238672 10/28/14 a u�"�AA'M
CITY OF CARMEL, INDIANA VENDOR: 367213
G/ \1 ONE CIVIC SQUARE R&T TIRE-LEBANON CHECK AMOUNT: $*******225.36*
s. =q, CARMEL, INDIANA 46032 1310 W SOUTH ST CHECK NUMBER: 238672
9M���ON�` LEBANON IN 46072 CHECK DATE: 10/28/14
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4351000 LOORCN 225.36 AUTO REPAIR & MAINTEN
R & T Tire-Lebanon R&T Frankfort(765)654-5588
� R&T Lebanon(765)482-5027
1310 W South Street Sheridan(317)758-4456
$�, R&T She
MD z 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 09/17/14 08:24 AM
1310 W. SOUTH STREET file id: LEB-35447 Page 1
LEBANON, IN 46052
Your P/0 A/R Acct Terms Ship Via
Inv: LOORM VANVORST L00168 1 ST 10TH
Sold-To: Ship-To: Type - Payment
CITY OF CARMEL (E13) $
760 THIRD AVENUE SW $
-` CARMEL, IN 46032
Total $ 0.00
**MEMBER OF THE GOODYEAR TIRE & SERVICE NETWORK** REP 317-571-2634
317-710-2321
Qty Shp B/O Item Number Description �8 r,� tr5/W ,FET Price Amount Init's
1 046120000 ROAD SERVICE PER HR/PER,4, (I2' 80.00 80.00 202,245
4 046100000 MTDI,SMOUNT 28.00 112.00 202,245
4 041263000 NEW VALUE STEM 4.50 18.00 202
dSHOP. SUPPLIES 15.36
5
--------------------
V/Info: ---- (N/A) (BLANK) Z* `
Unt# #42 ENGINE
_______ ___ _ _ � t____________________________
t i
� r
F Sub-Total
'L $225.36
I
` IN GOV'T, 0.00096
$0.00
;a,Lrfc 1,C9V 5
- --------- -- ---- -- -- - - ----- -- -- -- ---- _ - - ---Total--:-- —___$.2-25-:-36�_.�_
NewPymt: $0.00
Total Due: $225 . 36
Received By: SP:Terry Millikan
VOUCHER NO. WARRANT NO.
R & TT' e &Auto ALLOWED 20
IN SUM OF$
a� a
$225.36
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO#/Dept. INVOICE NO. ACCT#!TITLE AMOUNT Board Members
1120 LOORCN 43-510.00 $225.36 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
OCT 2 7 2014
1
VZO
Fire Chief
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
I
Invoice Invoice Description Amount
Date Number (or note attached invoice(s)or bill(s))
LOORCN E42 $225.36
I
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