233577 06/11/14 4+us C�gMf .
CITY OF CARMEL, INDIANA VENDOR: 00350983
® ,I ONE CIVIC SQUARE R&T TIRE&AUTO -NOBLESVILLE CHECK AMOUNT: $.....8,018.00'
CARMEL, INDIANA 46032 17016 CLOVER ROAD CHECK NUMBER: 233577
NOBLESVILLE IN 46060 CHECK DATE: 06/11/14
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4232000 31985 NOOT3Z 8,018.00 TIRES
TTire-Noblesville R&T Frankfort(765)654-5588
4R&T Lebanon(765)482-5027
p =% 17016 Clover Rd-' R&T Sheridan(317)758-4456
-� Noblesville,IN 46060 R&T Tipton(765)675-6775
317-773-3130
Since 1965
l
Store Location Store Phn Date Time
R & T Tire/Auto - NOB (317) 773-3130 05/20/14 11:41 AM
17016 CLOVER RD file id: NOB-37727 Page 1
NOBLESVILLE, IN 46060
Your P/0 A/R Acct Terms Ship Via
Inv: NOOT3Z JASON N05743 1 ST 10TH
Sold-To: Ship-To: Type - Payment
CARMEL POLICE DEPARTMENT $
3 CIVIC SQUARE $
CARMEL, IN 46032
Total $ 0.00
**MEMBER OF THE GOODYEAR TIRE & SERVICE NETWORK* a ARC 317-571-2546 GRAG W
Qty Shp B/O Item Number Description ' S/W, FET Price Amount Init's
20 GY732002500 P235/55R17 98W S2 EAG�RS A ,, 106.92 2138.40 18
12 GY732276500 P2�5/50R18 99W XL EP, fRS A 127.80 1533.60 18
20 GY732354500 P225/60R16 97V S2 EAG RS� 89.50 1790.00 18
20 GY73202650024S/55R3803V GY.EAGw"R$"'y ' 127.80 2556.00 18
3 � "
----------------=---
V/Info: )
Fix
---------------
----------------------------
Sub-Total
g � 8018.00
' IN GOV'T, 0.000°9
µ $0.00
1
Total: $8018.00
— -- NewPymt: $0.0.0 -
Total Due: $8018 . 00
Received By: SP:Pete Thomas
INDIANA RETAIL TAX EXEMPT PAGE
U itof Carmel CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 31
35-60000972
ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES,A/P
CARMEL, INDIANA 46032-2584 VOUCHER, DELIVERY MEMO, PACKING SLIPS,
SHIPPING LABELS AND ANY CORRESPONDENCE.
FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL-1997
PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. f__VENDOR NO. DESCRIPTION
6W=14
R&Trim and Auto Cabal Police Department
VENDOR SHIP 3 Civic squar'8
17010 Cl6ver Road TO Carrel, IN 46032
NobI Isvillc, IN dffM (317)571-2V59
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Account 42-320.00
20 Each tires GY732354500 $89.60 $1,790.00
12 Each tires GY732270500 $127.50 $1,533.80
20 Each tires CY732002500 $106.02 $2138.40
20 Each tires r r UGY73202W6 $127.30 $2,558.00
Sub Total: $8,018.00
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Send Invoice To:
Camel Pollco Dcpartmdut
Attn. Rat Young
3 Civic Square
Carmel, IN 4603°x- PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECTACCOUNT AMOUNT
Carmel Police Dept. �_ 11 t;,� PAYMENT $8,018.00
A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O.
NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND
VOUCHER HAS THE PROPER SWORN AFFID�VIT ATTACHED.
SHIPPING INSTRUCTIONS I HEREBY CERTIFYPHAT THERE IS AN UNOBLIGATED BALANCE IN
SHIP REPAID.
THIS APPROPRIATl N SUFFICIENT TO PAY FO THE-ABOVE ORDER.
• �/ i
•C.O.D.SHIPMENTS CANNOT BE ACCEPTED. ORDERED BY l !
•PURCHASE ORDER NUMBER MUST APPEAR ON ALL . ,�+�{i�
SHIPPING LABELS. yp➢Ief of Poll• ce
THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE �/
ANDCTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
CLERK-TREASURER
DOCUMENT CONTROL NO. 31985 A.P.V. COPY-SIGN AND RETURN TO CLERIC'S OFFICE
VOUCHER NO. WARRANT NO.
ALLOWED 20
IN THE SUM OF$
ON ACCOUNT OF APPROPRIATION FOR
I
Board Members
PO#or INVOICE NO. ACCT#/TITLE AMOUNT
DEPT# I 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_
f
20
Signature
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
VOUCHER NO. WARRANT NO.
R &T Tire and Auto ALLOWED 20
IN SUM OF$
17016 Clover Road
Noblesville, IN 46060
$8,018.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel Police Department
PO#/Dept. INVOICE NO. ACCT#frITLE AMOUNT Board Members
31985 NOOT3Z 42-320.00 $8,018.00 I 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, June 6, 2014
4/Z Chief of Police
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
j Invoice Invoice Description Amount
Date Number (or note attached invoice(s)or bill(s))
06/06/14 NOOT3Z tires $8,018.00
� II
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