221000 06/18/2013 CITY OF CARMEL, INDIANA VENDOR: 060700 Page 1 of 1
ONE CIVIC SQUARE CLARK TIRE INC
CARMEL, INDIANA 46032 622 C SOUTH RANGELINE RD CHECK AMOUNT: $395.94
'. ' CARMEL IN 46032 CHECK NUMBER: 221000
CHECK DATE: 6/18/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4350101 138712 78 . 00 TRASH COLLECTION
601 5023990 138716 317 . 94 OTHER EXPENSES
LARK 622C S. Rangeline Road
"YOU ARE RIDING ON OUR REPUTATION" Carmel, IN 46032
4w (317) 844-4839
ri RE
t rational PEp°"
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.1 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 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%.(Minunum 75) RECEIVED BY
i
SOLD TO: SHIP TO:
CARNET. POLICE DEPT. 6000/01 SANE INVOICE# 138712
THREE CIVIC SURE
CARMEL IN 46032
CLIST.P.O.# MAKE-MODEL ID# MILEAGE TELEPHONE ROUTE SLM SHIP VIA ORDER# PAGE REMARKS
(317)571-2580
571-2500 0 1 N/A 154919 1
INVOICE DATE INVOICE PREVIOUS SHIPPED TERMS
NUMBER INVOICE NUMBER
Opened by Operator # 7
06/07/2013 138712 NET 10TH 06107/13 10:46:00 7
UTITY UNIT
STOCK NUMBER SIZE DESCRIPTION ORDERS SHIPP o PREY.SHIP PRICE T F.E.T. EXTENSION
SCRAP SCRAP TIRE 26 26 3.00 .00 78.00
METHOD OF PAYMENT:
CHARGE: 78.00
CHANGE: .00
I
f
Thank you for your business
PARTS LABOR a TAX% AMOUNT TAX F.E.T. AMOUNT INVOICE TOTAL
PEASE PAY THIS AMOUNT
78.00 78.00
"You're Riding On Our Reputation"
NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201 (Rev.1995)
ALLOWED 20 ACCOUNTS PAYABLE VOUCHER
IN SUM OF $ CITY OF CARMEL
Rangeline Road An invoice or bill to be properly itemized must show: kind of service,where performed, dates service rendered, by
6032 whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc.
$78.00 Payee
Purchase Order No.
UNT OF APPROPRIATION FOR
Terms
mel Police Department
Date Due
Invoice Invoice Description Amount
NVOICE NO. ACCT#/TITLE AMOUNT Board Members Date Number (or note attached invoice(s) or bill(s))
I hereby certify that the attached invoice(s), or 06/07/13 138712 26 scrap tires $78.00
138712 43-501.01 $78.00
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
Friday, June 14, 2013
Chief of Police
Title
istribution ledger classification if I hereby certify that the attached invoice(s), or bill(s), is(are)true and correct and I have audited same in accordance
)aid motor vehicle highway fund with IC 5-11-10-1.6
20
Clerk-Treasurer
1
i 622C S. Rangeline Road
LARKYOU ARE RIDING ON OUR REPUTATION" Carmel,'IN 46032
(317) 844-4839
4W '
Fi RE
t ational PENS IL
I� 0 0
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 MP 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 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) RECEIVED BY
SOLD TO: SHIP TO:
CARMEL UTILITIES 6100/01 SAME INVOICE# 138716
760 3RD AYE SIR
CARMEL IN 46032
CLIST.P.O.# MAKE-MODEL ID# MILEAGE TELEPHONE ROUTE SLM SHIP VIA ORDER# PAGE REMARKS
TRK#140 140 (317)571-2634 0 5 N/A 154927 1
INVOICE DATE INVOICE PREVIOUS SHIPPED TERMS
NUMBER INVOICE NUMBER
Opened by Operator # 8
06/0712013 138716 NET 10TH 06/07/13 14:13:54 8
STOCK NUMBER SIZE DESCRIPTION QUANTITY, - UNIT T F.E.T. EXTENSION
ORDERS SHIPPED PREY.SHIP PRICE
50503 235/70R16 . ' COOPER DISCOVER H/T OWL (T) 2 2 158.72 02 .00 317.44
TF INDIANA TIRE FEE 2 2 .25 .00 .50
METHOD OF PAYMENT: _
CHARGE: 317.94
CHANGE:
i
I
1
ank you for your business Mech: Mike
PARTS LABOR TAX% TAXABLE TAX F.E.T. MISC. INVOICE TOTAL
AMOUNT AMOUNT
P EASE PAY THIS AMOUNT
317.94 317.94
"You're Riding On Our Reputation"
I
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 6/11/2013
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
6/11/2013 138716 $317.94
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 ,,dfficer
VOUCHER # 131872 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
138716 01-6500-07 $317.94
Voucher Total $317.94
Cost distribution ledger classification if
claim paid under vehicle highway fund