181367 01/13/2010 CITY OF CARMEL, INDIANA VENDOR: 00352955 Page 1 of 1
.i c ONE CIVIC SQUARE R T TIRE AUTO SHERIDAN CHECK AMOUNT: $22.00
i CARMEL INDIANA 46032 516 S. MAIN STREET
q a o SHERIDAN IN 46069 CHECK NUMBER: 181367
CHECK DATE: 1/13/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2201 4232000 5802 -24989 22.00 TIRES TUBES
CARQUEST
I R T AUTO SUPPLY, INC PAGE 1
516 S MAIN STREET REF V: 37347
AUTO PARTS SHERIDAN, IN 46069
(317)758-4456
SERVING A WORLD IN MOTION
S802-34989 2070
ANY PART RETURNED FOR CREDIT MUST BE ACCOMPANIED BY THIS RECEIPT. SEE CAROUEST STORE FOR DETAILS OF THIS COAST TO COAST GUARANTEE.
TOITY OF CARMEL CITY OF CARMEL.
L 3'400 W 131. S T 3Li00 W 131ST
T WESTFIELD, IN 46074 T trir l ESTFT L.. IN 46074
o
INvolcz cosTomFR DATE GUST. P.(1 NO. WU= BigaMirljkAiN egilrfaiLgS
5802-34989 ;'2070 ,01 04 /10
DRIA I CHARGE
pArrr NUMBEr C.)E ;5HILFIET.PJ IMQ1111111wsIg9Iggiiiiii INEINET11.1110ElicORMS STAWARIONITNI
LB7 TR7 1 1 36.67 2200 0.00 2200 N!N
TIRE REPAIR
WARRANTY DISCLAIMER: The factory warranty constitutes all 01 the warranties with respect to the sale of all items. The seller hereby expressly disclaims all warranties, either expressed or implied, including any
Implied warranty of merchantability or fitness for a particular purpose, and the sailer neither assumes nor authorizes any other person to assume for it any aabllity in connection with the sale of all Iten1S7
F R G J RNS MIIKPOPREMO IIMMOPASIN klb:.'FCRAIAVLORgpt ISMIWBAB
22.00 JeAralr AratMEEIMIBIEI 22.00
1 6.4k PAY THIS 2200
02 45 PM 2.2 r(P' TOTAL AMOUNT 1"-- CHAR
CASK REFUN
Customer Name
Customer Phone ft
Customer Mailin2,( 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
VOUCHER NO. WARRANT NO.
ALLOWED 20
R T Auto Supply
IN SUM OF
516 S. Main Street
Sheridan, IN 46069
$22.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO# Dept. INVOICE NO. ACCT #!TITLE AMOUNT Board Members
2201 5802 -24989 42- 320.00 $22.00 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
r.
i1 /2
l
,1„ IThursday, January07, 201
✓d
Street .Commissioner_
4
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
Prescribed by State Board or 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))
01/04/10 5802 -24989 $22.00
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