223432 08/27/2013 CITY OF CARMEL, INDIANA VENDOR: 00351640 Page 1 of 1
ONE CIVIC SQUARE CLARK TIRE FISHERS
' CARMEL, INDIANA 46032 Po Box iss CHECK AMOUNT: $75.25
FISHERS IN 46038
CHECK NUMBER: 223432
CHECK DATE: 8/27/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1207 4350000 IN00134847 75 . 25 EQUIPMENT REPAIRS & M
& REYNOLDS ROAD (HWY 37 NO.) FAST! Service at your Farm,
P.O. BOX 195
FISHERS, INDIANA 46038 Commercial Site or on the Road.
317-842-0544 OR 1-800-444-5985 All Major Brands Available
TIRE FISHERS �' Fax 317-577-3956
NAME/ADDRESS ACCOUNT NO. 1 HOME PHONE REFERENCE NO.
BROOKSH (317)571-2427 I NOO 13484'7
BRMKSHi RE GMF CLUB P.O.NO. WORK PHONE DATE/TIME
15126 E+MSHI RE PARWAY (,.317) — 08/09/13 11 : 18
RESALE NO. VIN NO. WO-ES NO.
CARVa, IN 458.x. W00121090276
YEAR/MAKE/MODEL LICENSE NO. TAG NO. NEXT INSP.DATE BAR NO.
SAVE PARTS ALL PARTS NEW UNLESS PROMISED DATE/TIME MILEAGE _WRITTEN BY
Y. N OTHERWISE SPECIFIED BS
AMOUNT ESTIMATE DATE TIME EMPLOYEE PHONE CUSTOMER
L ❑ FREE ROTATION
(EVERY 5,000 MILES)
notice and oral approval of an increase in the original estimate price. ROAD HAZARD WARRANTY I
PARTS & OTHERS LABOR
CITY. PART NO. DESCRIPTION E�CHI' DESCRIPTION
1 511485 201068-8/4 TURF N iSTER 75.00 75.06 1.00 INDIANA TIRE FEEL' 0.25
I
Reason for ariginal estimate:
Any warranties on the itemfitems sold hereby are those made by the manufacturer.The seller,CLARK TIRE,hereby expressly
disclaims all warranties either express or implied,including any Implied warranty of merchantability or fitness for a particular
pur se,and CLARK TIRE neither assumes nor authorizes any other person to assume for it any liability in connection with the sale
Igo liemfitems.
FeCHARGE OF 13/4%PER MONTH(21%ANNUALLY)WILL BE CHARGED ON ALL ACCOUNT PAST DUE 30 DAYS.NET 10th PROX. PLACED IN
THE OF AND4GENCY OR ATTORNEY FOR COLLEC ION OR EGAL ACTION TO PAY AN ADD TIONAL CHARGEIEQUALL TO THE COST OF PARTS 7 5. O0
N INCLUDING AGENCY AND ATTORNEY FEES AND COURT COSTS INCURREb AND PERMITTED BY LAW GOVERNING THESE TRANSACTIONS LABOR 1�1„thorize the repair work to be dong��o ith the/neces ry materlals.You and your employees may operate vehicle for purposes of testing, OTHER
or delivery at my�s!C.An expres�rmec ft c's li a owledged on vehicle to secure the amount of repairs thereto.It is also understood that
be held respo le for loss or m 'to ca or a e elt-in cars in case of fire,theft or any other cause beyond your control. SUBLET
Signature X SUBTOTAL 75. 25
TAX 0. 00
Rec'd By TOTAL 75. 25
CASH AMOUNT CHECK AMOUNT CHECK NO. C.C.AMOUNT C.C.TYPE C.C.APPROVAL CODE ON ACCOUNT THANK
75.25 YOU!
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))
08/09/13 IN00134847 Tire I $75.25
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
VOUCHER NO. WARRANT NO.
ALLOWED 20
Clark Tire Fishers
IN SUM OF $
P.O. Box 195
Fishers, IN 46038
$75.25
ON ACCOUNT OF APPROPRIATION FOR
Brookshire Golf Club
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1207 I IN00134847 I 43-500.00 I $75.25 1 hereby certify that the attached invoice(s), or
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, August 23, 2013
tZI 4 /,J-
Director, Brook re Golf Club
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund