245960 06/03/15 0%' \. CITY OF CARMEL, INDIANA VENDOR: 00350579
® ONE CIVIC SQUARE R &T AUTO SUPPLY, INC CHECK AMOUNT: $*******212.50*
�_� CARMEL, INDIANA 46032 516 S MAIN ST CHECK NUMBER: 245960
v��TON�°� SHERIDAN IN 46069 CHECK DATE: 06/03/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2201 4232000 5802-128700 212.50 TIRES & TUBES
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ANY PART RETURNED FOR CREDIT MUST BE ACCOMPANIED BY THIS RECEIPT SEE CARQUEST STORE FOR DETAILS OF THIS COAST TO COAST GUARANTEE.
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WARRANTY DISCLAIMER:The rnanufacturar's warranty, To 11h respecttothe seds of all goods. HEREBY EXPRESSLY DISCLAIMS ALL WARRANTIES EITHER EXPRESSED OR IMPLIED,
INCLUDING ANY IMPLIED WARRANTY OF MERCHANTABILITY OR FITNESS FORA PARTICULAR PURPOSE.Geller does not authorize ze any person to grant my warranty or assume my liability by Seller.
II my,constitutes the a
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13 �J, PAY THIS 212, SC)
AMOUNT
CASH REFUND
Customer Name
Customer Phone # ( )
Customer Mailing Address
Original Cash Sale Invoice #
Customer's Signature
— --- ------Counterpto's-Sign ature
Counterpro's #
Manager's Initials
This is a company policy to help verify cash refunds and thus safeguard our assets.
VOUCHER NO. WARRANT NO.
ALLOWED 20
R &T Auto Supply
IN SUM OF$
516 S. Main Street
Sheridan, IN 46069
$212.50
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
2201 I 5802-128700 I 42-320.001 $212.50 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
6
Aadz ' 015
Street Commissioner
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
,I
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
Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
05/21/15 5802-128700 $212.50
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