260290 06/28/16 r CAq
J`%` M?� CITY OF CARMEL, INDIANA VENDOR: 00350983
;.� "a ONE CIVIC SQUARE R &T TIRE&AUTO-NOBLESVILLE CHECK AMOUNT: $"""2,200.40•
_° CARMEL, INDIANA 46032 17016 CLOVER ROAD CHECK NUMBER: 260290
+M�roN NOBLESVILLE IN 46060 CHECK DATE: 06/28/16
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4232000 34036 N01ACY 2,200.40 TIRES
VOUCHER NO. WARRANT NO'. Prescribed by State Board of Accounts City Form No.201(Rev.1995)
R&T TIRE &AUTO-NOBLESVILLE ALLOWED 20 ACCOUNTS PAYABLE VOUCHER
17016 CLOVER ROAD IN SUM OF$ CITY OF CARMEL
An invoice or bill to be properly itemized must show:kind of service,where performed,dates service
C
NOBLESVILLE, IN 46060 rendered,by whom,rates per day,number of hours,rate per hour,number of units,price per unit,etc.
$2,200.40 Payee
ON ACCOUNT OF APPROPRIATION FOR Purchase Order#
Carmel Police Terms
Date Due
PO ACCT# DATE INVOICE# DESCRIPTION
DEPT# INVOICE# Fund# AMOUNT Board Members DEPT# FUND# (or note attached invoice(s)or bill(s)) AMOUNT
j 34 N01ACY 42-320.00 $2,200.40 1 hereby certify that the attached invoice(s),or 6/20/16 N01ACY 20 tires $2,200.40
1110 101 1110 101
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,June 23,2016
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—
Cost
20Cost distribution ledger classification if claim paid motor vehicle highway fund. Clerk-Treasurer
& T. Tire-Noblesville R&T Frankfort(765)654-5588
17016 Clover Rd R&T Lebanon(765)482-5027
4456
�� D �•� � ;s R&T Sheridan(317)758-4456
%,���/� Noblesville,M 46060 R&T Tipton(765)675-6775
�I �?�' 317-773-3130
sanoeises �O
qfo
Store Location Store Phn Date Time
R & T Tire/Auto - NOB (317) 773-3130 06/20/16 07:28 AM
17016 CLOVER RD file id: NOB-60082 Page 1
NOBLESVILLE, IN 46060
Your P/O A/R Acct Terms
Inv: NOlACY 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 rS/W FET Price Amount Init's
20 GY732002500 P235/55R17 98W S2 E7Ugg>RS A 110.02 2200.40 5
--------------------
V/Info:
1 Sub-Total
$2200.40
` a
0 IN GOV'T, 0.000%
f $0.00
r Total: $2200.40
NewPymt:
$0.00
Total Due: $2200 .40
Received By: SP: Chuck Godby
1