215397 12/11/2012 CITY OF CARMEL, INDIANA VENDOR: 00350579 Page 1 of 1
ONE CIVIC SQUARE R&T AUTO SUPPLY,INC
o CARMEL, INDIANA 46032 516 S MAIN ST CHECK AMOUNT: $197.92
SHERIDAN IN 46069 CHECK NUMBER: 215397
CHECK DATE: 12/11/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2201 4232000 5802-87493 197 . 92 TIRES & TUBES
ORQUEST
IF" R & T AUTO SUPPLY, INC PAGE 1
��U��� ������� 516 S MAIN STREET REF# 92547
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SHERIDAN, IN 46069
(317 ) 758-4456
SERVING A WORLD IN MOTION ! ! !
5802-87493 no -70
ANY PART RETURNED FOR CREDIT MUST os ACCOMPANIED m THIS RECEIPT SEE o*nuuEST STORE FOR DETAILS op THIS COAST TO COAST su^n^wraE.
G S
' OF CARMEL ITY OF CARMEL
400 W 131ST OO W 131ST
MEL, IN 46074 | �ARMEL, IN
5802-67493 2070 12/
IS DISPOSAL 11 11 S.00 13.00 0.00 33.00 N/N
WARRANTY DISCLAI MER:The rnanufacturer's warrant nly—'r. ith rzect to the sale of all=,SELLER HEREBY EXPRESSLY DISCLAIMS ALL WARRANTIES,EITHER EXPRESSED OR IMPLIED,
INCLUDING ANY IMPLIED WARRANTY OF MERCHANT BILITY OR FITNESS FOR A PARTICWR FUR OSE.Sailor does not ze any person to grant any warranty or assurne any liability by Sailer.
AMOUNT 197 .92
Customer Name
Customer Phone # ( )
Customer Mailing Address
Original Cash Sale Invoice #
Customer's Signature
Counterpro's Sitnaturc
Counterpro's #
Manager's Initials
This is a company policy to help verify cash refunds and thus safeguard our assets.
VOUCHER NO. WARRANT NO.
ALLOWED 20
R & T Auto Supply
IN SUM OF $
516 S. Main Street
Sheridan, IN 46069
$197.92
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
2201 I 5802-87493 I 42-320.001 $197.92 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
Friday, Decinei bUrOI 2012
SSf4bf"Comrriissioner
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))
12/04/12 5802-87493 $197.92
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