248995 08/26/15 �' �,A,f CITY OF CARMEL, INDIANA VENDOR: 00350983
a;
® i; ONE CIVIC SQUARE R &T TIRE & AUTO - NOBLESVILLE CHECK AMOUNT: $*****1,710.72*
x. a° CARMEL, INDIANA 46032 17016 CLOVER ROAD CHECK NUMBER: 248995
M�ruN�O' NOBLESVILLE IN 46060 CHECK DATE: 08/26/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4232000 33019 N013P4 1,710.72 TIRES
R & T Tire-Noblesville R&T Frankfort(765)654-5588
17016 Clover Rd R&T Lebanon(765) -5027
�- R&T Sheridan(317 758
-%�z
) 758-4456
IRA, �� " 10( Noblesville,IN 46060 R&T Tipton(765)675-6775
o "C \ 317-773-3130
Since 1965 \\
c V
Store Location Store Phn Date Time
R & T Tire/Auto - NOB (317) 773-3130 08/07/15 08 :06 AM
17016 CLOVER RD file id: NOB-51448 Page 1
NOBLESVILLE, IN 46060
Your P/O A/R Acct Terms
Inv: N013P4 JASON N05743 1 ST 10TH
Sold-To: Type - Payment
CARMEL POLICE DEPARTMENT $
3 CIVIC SQUARE $
CARMEL, IN 46032
Total $ 0.00
**MEMBER OF THE GOODYEAR TIRE & SERVICE NETWORK** ; ARC 317-571-2546 GRAG W
Qty Shp B/O Item Number Description ': .S/W FET Price Amount Init's
P
16 GY732002500 P235/55R17 98W S2 EAG::"RS-A 106. 92 1710 .72 5
--------------------
V/Info: "
Sub-Total
$171c.7z
IN GOV'T, 0.000°%
_ $0.00
Total: $1710 .72
NewPymt: $0.00
Total Due:
$1710 . 72
Received By: SP:Chuck Godby
INDIANA RETAIL TAX EXEMPT PAGE
City of
Carmel CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT =19
;i 35-60000972
ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES,A P
CARMEL, INDIANA 46032-2584 VOUCHER, DELIVERY MEMO, PACKING SLIPS,
FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL- 1997 SHIPPING LABELS AND ANY CORRESPONDENCE.
PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION
efft2o1g
R Z T 41m and Auto C@meal Police DOPEAfont
VENDOR SHIP 3 CIVIC sgum
W016 Clow®P Road TO Cuffial, IN 46m
Nobleovllle, IN 4=0 (317)671
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Account 42-320.09
10 Each Tires P235-53 R17 $100.02 $1,710.72
Sub Total: $1,710.72
Send Invoice To. Z/-00
Camol Pollco Dop&K Gnt
Attn: Pat Young
3 CIVIC squm
Camel, IN 4M- PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT I PROJECT ACCOUNT AMOUNT
Carmel Police Dept. PAYMENT �1,710.72
• A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O.
NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND
VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED.
SHIPPING INSTRUCTIONS I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN
SHIP REPAID. THIS APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER.
•
•C.O.D.SHIPMENTS CANNOT BE ACCEPTED.
•PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY`,-_
/yam \�•-� ,._
SHIPPING LABELS. �•� 1 ' 1� C�I(dY of l7ollea
•THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE�Q*
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. '
CLERK-TREASURER
DOCUMENT CONTROL NO. 33019 A.P.V. COPY-SIGN AND RETURN TO CLERK'S OFFICE
VOUCHER NO. WARRANT NO.
ALLOWED 20
IN THE SUM OF$
ON ACCOUNT OF APPROPRIATION FOR a
Board Members
PO#or INVOICE NO. ACCT#/TITLE AMOUNT
DEPT.# 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 _
20
Signature
-----------....----------..._.-_.... - -.............................................-- -
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
Invoice Invoice Description Amount
Date Number (or note attached invoice(s)or bill(s))
08/07/15 N013P4 tires $1,710.72
1 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 and Auto
IN SUM OF $
17016 Clover Road
Noblesville, IN 46060
$1,710.72
ON ACCOUNT OF APPROPRIATION FOR
Carmel Police Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
33019 I N013P4 I 42-320.00 I $1,710.72 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
Thursday, August 20, 2015
Chief of Police
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund