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179817 11/24/2009 CITY OF CARMEL, INDIANA VENDOR: 00350579 Page 1 of 1 ONE CIVIC SQUARE R T AUTO SUPPLY, INC CHECK AMOUNT: $447.00 CARMEL, INDIANA 46032 516 S MAIN ST SHERIDAN IN 46069 CHECK NUMBER: 179817 CHECK DATE: 11/24/2009 DEPA ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 2201 4232000 580232140 447.00 TIRES TUBES OR R T AUTO SUPPLY, INC PAGE 1 516 S MAIN STREET REF# 34302 AUTO PARTS SHERIDAN, IN 46O69 (317>758-4456 SERVING A WORLD IN MOTION!!! 5802-32140 2O7O ANY PART RETURNED FOR CREDIT MUST as ACCOMPANIED sn THIS RECEIPT SEE cmnuuESn STORE FOR DETAILS or THIS COAST TO COAST GUARANTEE. F OF CARMEL �CITY OF CARMEL W 13 1ST "34OO W 131ST STFIELD�_ IN 46O74 �WESTFIELD, IN 46O74 F- VUST 1 ,4 1 R A N G L ER R TS 0.00 396.00 JN/N IX7 EPA TAX 4 4 0.42 O.2S 0.00 1. oo �/I MIS STEM L VALVE STEM WHEEL BALANCE TIRE DISPOSAL WARRANTY DISCLAIMER: 'The factoW warranty constitutes all of the warranties with respect to the sale of all items. The seller hereby expressly disclaims all warranties, t athIl s ox to sed or implied, including any implied warranty of merchantability or tness for a particular purpose. and the seller n assumes nor authorizes any other person to assume to, it any liability in connection with he sal Fatilorns. 7L 00 PAY THIS 09211 AM W7 AMOUNT IaR f R r CASH REIFUNID Customer Name Customer Phone Customer bailing Address Original Cash Sale Invoice Customer's Signature Counterhro'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) f, 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)) 11/05/09 5802 -32140 $447.00 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 VOUCHER NO: WARRANT N ALLOWED 20 R T Auto Supply IN SUM OF 616 S. Main Street Sheridan, IN 46069 $447.00 ON ACCOUNT OF APPROPRIATION FOR Carmel Street Department PO# Dept. INVOICE NO. ACCT# /TITLE AMOUNT Board Members 2201 5802 -32140 42- 320.00 $447.00 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 /Thursd ay, No /I er 19, 2009 Street Commiss r Street C' T mm s Cost distribution ledger classification if claim paid motor vehicle highway fund