HomeMy WebLinkAbout156303 02/06/2008 CITY OF CARMEL, INDIANA VENDOR: 00350983 Page 1 of 1
ONE CIVIC SQUARE R T TIRE AUTO NOBLESVILLE
CARMEL, INDIANA 46032 17016 CLOVER ROAD CHECK AMOUNT: $6,000.00
NOBLESVILLEIN 46060 CHECK NUMBER: 156303
CHECK DATE: 2/6/2008
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMB AMOUNT DESCRIPTION
1110 4232000 17339 86248 6,000.00 TIRES
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CUSTOMER ASSISTANCE LINE
INDIANA RETAIL TAX EXEMPT PAGE
C it y o C rme CERTIFICATE NO.003120155 002 0 1 1
1i \��111•••/// lS.�s11 JJII PURCHASE ORDER NUMBER
Police Department FEDERAL EXCISE TAX EXEMPT
35- 60000972 1731
3 ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES, A/P
CARMEL, INDIANA 46032 -2584 VOUCHER, DELIVERY MEMO, PACKING SLIPS,
SHIPPING LABELS AND ANY CORRESPONDENCE.
FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL 1997
PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION
January 2 2 OS t c?
VENDOR R T Tire and Auto SHIP City of Carmel Police Depat @went
17016 Clover Road TO 3 Civic Square
Noblesville, IN 46060 Carmel, IN' 46032
CONFIRMATION B=UNIT PAYMENT TERMS FREIGHT
QUANTITY DESCRIPTION UNIT PRICE EXTENSION
100 tires 59.75 5,975.00
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Send Invoice To:
PLEASE INVOICE IN DUPLICATE
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DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
1110 320 tires and tubed I v x PAYMENT
A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O.
1 NUMBER IS MADE APART OF THE VOUCHER AND EVERY INVOICE AND
VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED.
SHIPPING INSTRUCTIONS I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN
THIS APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER.
SHIP REPAID.
C.O.D. SHIPMENTS CANNOT BE ACCEPTED.
PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY
SHIPPING LABELS.
THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945 TITLE Chief of Police
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
CLERK- TREASURER
DOCUMENT CONTROL NO.1 C 3 3 9A.P.V. COPY SIGN AND RETURN TO CLERK'S OFFICE
VOUCHER NO. WARRANT NO.
ALLOWED 20
IN THE SUM OF
ON ACCOUNT OF APPROPRIATION FOR
Board Members
PO# or INVOICE NO. ACCT #/TITLE AMOUNT
DEPT. I hereby certify that the attached invoices 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
20
Signature
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No. 201 (Rev. 1995)
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
R T Tire and Auto Purchase Order No. 17339F
17016 Clover Road Terms
Noblesville, IN 46060 Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
1/29/08 86248 a ent for tires 6,000.00
Total
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
VOUCHER NO. WARRANT NO.
ALLOWED 20
R T Tire and Auto IN SUM OF
17016 Clover Road
Noblesville, IN 46060
6,000.00
ON ACCOUNT OF APPROPRIATION FOR
police general fund
Board Members
PO# or INVOICE NO. ACCT #/TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
17339F 86248 320 6,000. 0 bill(s) is (are) true and correct and that the
materials or services itemized thereon for
�/J� t which charge is made were ordered and
�bK/'
received except
i
a
February 1 20 08
Signature
Chief of Police
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund