HomeMy WebLinkAbout204941 12/20/2011 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: $783.00
NOBLESVILLE IN 46060 CHECK NUMBER: 204941
CHECK DATE: 12/2012011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4232000 25932 N005LC 783.00 TIRES
T Tire N® esyjIle R .$�7�.ranZlnrl.�ZEa�,4,a:'�aaS�
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Store Location Store Phn Date Time
R T Tire /Auto NOB (317) 773 -3130 12/13/11 09:30 AM RePrint
17016 CLOVER RD Page 1
NOBLESVILLE, IN 46060
Your P/0 A/R Acct# Terms Ship Via
Inv: N005LC 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
Qty Shp B/O Item Number Description S/W FET Price Amount Init's
12 12 GY732354500 P225/60R16 97V S2 EAGiRS A.' 65.00 780.00 5
12 12 EPA STATE TIRE FEE (INDIANA): 0.25 3.00 5
V /Info:
f
Sub -Total
$783.00
IN GOV'T,0.000
$0.00
Total: $783.00
,k
NewPymt: $0.00
$783.00
Received By: SP:Chuck Godby
INDIANA RETAIL TAX EXEMPT PAGE
Ci of C arm el CERTIFICATE NO. 003120155 002 0
PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 22
35- 60000972
ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES, A/P
CARMEL, INDIANA 46032 -2584 VOUCHER, DELIVERY MEMO, PACKING SLIPS,
FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL 1997 SHIPPING LABELS AND ANY CORRESPONDENCE.
'URCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION
92rt�99
R [A T Tire and Auto Carmel Police Department
VENDOR SHIP 3 Civic Squ=
TO
97090 Clover Road Carmel, IN 4M
Nobioavillo, IN 4M (397) 579
coNFIRMn71DN BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Account 42-320.0
42 Each tires $05.25 $783.00
Sub Total: $783.00
a
4
Send Invoice To:
Carmel Police Department
Attn: oros@ Anderson
3 Civic Squam
Cannel, IN 462- PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT I PROJECT ACCOUNT_ AMOUNT
armei Police Dept. PAYMENT =(w
A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O.
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 APPR�N OF ICIENT TO PAY FOR THE ABOVE ORDER.
C.O.D. SHIPMENTS CANNOT BE ACCEPTED. ORDERED BY
PURCHASE ORDER NUMBER MUST APPEAR ON ALL
SHIPPING LABELS.
THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945 TITLE W of Police
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THE
IOCUMENT CONTROL NO 2 5 9 3 2 CLERK- TREASURER
COPY -SIGN AND RETURN TO CLERIC'S OFFICE
VOUCHER NO. WARRANT
ALLOWED 20
IN THE SUM OF
ON ACCOUNT OF APPROPRIATION FOR
r
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
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))
12/13/11 N005LC tires $783.00
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
VOUCH NO. WAR NO.
ALLOWED 20
R T Tire and Auto
IN SUM OF
17016 Clover Road
Noblesville, IN 46060
$783.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel Police Department
PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members
25932 I N005LC I 42- 320.00 I $783.00 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
Thursday, December 15, 2011
Chief of Police
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund