236994 09/10/14 i \° CITY OF CARMEL, INDIANA VENDOR: 367213
`1 ONE CIVIC SQUARE R&T TIRE-LEBANON CHECK AMOUNT: $*****2,072.96*
:. =a, CARMEL, INDIANA 46032 1310 w SOUTH ST CHECK NUMBER: 236994
'M;�ioN�: LEBANON IN 46072 CHECK DATE: 09/10/14
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4351000 LOOQR5 2,072.96 AUTO REPAIR & MAINTEN
R & T Tire-Lebanon R&T Frankfort(765)654-5588
R&T Lebanon(765)482-5027
p 1310 W South Street R&T Sheridan(3 i 7)758-4456
Lebanon,IN 46052 R&T Tipton(765)675-6775
765-482-5027
Since 1965
Store Location Store Phn Date Time
R & T Tire/Auto - LEB (765) 482-5027 08/18/14 08:48 AM
1310 W. SOUTH STREET file id: LEB-34673 Page 1
LEBANON, IN 46052
Your P/O A/R Acct Terms Ship Via
Inv: LOOQR5 L00259 1 ST 10TH
Sold-To: Ship-To: Type - Payment
CARMEL FIRE DEPT $
2 CIVIC SQUARE $
CARMEL, IN 46032
Total $ 0.00
**MEMBER OF THE GOODYEAR TIRE & SERVICE NETWORKt REP 317-664-0958
317-571-2615
4 r6f
Qty Shp B/O Item Number Description9s S/W FET Price Amount Init's
AMBULANCE 46 '
4 GY139172205 225"%70R195 G G622 RSD 300.22 1200.88 222
dot# MJ9Y62AW29' 4z, MJ9Y62AW2914j, MJ9Y62AW2914,;`,MJ9Y62AW3014
2 GY139172053 225708195 G_ G64.7RSS '. 296.29 592.58 222
dot# MJ9YJ2AW4313, MJ9YJ2AW0514;
1 046120000 ROAD SERIICE PER HR/PER MAN {R 80.00 80.00 222,245
6 046100000 MOUNT/D SMOUNI' �s Ej 28.00 168.00 222,245
6 EPA STAZE TItE FEE, (ITDTANA) i 0.25 1.50 222
6 ----093002000 TIRE DISO$AL 5.00 30.00 222,245
Ln
V/Info:
------------------------------------------------------------------------------------------------
3
Sub-Total
-- - _
$2072.96 _
IN GOV'T,0.000%
$0.00
Total: $2072.96
NewPymt: $0.00
Total Due: $2072 . 96
Received By: SP:JEFF HOGG
i
VOUCHER NO. WARRANT NO.
ALLOWED 20
R & T Tire &Auto
S_
IN SUM OF$
13�� ttil S'�, I
9-7016 (`.In%ar Road
<Aj
' x,60 SZ
$2,072.96
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1120 LOOQR5 43-510.00 $2,072.96 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
EP -
Fire Chief
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
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 service rendered, by
whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc.
Payee
i
Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s)or bill(s))
I_000R5 A46 $2,072.96
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
120-
Clerk-Treasurer
0Clerk-Treasurer