------------------------------------------------------------------------
6 OZ BAG COUNTERACT 64 7. 50 480.00
0060
MERCHANDISE: 480.00
INVOICE TOTAL: 480.00
ON ACCOUNT A/R 480.00
LUG NUTS SHOULD BE RETORQUED AFTER 50 TO 100 MILES
Signature Printed Name
Page 1
SHPN577100181
POMP'S TIRE-LAFAYETTE INVOICE #: 910008946
2700 SCHUYLER AVE
PAGE: 1
LAFAYETTE, IN 47905
765/742-4000
CUSTOMER: CITY OF CARMEL STREET DEP SHIP TO: DELIVER VIA SHANE
2264 3400 W 131ST STREET
CARMEL, IN
46074
CREATED BY TIM
REF NUMBER: DR497674
FAX NUMBER: 3177332005
WORK: 317/733-2001 0
SALESMAN: MICHAEL S RUMMEL
INVOICE DATE: 04/23/13 TERMS: 1 PMT DUE 10TH OF MON AFTR INV
-------------------------------------------------------------------------------
PRODUCT MECHANIC QUANTITY PRICE F.E.T. EXTENSION
-------------------------------------------------------------------------------
315/80R22.5/20 GDYR G291 1 686.84 686.84
7566256420
TIRE USER FEE - IN 1 .25 0.25
950L13
TRK DISMOUNT&MOUNT ON UNIT/SHP 9115 1.00 25.00 25.00
TDMS
10 OZ BAG COUNTERACT 1 20.00 20.00
OlOC
STANDARD BRASS TRUCK VALVE 1 6.00 6.00
TVALV
CM#75135788 DJS
MERCHANDISE: 712.84
LABOR: 25.00
OTHER: 0.25
INVOICE TOTAL: 738.09
GOVERNMENT 738.09
LUG NUTS SHOULD BE RETORQUED AFTER 50 TO 100 MILES
Signature Printed Name
Page 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 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))
04/23/13 910008946 $738.09
04/26/13 910009162 $480.00
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
Pomp's Tire Service, Inc.
A/R Department
IN SUM OF $
p. O. Box 1630
Green Bay, WI 54305-1630
$1,218.09
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
2201 910008946 42-320.00 $738.09 1 hereby certify that the attached invoice(s), or
2201 910009162 42-320.00 $480.00 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
0
F a
]A F t All Z& 2013
StffitreGt&ffrissiksiener
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund