215749 12/18/2012 CITY OF CARMEL, INDIANA VENDOR: 00350579 Page 1 of 1
f, ONE CIVIC SQUARE R&T AUTO SUPPLY,INC
CARMEL, INDIANA 46032 516 S MAIN ST CHECK AMOUNT: $14,834.98
SHERIDAN IN 46069 CHECK NUMBER: 215749
CHECK DATE: 12/18/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2201 4232000 5802-87766 -164 .42 TIRES & TUBES
2201 4232000 5802-87985 14 , 999 .40 TIRES & TUBES
ORQUEST
R & T AUTO SUPPLY, INC PAGE 1
516 S MAIN STREET REF# 92856
AUTO PARTS SHERIDAN, IN 46069
� (317 ) 758-4456
SERVING A WORLD IN MOTION ! � !
` 58O2-87766 2070
ANY PART RETURNED FOR CREDIT MUST vs ACCOMPANIED av THIS RECEIPT SEE o^xuoEST STORE FOR DETAILS or THIS COAST TO COAST ou^n^mrss.
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31ST OO W 131GT
RMEL, IN 46O74 | LRMEL, IN 46O74
� 58O2-87766 207C) 12110/20 ' BRIA CHARGE
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WARRANTY DISCLAIMER:The ananufacturer's warranIX,If my,constitutes the only warra?,with re.rctEto the sale of all goods.SELLER HEREBY EXPRESSLY DISCLAIMS ALL WARRANTIES,EITHER EXPRESSED OR IMPLIED,
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INCLUDING ANY IMPLIED WARRANTY OF MERCHANT BILITY OR FITNESS FOR A PARTIC LAR PUR Seller does not authorl�any person to grant my warranty or assume my liability by Seiler.
AMOUNT
CHAR'
CASH lI�I��F.�UI�?�1,;::
Customer Name
Customer. Phone # ( )
Customer Mailing Address
Original Cash Sale Invoice #
Custor-ier 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.
Dec 1412 12:19p Rtauto 3177580313 p.1
WRIQUEST
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ANY PART RETURNED POP CREDIT(BUST BE ACCOMPANIED BY THIS RECEIPT. SEE CARQUEST STORE FOR DETAILS OF THIS COAST TO CO 3T GUARANTEE.
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ANY PART RETURNED FOR CREDIT MUST BE ACCOMPANIED BY THIS RECEIPT. SEE CARCUEST STORE FOR DETAILS OF THIS COAST—0 CO ST GUARANTEE.
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R A PAR TI �L. —d.�EU_Efl HEREBY E)PRESSLY DISCLAIMS ALL WARMAN (PRESSED CR IMPLIED.
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AMOUNT
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VOUCHER NO. WARRANT NO.
ALLOWED 20
R & T Auto Supply
IN SUM OF $
516 S. Main Street
Sheridan, IN 46069
$14,834.98
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
2201 5802-87766 42-320.00 ($164.42) 1 hereby certify that the attached invoice(s), or
2201 5802-87985 42-320.00 $14,999.40 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;;December 14,-2012
Street Commissioner
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))
12/10/12 5802-87766 ($164.42)
12/14/12 5802-87985 $14,999.40
I 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