172002 04/29/2009 CITY OF CARMEL, INDIANA VENDOR: 00350579 Page 1 of 1
0 ONE CIVIC SQUARE R T AUTO SUPPLY, INC
CARMEL, INDIANA 46032 516 S MAIN ST CHECK AMOUNT: $fi52.68
SHERIDAN IN 46068
CHECK NUMBER: 172002
CHECK DATE: 4(2912009
ACCOUNT PO NUMBE INVO NUMBER A MOUNT DESCRIPTION
2201 4232000 5802--21879 652.68 TIRES TUBES
CAR VEST
R c 1 AUTO SUPPLY, INC PAGE 1.
516) S MAIN STREET REFu 2 3544
AUTO PARTS SHERIDAN, IN 46069
.317) 7S8-4I-+S6
SERVING A WORLD IN MOTION'''
S 60 2- 12C 18 7 9 '2
ANY PART RETURNED FOR CREDIT MUST BE ACCOMPANIED BY THIS RECEIPT SEE CARQUEST STORE FOR DETAILS OF THIS COAST TO COAST GUARANTEE.
1 i 3 1TY OF CARMEL I TY 01:::' CARMEL
L
00 W 131ST 00 W 1313T
4 li L+
T IE STFIELD, 'IN 46074 STFIELD. IN 1 4i--)1'-)7L+
C 1,1 1 IS".0 1 .1ir n 1 40 CI KID. ('40.
5802---21879 ;2p 7 0 4 5/09 D R I I CHARGE
f 31"D 1 4t .7 �'k 4 4 2 1 so 7 0 150.42 0.00 601.66 N/N
WRANGLER SRA E
I X E FA L L 0 2S 0 1.00 N/N
Mib blEPI L+ L a 33 0.00 8.00 N/N
VALVE ITEM
Ebl WL17
WHEEL BALANCE
MIb I ISFU�€)L- e 7 s a 0 e 00 TT/
TIRE DISPOSAL
WARRANTY DISCLAIMER: 'The factory warranty constitutes .11 of the warranties with —1 10 the a.le of all items. The sell., hereby expressly disclaims all warranties, either expressed or implied, including any
Implied wreninly of mv,oh-ti htnass for a padlcular purpose, and the stille, n.illen, assu mes nor authorizes pry other person to assume for it any liability in connection with the sale of all items.
rA
3 6S2.68
00 0.00 0 00
-6 L TC ,M/ .80 PAY
S�e. 68
D T 6
2q 0 AM OUN T
10 0 3 A I W y JL ;�P� 1 rHAR
CASH REFUND
Customer blame
Customer 'hone
Customer Mailii '.Address
Original !Cash Sale Invoicze
Customer's Signature
Counterpro'.s Signature
CocInterl)ro
Manager's Initial }a.
This is a conipany policy to help verify cash refunds and thus safeguard our asset;;.
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))
04/15/09 5802 -21879 $652.68
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
516 S. Main Street
Sheridan, IN 46069
$652.68
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO# Dept. INVOICE NO. ACCT #!TITLE AMOUNT Board Members
2201 5802 -21879 42- 320.00 $652 -68 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
y Wedr�e day ri122, 0 9
9 41 c
SIM0 COUP,; qM§ W'Nrer
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund