259667 06/14/16 (9,
CITY OF CARMEL, INDIANA VENDOR: 00350983
ONE CIVIC SQUARE R &T TIRE&AUTO-NOBLESVILLE CHECK AMOUNT: $*******428.42*
CARMEL, INDIANA 46032 17016 CLOVER ROAD CHECK NUMBER: 259667
NOBLESVILLE IN 46060 CHECK DATE: 06/14/16
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
911 4351000 N0190W 428.42 AUTO REPAIR & MAINTEN
VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201 (Rev.1995)
R &T TIRE&AUTO- NOBLESVILLE ALLOWED 20 ACCOUNTS PAYABLE VOUCHER
17016 CLOVER ROAD IN SUM OF$ CITY OF CARMEL
An invoice or bill to be properly itemized must show:kind of service,where performed,dates service
NOBLESVILLE, IN 46060 rendered,by whom,rates per day,number of hours,rate per hour,number of units,price per unit,etc.
$428.42 Payee
Purchase Order#
ON ACCOUNT OF APPROPRIATION FOR
HCDTF Terms
Project#2016-911 and Task 2016-2 Date Due
PO# ACCT# DATE INVOICE# DESCRIPTION
DEPT# INVOICE# Fund# AMOUNT Board Members DEPT# FUND# (or note attached invoice(s)or bill(s)) AMOUNT
N019OW 43-510.00 $428.42 1 hereby certify that the attached invoice(s),or 4/21/16 N019OW $428.42
911 911 911 911
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, May 31, 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
120
Cost distribution ledger classification if claim paid motor vehicle highway fund. Clerk-Treasurer
1^®~� R & T Tire-Noblesville R&T Frankfort(765)654-5588
113-9
17016 Clover Rd R&T Lebanon(765)482-5027
1 D �/' R&T Sheridan(317)758-4456
Noblesville,IN 46060 R&T Tipton(765)675-6775
(/ 317-773-3130
Since 1965 J`�
Store Location Store Phn Date Time
R & T Tire/Auto (317) 773-3130 04/21/16 02:22 PM
17016 CLOVER RD file id: NOB-58352 Page 1
NOBLESVILLE, IN 46060
Your P/0 A/R Acct Terms
Inv: N0190W CHUCK 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 Descriptions" f> � S/W,, FET Price Amount Init's
If, r .
2 M126027 245-/40R17 MIC PRIMACY MXM4 G`RX 3 214.21 428.42 18
--------------------
V/Info:
---------------------------- -
---------------------------
Sub-Total
$4.28.42
Nk
IN GOV'T, 0.000-.
° $0.00
i Total: $428.42
NewPymt: $0.00
Total Due: $428 . 42
3 h
Received By: SP: Pete Thomas