304741 10/31/16 0`��' "F CITY OF CARMEL, INDIANA VENDOR: 00350579
.j® ONE CIVIC SQUARE R &T AUTO SUPPLY, INC CHECK AMOUNT: $********83.50*
:9 ,?� CARMEL, INDIANA 46032 516 S MAIN ST CHECK NUMBER: 304741
.y,«oN�. SHERIDAN IN 46069 CHECK DATE: 10/31116
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2201 4232000 180269 83.50 TIRES & TUBES
VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201 (Rev.1995)
R&T AUTO SUPPLY, INC ALLOWED 20 ACCOUNTS PAYABLE VOUCHER
516 S MAIN ST IN SUM OF$ CITY OF CARMEL
An invoice or bill to be properly itemized must show:kind of service,where performed,dates service
SH ERI DAN, IN 46069 rendered,by whom,rates per day,number of hours,rate per hour,number of units,price per unit,etc.
$83.50 Payee
Purchase Order#
ON ACCOUNT OF APPROPRIATION FOR
Street Department 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
5802-149319 42-320.00 $83.50 1 hereby certify that the attached invoice(s),or 10/13/16 5802-149319 $83.50
2201 201 2201 201
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
Tuesday, October 18,2016
Dave Huffman
Director
I hereby certify that the attached invoice(s),or bill(s),is(are)true and correct and 1 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
WRIQUEST
R & T AUTO SUPPLY. INC PAGE 1
516 S MAIN STREET REF# 18026�
AUTO PARTS SHERIDAN, IN 46069
^ (317 > 758-4456
SERVING A WORLD IN MOTION! � !
5802-149319 2O7O
ANY PART RETURNED FOR CREDIT MUST BE ACCOMPANIED BY THmRECEIPI SEE oARuenSTORE FOR DETAILS opTHIS COAST mCOAST GUARANTEE.
/CITY OF CARMEL I
TY OF CARM L
L 4OO W 131ST / +OO W 131ST
|�CARMELr IN 46O74 | | �CARMEL, IN
r / | ~ --
58O2-149319 2O70 1O/13/20 JIM CHARGE
CASH REFUND
Customer Mame
Customer Phone #
Customer Mailing.Address
Original Cash Sale Invoice #
Customer's Signature
Counterpro's.Signature
Counterpro's #
Manager's Initials
This is a company policy to help verify cash refunds and thus safeguard our assets.