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227468 12/17/2013 f CITY OF CARMEL, INDIANA VENDOR: 366480 Page 1 of 1 ONE CIVIC SQUARE POMP'S TIRE CHECK AMOUNT: $11,902.67 CARMEL, INDIANA 46032 ATTN:AR DEPARTMENT •9 ':+� PO BOX 1630 CHECK NUMBER: 227468 '0H° GREEN BAY WI 54305-1630 CHECK DATE: 1211712013 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 601 5023990 830024275 1, 898 .40 OTHER EXPENSES 2201 4232000 910015892 1, 592 . 11 TIRES & TUBES 2201 4232000 910015893 8, 412 . 16 TIRES & TUBES POMP'S TIRE SERVICE, INC. POMP'STRES RDVIICE,INC. ATTN:AR DEPARTMENT h-y P.O.BOX 1630 GREEN BAY,WI 54305-1630 POMP'S TIRE-LAFAYETTE INVOICE #: 910015892 2700 SCHUYLER AVE PAGE: 1 LAFAYETTE, IN 47905 765/742-4000 CUSTOMER: CITY OF CARMEL STREET DEP SHIP TO: DELIVERED VIA S. RUMMEL 3400 W 131ST STREET 2264 CARMEL, IN 46074 CREATED BY DBL, REF NUMBER: DR0960185 FAX NUMBER: 3177332005 WORK: 317/733-2001 0 PO NUMBER: GOV SALESMAN: MICHAEL S RUMMEL INVOICE DATE: 12/12/13 TERMS: 1 PMT DUE 10TH OF MON AFTR INV PRODUCT MECHANIC..'4UANTITY `;`w. :,PRICE r F,.E T ;EXTENSION LT245/75R17/10 TRANSFRC AT WL 13 122 .22 1588.86 205F222 TIRE USER FEE - IN 13 .25 3.25 950L13 GOV F/S 7130 CM#6419909334 DJS MERCHANDISE: 1588.86 " OTHER: 3 .25 INVOICE TOTAL: 1592.11 GOVERNMENT 1592.11 Printed Name Signature LUG NUTS MUST BE RE-TORQUED AFTER 50-100 MILES. A linanee cMr e o f 1.5%per month 18%APR will lbe added to the unpaid balance otter 30 days. CUSTOMER ESTIMATE SELECTION I hereby aulhorlee the below repair work to be done along wPh necessary melatlals.You entl your employees may operate You are entitled to a price e911mata for the repalrs you have authorized.The repair price may be less than the estimate but venicle for porposes of testing.Inspection or delivery at my bsk.An express mechanics lien is acinowledged on vehicle to wilt net Waal The aslimala wlihout your permission,Your signa lure will Indicate your estimate selection. secure the amount of repairs thereto.You will hot be held responsible for loss or damage to wmicfe or articles left in vehicle 1.I reouest an estimate in writing before you begin repalrs. in case of fire.titan.accident,damage from freezing due to lack of anti-freeze or any other causes beyond your control, 2.Please proceed with iepalre but Call me before Continuing if Price will exceed $ CUSTOMER SIGNATURE 3.l do not went an estimate. ADDITIONAL WORK AUTHORIZED BY: 00 Cu y want the replaced pans you aro entitled rc Q Y_$ �NO IM E C riF/,I A M hane ❑Tula venicle received without lace to lace contam. —� �_�—��--- — ---- P ----- a POMP'S TIRE SERVICE, IN POMP'S TIRE SERDVIICE,INC. ATTN:AR DEPARTMENT �xx s, ex Eh w r P.O.BOX 1630 GREEN BAY,WI 54305-1630 POMP'S TIRE—LAFAYETTE 2700 SCHUYLER AVE INVOICE #: 910015893 PAGE: 1 LAFAYETTE, IN 47905 765/742-4000 CUSTOMER: CITY OF CARMEL STREET DEP SHIP TO: DELIVERED VIA S. RUMMEL 3400 W 131ST STREET 2264 CARMEL, IN 46074 CREATED BY DBL REF NUMBER: DRM999484 FAX NUMBER: 3177332005 WORK: 317/733-2001 0 PO NUMBER: GOV SALESMAN: MICHAEL S RUMMEL INVOICE DATE: 12/12/13 TERMS: 1 PMT DUE 10TH OF MON AFTR INV PRODUCTt MECHANIC QUANTITY , :PRICE F.E:T.. EXTENSION _ 315/80R22 .5/20 CNTNTL HSU2+ 4 505.85 2023.40 514CO28 TIRE USER FEE - IN 4 .25 1.00 95OL13 11822.5/16 CNTNTL HDR2 M+S 8 397.87 3182.96 522CO42 TIRE USER FEE - IN 8 .25 2. 00 950L13 225/70R19.5/14 CNTNTL HDR 12 266.65 3199.80 478C211 TIRE USER FEE - IN 12 .25 3.00 950L13 GOV CN GING3AA6 CM#5076757539 DJS MERCHANDISE: 8406.16 OTHER: 6. 00 INVOICE TOTAL: 8412.16 GOVERNMENT 8412. 16 Printed Name Signature LUG NUTS MUST BE RE-TORQUED AFTER 50-100 MILES. A finange char e of 1.5%Par month 18%APR will be added to the unpaid balance after 70 days. CUSTOMER ESTIMATE SELECTION I hereby authorize the below repair work to be done along with necessary materials.You and your omployees they operate You are entllled Id a price estimate for Ne repairs you nave autholl2ed,The repair price may be less than the esllmete out vehicle for purposes of testing,Inspection of delivery at my risk.An express mechanic's lien is acknowledged on vehicle to will not exceed the ealimale wllhout your permission.Your sign:lure wllt indicela your arlmalr,selection. secure the amount of repairs thereto.You will not be held responslola for loss or damage to vehicle or arucies left in vehicle 1.1 request an estimate in.,ling before you begin repairs. in case of fire.Iheh,accident,damage from freezing due to lack of ami freaze or any other causes beyond Your control. 2.Pieaee proceed with repair$but.11 me before continuing if price will exceed s CUSTOMER SIGNATURE X 3.I do not went an estimate. ADDITIONAL WORK AUTHORIZED BY: Do you went the replaced pane you ere entllled 10?❑YES 0 NO s <iE is C c M rs AUTHORIZED NeR< ❑ This WICla recelved without face to face contact. E —CATF--- --TIpE-- pu ----- -[Aitp3 kx--yrg;lp 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 $10,004.27 ON ACCOUNT OF APPROPRIATION FOR Carmel Street Department PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members 2201 910015893 42-320.00 $8,412.16 I hereby certify that the attached invoice(s), or 2201 910015892 42-320.00 $1,592.11 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 Fr' y, kq�Th , !2013 11 ,�a8tre�t��'i rTrtS'i��i6�i>r r 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)) 12/12/13 910015893 $8,412.16 12/12/13 910015892 $1,592.11 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 POMP1 REMITTANCE ADDRESS: S TIRE SERVICE, INC. POMP'S TIRE SERVICE,INC. ® ATTN:AR DEPARTMENT P.O.BOX 1630 GREEN BAY,WI 54305-1630 POMP'S TIRE-LEBANON 1316 WEST SOUTH STREET INVOICE #: 830024275 PAGE: 1 LEBANON, IN 46052 765/482-4359 CUSTOMER: CITY OF CARMEL WATER OPER SHIP TO: TRK 145 3450 W 131ST STREET 2266 CARMEL, IN 46074 CREATED BY SBR REF NUMBER: DRM998990 FAX NUMBER: 3177332053 WORK: 317/733-2855 0 PO NUMBER: GOV SALESMAN: MICHAEL S RUMMEL INVOICE DATE: 12/11/13 TERMS: 1 PMT DUE 10TH OF MON AFTR INV VO PRODUCT 'a MECHANIC, <QUANTITY': PRICE F E:T EXTENSI''d Nx 245/70R19.5/16 CNTNTL HDR 6 294.15 1764.90 522CO20 TIRE USER FEE - IN 6 .25 1.50 950L13 TRK DISMOUNT&MOUNT ON UNIT/SHP 7971 6.00 18.00 108.00 TDMS TRUCK REJECT AND SCRAP CHARGE 4 6.00 24.00 TDISP TWO GOOD TIRES BACK W/ CUSTOMER CM#5076750212 DJS MERCHANDISE: 1764.90 LABOR: 108.00 OTHER: 25.50 INVOICE TOTAL: 1898.40 GOVERNMENT 1898.40 THANK YOU FOR YOUR BUSINESS! ! ! ! Printed Name Signature LUG NUTS MUST BE RE-TORQUED AFTER 50-100 MILES. A finance char a of 1.5`k er month 18;4 APR)will be added to the unpaid balance after 70 tlaye. EC CUSTOMER ESTIMATE SELTION II c 1' ed tI ca- 6mo 'I - nI.Y n ryc a1 I tc ye,a C itkdt a price Cs:_m.!e for th Ga S"Uh v Ih fh Cpa p .m C 'tr r:te e5.inee bul :'eh fo p'"p— 'Jfl s :' -I e -I-(al nSA F � Charc,le I I ad r.1vlsCgoC e ch 101:7 .11 no!CY..-ed the eltlnleie klhow yC petn tssion.Y C_ra_le,re�:1-,d Ie/au f oal�.mala sde,.or.. wc.J"Dlbe 2>InUnII ,G�.I�.r.::e1n .�1.:1ot be"Id-pa—,efor MSclCantag lC lei:...,^.f afl GlcSrllf Yeh<:e 1.1:cql Cs!ar esllmale t.r't"t�ofe roil be;,rnpa ls. ;l lire.;nclt ,a a,e f ecl�g d,1.:lack of antl rrce:c or any cl,.rr_,daes b.,ord r',,a roc Z Please ........ ..._._........ ....... .......ir. -T <:� p�c'sM.'vnlh rep��r5 but call me xl t.,r_im::g Ip-iceklexceed ; CUSTOMER SIGNATURE X. do not ar an es alo. -Do ye, td 0a Ap f 11 �i$ °P'"` F-r=^� �ADDITIONAL WORK AUTHORIZED BY IJ T.n—do f.—Ned uilh.ul ia.e 1, a..e t art. - ..._ .u.p._........ ___...._. VOUCHER # 133597 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 i 830024275 01-6500-05 $1,898.40 Voucher Total $1,898.40 Cost distribution ledger classification if claim paid under 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 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 12/12/2013 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) Amount 12/12/201: 830024275 $1,898.40 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