190554 09/29/2010 CITY OF CARMEL, INDIANA VENDOR: 00352955 Page 1 of 1
0 ONE CIVIC SQUARE R T TIRE AUTO SHERIDAN CHECK AMOUNT: $289.04
CARMEL, INDIANA 46032 516 S. MAIN STREET
•c, o SHERIDAN IN 46069 CHECK NUMBER: 190554
CHECK DATE: 9/29/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2201 4232000 5802 -48230 489.76 TIRES TUBES
2201 4232000 5802 -48306 200.72 TIRES TUBES
ORQUEST
R T AUTO SUPPL.-Y, INC PAG 1
lo
516 S MAIN STREET REFu 51170
AUTO PARTS SHERIDAN, IN 46069
(317 7S8-4L+S6
SERVING A WORLD IN MOTION!
S802-482 2070
ANY PART RETURNED FOR CREDIT MUST BE ACCOMPANIED BY THIS RECEIPT SEE CARQUEST STORE FOR DETAILS OF THIS COAST TO COAST GUARANTEE.
BCITY OF CARMEL r�ITY OF CARMEL_
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T CARMEL, IN 4?1'1074 ,CARMEL, I 4604
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WARRANTY DISCLAIMER: 'The facto warranty all of the warranties with respect to the sets of all Items. The sailer here expressly disclaims all warranties, either expressed or implied, including any
implied warranty of merchantability or Winne to e particular purpose, and the salter neither assumes nor authorizes any other person to asse for I any liability in connection with the as a ol Items'
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20. 0.00 0.00 489.76
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W. t 5 t AMOUNT C --iA R
1
Customer Nanle
Customer Phone#
Customer 1Vlail1ng 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. f
MUM
ORQUEST
go R T AUTO SUPPLY, INC PAGE 1
516 S MAIN STREET REF# 51394
AUTO PARTS SHERIDAN, IN 46069
(317)758-4456
SERVING A WORLD IN MOTION!!!
5802-48306 2070
ANY PART RETURNED FOR CREDIT MUST BE ACCOMPANIED BY THIS RECEIPT SEE CARQUEST STORE FOR DETAILS OF THIS COAST TO COAST GUARANTEE.
TCARMEL, IN 46074 CARMEL, IN 46074
FR
S802-48306 2070 bq/13/10 1 UM
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1� 1 R --200. 72 0.00 --200. 7'2 N/N
RE RETL RN
WARRANTY DISCLAIMER: 'The faclo7 warrarp constitutes all of the warranties with respect to the sale of all Items. The seller hereby ax ressly disclaims all warrantles, either ex res or Implied. Including any
implied warranty of merchantability or itness particular purpose. and the seller neither assumes nor authorizes any other person to nasume forpi any liability in connection with th sale ofall it
PAY THIS
CASH EFUND
Customer Name
Customer Phone
Customer Mailing -Address
Original Cash Sale Invoice
Customer's Signature
C.ounterpro'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
$289.04
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Member
2201 5802 -48230 42- 320.00 $489.76 I hereby certify that the attached invoice(s), or
2201 5802 -48306 42- 320.00 ($200.72)
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
T tirsday, /Septerb r 23, 2010
Street Commissione.
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: 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))
09/10/10 5802 -48230 $489.76
09/13/10 5802 -48306 J ($200.72)
1 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