HomeMy WebLinkAbout253187 01/11/16 C1q
CITY OF CARMEL, INDIANA VENDOR: 00350983
;; d •I ONE CIVIC SQUARE R &T TIRE&AUTO-NOBLESVILLE CHECK AMOUNT: $" " `3,738,32"
a CARMEL, INDIANA 46032 17016 CLOVER ROAD CHECK NUMBER: 253187
NOBLESVILLE IN 46060 CHECK DATE: 01/11/16
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 R4232000 33332 N016HT 3,738.32 TIRES
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Sze R & T Tire-Noblesville R&T Frankfort(765)654-5588
17016 Clover Rd R&T Lebanon(765)482-5027
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RIP
R&T Sheridan(317)758-4456
Noblesville,IN 46060 R&T Tipton(765)675-6775
317-773-3130
Since 1965
Store Location I Store Phn pate Time
R & T Tire/Auto - NOB (317) 773-3130 12/14/15 10:43 AM
17016 CLOVER RD file id: NOB-55073 Page 1
NOBLESVILLE, IN 46060
Your P/O A/R Acct Terms
Inv: N016HT N05743 1 ST 10TH
Sold-To: Type - Payment
CARMEL POLICE DEPARTMENT ! $
3 CIVIC SQUARE j $
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CARMEL, IN 46032
Total $ 0.00
**MEMBER OF THE GOODYEAR TIRE &i SERVICE NETWORK* ' M 317-571-2546 GRAG W
Qty Shp B/0 Item Number I Description S/W.. FET Price Amount Init's
4 GY183106436 P265/70R17 113R S2 WRL' SSR Ai'. 115.13 460.52 5
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11 GY732026500 245J55R18 103V GY EAGLE -RS A 127.80 1405.80 5
8 GY732301500 P265/60R17 108V SL EAG 3RS Aµ 125.00 1000.00 5
8 GY732002500 P23tEARS A 109.00 872.00 5
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V/Info:
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' Sub-Total
$3738.32
IN GOV'T, 0.000%
s $0.00
.,., .' Total: $3738.32
iNewPymt: .$0.00
Total Due: $3738 . 32
Received By: SP: Chuck Godby
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®�° INDIANA RETAIL TAX EXEMPT PAGE
City ,11f Carme,"I CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT
35-60000972
ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES,A/
CARMEL, INDIANA 46032-2584 VOUCHER, DELIVERY MEMO, PACKING SLIP;
FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL-1997 SHIPPING LABELS AND ANY CORRESPONDENCI
JRCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION
R&T Tim and Auto Camel Polido Department
3 Chid squ
VENDOR SHIP
,7016 Clover Rosa TO Camel, IN 46032
Noblesville, IN 4 (317)571-26M
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
tcount ee�9��g��yg
1 Each Urn $3,738.32 $3,738.32
Sub Total: $3,738.32
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Send Invoice To:
Camel Pollee Dopartment f,
Attn. Pat Young
3 Civic Square
Carmel, IN 4032= PLEASE INVOICE IN DUPLICATE
DERARJMENT ACCOUNT PROJECT PROJECT ACCOUNT �a, AMOUNT
;x1111 A 1 1'wo19 w wVII/&a µ...� r r mas•va
PAYMENT
S A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O.
NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND
VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED.
SHIPPING INSTRUCTIONS I HEREBY CERTIFY THgTyERE IS AN UNOBLIGATED BALANCE IN
THIS APPROPRIAT, ,SU FICIENT TO PAY FOR THE ABOVE ORDER.
•SHIP REPAID. A/
•C.O.D.SHIPMENTS CANNOT BE ACCEPTED. /
•PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY
SHIPPING LABELS. &Oof of Polido
•THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
CLERK-TREASURER
DOCUMENT CONTROL NO. 3 A.P.V. COPY-SIGN,4N® RETURN TO CLERK'S OFFICE
VOUCHER NO. _ WARRANT NO.
ALLOWED 20
IN THE SUM OF$
ON ACCOUNT OF APPROPRIATION FOR
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
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: kindof 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 Date Invoice# Description Amount
Dept., Fund# (or noteattached invoice(s)or bill(s))
12/14/15 N016HT tires, $3,738.32
1110 101
I hereby certify.that the attached invoice(s), or bill(s), is(are)true and correct and I have audited same in accordance
with IC 5-11-10-1.6
' 20
Clerk-Treasurer
VOUCHER NO. WARRANT NO..
ALLOWED 20
R&T TIRE&AUTO NOBLESVILLE
17016 CLOVER ROAD
IN
SUM OF$
NOBLESVILLE, IN 46060.
$3,738.32
ON ACCOUNT OF APPROPRIATION FOR
,tfO#/Dept. INVOICE NO. ACCT#%Fund AMOUNT
Board Member:
,03332N016HT 42-320:00 $3,738.32 I hereby certify that the attached-invoice(s), or
Encumbered. :I 101_ . I.Prior Year
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
Monday,January 04, 201.6
Cost distribution ledger classification if
claim paid motorvehicle highway fund