216850 01/29/2013 CITY OF CARMEL, INDIANA VENDOR: 00350983 Page 1 of 1
ONE CIVIC SQUARE R&T TIRE&AUTO-NOBLESVILLE
?o CARMEL, INDIANA 46032 17016 CLOVER ROAD CHECK AMOUNT: $7,219.76
NOBLESVILLE IN 46060 CHECK NUMBER: 216850
CHECK DATE: 1/29/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4232000 25606 NOOFRW 7, 219 . 76 TIRES
01/22/2013 14:21 3177733139 RTAUTONOBLESVILLE #1277 P. 001/001
R & Tire-Noblesville R&T Frankfort(765)654-5588
17016 Clover Rd R&T 1- ' °n{765)482-5027
( R&T Sheridan(317)758.4456
V� Noblesville,IN 46060 R&T Tipton(765)675-6775
317-773-3130
S�ce j94i6
Store Location Store Phn Date Time
R & T Tire/Auto - NOB (317) 773-3130 01/11/13 02:12 PM RePrint
17016 CLOVER RD file id: NOB-20444 Page 1
NOBLESVILLE, IN 46060
Your P/O # A/R Acct# Terms ship Via
Inv: NOOFRW N05743
Sold-To: Ship-To: Type - Payment
CA12MRL POLICE DEPARTMZXT $
3 CIVIC SQUARE
S
CARMEL, IN 46032
Total 0.00
ARC 317-733-4600
Qty Shp B/o Item Number Description 8/W PET Price A=unt Iait's
a GY732276500 P235/50R18 99W XL EAG .R.jS-.k 121.72 973.76 18
40 GY732297500 23S/55R17 EAG RS-A 98W $2 VSB, VSB 104.78 4191.20 18
40 GY'732354500 ..?225/60R16 97V S2 EAG AS--A 65.00 2600.00 18
-40 GY732297500 235/55R17 BAG RS-A 9.8W 51 VSB VSB 104.78 -4191.20 18
40 CY732002500 P235./55R17 98W S2 EAG• RS-A 91.15 3646.00 18
V/Info:
------------------------------ -------------„--------------- --------------------------------
sub-Total
$7219.76
IN GOVIT,0.000W
$0.00
Total: $7219.76
NewPymt: $0.00
Total Due: $7219 .76
Received By: SP:Pete Thomas
� 4 INDIANA RETAIL TAX EXEMPT PAGE
� o Carmel CERTIFICATE NO.003120155 002 0��// � Jl PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT
35-60000972 vlem
ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES,A/P
CARMEL, INDIANA 46032-2584 VSHIPPING LABELS AND ANY COflRESPONDENCE.OUCHER, DELIVERY MEMO, PACKING SLIPS,
FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL-1997
PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION
'110 `13
R&T Tire and AWW Carmel Police Dop2rtme t
SHIP
VENDOR TO 3 Civic Square
17016 CIOV@F Roads Catmel, IN 4
Noblesville. IN 46NO (31171571-2ffig
CONFIRMATION BLANKET CONTRACT PAYMENTTERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Account 42-320.0
83 Each tires $88.24 $7,764.96
Sub Total: $7,784.95
is 71-7-111 f ...
✓ u e {0 I e e i x� y•rr
Send Invoice To: Y
Carmel Police Department
Attn: Tease Anderson
3 Civic Square
Carmel, IN 4SM2- PLEASE INVOICE IN DUPLICATE
DEPARTMENT _ ACCOUNT PROJECT I PROJECT ACCOUNT AMOUNT
Carmel Police Dept. �� PAYMENT $7,764.35
• A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O.
NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND
VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED.
SHIPPING INSTRUCTIONS I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN
SHIP REPAID.
THIS APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER.
•
•C.O.D.SHIPMENTS CANNOT BE ACCEPTED. ORDERED BY
•PURCHASE ORDER NUMBER MUST APPEAR ON ALL `
SHIPPING LABELS. /, j/,>
•THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE 4!'sti.ox-F 15-11...a.
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
5 6
qp j CLERK-TREASURER
DOCUMENT CONTROL NO. • • COPY-SIGN AND RETURN TO CLERK'S OFFICE
VOUCHER NO. WARRANT NO.
ALLOWED 20
IN THE SUM OF$
ON ACCOUNT OF APPROPRIATION FOR
Board Members
PO#or INVOICE NO. ACCT#!TITLE AMOUNT
DEPT.# I 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. - - - - --- — -- ---- --
20
................................................................................_.....................-................................-...................
..-_...
Signature
................._.__....---..............._..........................................----...-_.............
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
VOUCHER NO. WARRANT NO.
ALLOWED 20
R & T Tire and Auto
IN SUM OF $
17016 Clover Road
Noblesville, IN 46060
$7,219.76
ON ACCOUNT OF APPROPRIATION FOR
Carmel Police Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT
Board Members
25606 I NOOFRW I 42-320.00 I $7,219.76 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, January 25, 2013
Chief of Police
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))
01/11/13 NOOFRW tires $7,219.76
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