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HomeMy WebLinkAbout202278 09/27/2011 CITY OF CARMEL, INDIANA VENDOR: 00350983 Page 1 of 1 ONE CIVIC SQUARE R T TIRE AUTO NOBLESVILLE CHECK AMOUNT: $4,893.75 s ��a CARMEL, INDIANA 46032 17016 CLOVER ROAD NOBLESVILLE IN 46060 CHECK NUMBER: 202278 CHECK DATE: 9/2712011 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1110 4232000 27896 N0026H 4,893.75 TIRES 09/22/2011 11:28 3177733139 RTTIRE PAGE 01 R T irx N oblesville R+.: &.rL5�1t1ki(]�.��feS��S?.ei3363d Store Location store Phn Date Time R T Tire /Auto NOP (317) 773 -3130 08/18/11 11:24 AM 17 016 CLOVER RD Re Print 1 NOBLESVILLE, IN 46060 Your P/O A/R Acct# Terme Ship Via Inv: N0026H JASON N05743 1 ST 10TH Sold -To: Ship -TO: Type payment CARMEL, POLICE DEPARTMENT 3 CIVIC SQUARE CARMEL, IN 46032 Total 0.00 .ARC 317- 733 -4600 atc;: •ii Qty Shp H/0 Itart► Number Description 'qrST Price Amount Init'a 75 75 GY732354500 PO 5/60R16 97V S2 EAC+ l,; 65.00 4875.00 5 75 75 EPA E TI RE FEE (INDIANA) 0.25 18.75 5 c, aa113{ lel, 11 V /Info: i` 1111 1 I a Irillnr I`11 8llb hi�.y I•, I I' I irw-I'�la u $4893 I. IN GOVIT,0.000§ $0.00 Total: $4893.75 9, +I k X t $0.00 a Total Due: 4893.75 Received By: SP:Chuck Godby INDIANA RETAIL TAX EXEMPT PAGE City o f Ca' CERTIFICATE N0.003120155 002 0 PURCHASE ORDER NUMBER FEDERAL EXCISE TAX EXEMPT 35- 60000972 MEW ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES, A/P CARMEL, INDIANA 46032 -2584 VOUCHER DELIVERY MEMO, PACKING SLIPS, FARM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL 1997 SHIPPING LABELS AND ANY CORRESPONDENCE. PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. F VENDOR NO. k DESCRIPTION RA T Tim an Auto Cwmal Police DGpaldmoat VENDOR SHIP TO 3 Clbic squam MIS Clovor Romd Ca mol, Ili CONFIRMATION BLANKET CONTRACT PAYMENTTERMS FREIGHT QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION Account 42-32040 75 Each t i res $55.00 $4,875.00 Sub Total: $4,875.00 Vim. Send Invoice To: Cum al Police Departmont Attn: Tova$m An ds mon a Clvlc squ PLEASE INVOICE IN DUPLICATE C DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT Carmel Po lice Dept. PAYMEN PP A/P VOUCH CANNOT BE APPROVED FOR PAYMENT LR .O. Carmel h!� NUMBER IS MADE A PART 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 SHIP REPAID. THIS APPROPRIATION Uff ICIENT TO PAY FOR THE ABOVE ORDER. 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 i _o AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. CLERK TREASURER DOCUMENT CONTROL NO. 27896 A.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 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_ 20 Signature Title Cost distribution ledger classification if claim paid motor vehicle highway fund VOUCHER NO. WARRANT NO. ALLOWED 20 R T Tire and Auto IN SUM OF 17016 Clover Road Noblesville, IN 46060 $4,893.75 ON ACCOUNT OF APPROPRIATION FOR Carmel Police Department PO# Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Members 27896 I N0026H I 42- 320.00 I $4,89375 1 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 Friday, September 23, 2011 Chief of Police 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)) 08/18/11 N0026H payment for tires $4,893.75 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