205265 01/05/2012 CITY OF CARMEL, INDIANA VENDOR: 00350579 Page 1 of 1
0 ONE CIVIC SQUARE R T AUTO SUPPLY, INC CHECK AMOUNT: $735.28
CARMEL, INDIANA 46032 516 S MAIN ST
SHERIDAN IN 46069
CHECK NUMBER: 205265
CHECK DATE: 1/5/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2201 4232000 5802 -71460 735.28 TIRES TUBES
Omm m
T AUTO SUPPLY, INC PAGE 1
516 S MAIN STREET REF# 75795
AUTO PARTS SHERIDAN, IN 46069
(317)758-4456
SERVING A WORLD IN MOTION!!!
58O2-7146O 2O70
ANY PART RETURNED FOR CREDIT MUST BE ACCOMPANIED BYTHIS RECEIPT. SEE CARQosST STORE FOR DETAIL op THIS COAST m COAST GUARANTEE.
F- Y
LTc O F CARMEL �CITY OF CARM
4OO W 131ST '34OO W 131ST
ARMEL, IN 46O74 |�C�RMEL, IN
TIM
58O2-7146O 2 O7O 12/21/11 BRIA CHARGE
10 it VK ME I I LAN 00990" INK
MARATHON RADIAL
WARRANTY DISCLAIMER: Th. """f-W.". if my, constitut" the onlyp-rraT resgect to the set. of wl g.odg. SELLER HEREBY EXPRESSLY DISCLAIMS ALL WARRANTIES, EITHER EXPRESSED OR IMPLIED,
INCLUDING ANY IMPLIED WARRANTY OF MERCHANT BILITY OR FITNESS FOR R PUR OSE. Sailor does not r ze any person to grant any warranty or assume any Ilability by Sailer.
PAY THIS po
CASH. REFUND
Customer Name
Customer Phone
Customer Mailing 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.
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))
12/21/11 5802 -71460 $735.28
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
VOUCHER NO. WARRANT NO.
ALLOWED 20
R T Auto Supply
IN SUM OF
516 S. Main Street
Sheridan, IN 46069
$735.28
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO# Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Members
2201 5802 -71460 42- 320.00 $735.28 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
Tuesday, January 03, 2012
Street Commissioner
b
JLI CC l-l 7 !nissl one r
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund