214791 11/20/2012 ,.F CITY OF CARMEL, INDIANA VENDOR: 00350579 Page 1 of 1
ONE CIVIC SQUARE R&T AUTO SUPPLY,INC
CARMEL, INDIANA 46032 516 S MAIN ST CHECK AMOUNT: $114.62
SHERIDAN IN 46069
CHECK NUMBER: 214791
CHECK DATE: 11/20/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2201 4232000 5802-86012 114 . 62 TIRES & TUBES
ORQUEST
R & T AUTO SUPPLY, INC PAGE ' 1
—~�— 516 S MAIN STREET REF# 91OO9
AUTO PARTS SHERIDAN, IN 46O69
(317 ) 758-4456
SERVING A WORLD IN MOTION ! ! !
58O2-86O12 2O7O
ANY PART RETURNED FOR CREDIT MUST BE ACCOMPANIED BY THIS RECEIPT. SEE oARusST STORE FOR DETAILS op THIS COAST ro COAST GUARANTEE.
rITY OF CARMEL �ITY OF CARM EEL
S4OO W 131ST 34OO W 131ST
' RM EL, IN 46O74 | |�ARMEL, IN
��( 58O2-86O12 2O7O 11/2/2O1 TOM CHARGE
C-"A'RQ LJ 1-*---. `L27
WARRANTY DISCLAIMER:The rranufacturer's warrant ratitutel;the only warrar&�Ith res;oct to the sale of all goods.SELLER HEREBY EXPRESSLY DISCLAIMS ALL WARRANTIES,EITHER EXPRESSED OR IMPLIED,
INCLUDING ANY IMPLIED WARRANTY OF MERCHANT BILIT R FITN E FOR R FUR OSE.Salter does not authorize any person to grant my warranty or rulaurne my liability by Seller.
0' Aff,04YAWYA—IL MVA�vm 4#11
PAY THIS
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'
(CASH AIEFUND
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 companv policy to help verily 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))
11/02/12 5802-86012 $114.62
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.
R & T Auto Supply ALLOWED 20
IN SUM OF $
516 S. Main Street
Sheridan, IN 46069
$114.62
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
2201 I 5802-86012 ( 42-320.001 $114.62 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, November 15, 2012
1 r Z
P ;r
„Street-Commissioner
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund