231848 4 /23/2014 a CITY OF CARMEL, INDIANA VENDOR: 367213
ONE CIVIC SQUARE R &T TIRE-LEBANON CHECK AMOUNT: $*****1,273.92*
CARMEL, INDIANA 46032 1310 W SOUTH ST CHECK NUMBER: 231848
LEBANON IN 46072 CHECK DATE: 04/23/14
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4351000 LOOMHM 1,273.92 AUTO REPAIR & MAINTEN
R & T Tire-Lebanon R&T Frankfart(765)654-5588
I 1310 W South Street R&T Lebanon(765)782-502?
R&T Sheridan(3 17)758-4456
Lebanon,IN 46072 R&T Tipton(765)675-6775
rl
6w,
765-482-5027
Since 1965
Store Location Store Phn Date Time
R & T Tire/Auto - LEB (765) 48i-5027 03/24/14 03:44 Prii RePrint
1310 ZIT. SOUTH STREET file id: LEB-29146 Page 1
LEBANON, IN 46052
Your P/O A/R Acct Terms Ship Via
Inv: LOOM M L00259 1 ST 10TH
Sold-To: I Shia- 'o: Type - Payment
CARMEL FIRE DEPT $
2 CIVIC SQUARE $
CARMEL, IN 46032
Total. $ 0.00
"MEMBER OF THE GOODYEAR TIRE & SERVICE NETWORK** REP 317-E&5-0958
317-571-2615
Qty Shp B/O Item Number Description =- P S/W :FET Price Amount Init's
4 GY139913205 245/70R195 G G622 RSD „i 318.23 1272 .92 222
dot# MCCRLROR1513;.`_MCCRLROR1513, MCCRLR0315-13, MCCRLROR1513
- ...
4 EPA STF:TE:_TTFc);_FEE :`(I�IDIAIVA) . -
0.25 1.00 222
G0002624 STATE OF INDIANA:.BODK. . =..-
DELIVERED TO_.CUSTOM TRUCK
V/Info: _
= _ Z
------------------------------------------= - ----- ---- -----------------------------
Sub-Total
$1273.92
_. .._ .._.. ._-. IN GOV'T,0.000%
$0.00
Total: $1273.92
NewPymt: $0.00
Total Due: $1273 . 92
Received By: SP:JEFF HOGG
L-d 9LbO£8b49L uouegel 1'82
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))
LOOM H M A42 $1,273.92
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
R & T Tire &Auto
IN SUM OF $
1a
$1,273.92
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1120 LOOMHM 43-510.00 $1,273.92 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
APS? 7 1 2014
I
Fire Chief
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund