218597 03/25/2013 "^*F CITY OF CARMEL, INDIANA VENDOR: 00350983 Page 1 of 1
ONE CIVIC SQUARE R&T TIRE&AUTO-NOBLESVILLE
CHECK AMOUNT: $2,600.00
CARMEL, INDIANA 46032 17016 CLOVER ROAD
t� NOBLESVILLE IN 46060 CHECK NUMBER: 218597
CHECK DATE: 3125/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4232000 25660 NOOGY5 2, 600 . 00 TIRES
� �1® & T Tire—Noblesville! R&T Frankfort(765)654-5583
R&T Lebanon(765)482-5027
-=4,� .= 17016 Clover Rd R&T Sheridan(3 17)758-4456
�--`
Noblesville,IN 46060 R&T Tipton(765)675-6775
317-773-3130
since 1965 !.-
Store Location Store Phn Date Time
R & T Tire/Auto - NOB (317) 773-3130 03/05/13 10 : 10 AM
17016 CLOVER RD file id: NOB-21965 Page 1
NOBLESVILLE, IN 46060
Your P/0 # A/R Acct# Terms Ship Via
Inv: NOOGY5 N05743 1 ST 10TH
Sold-To: Ship-To: Type - Payment
CARMEL POLICE DEPARTMENT $
3 CIVIC SQUARE $
CARMEL, IN 46032
Total $ 0.00
**MEMBER OF THE GOODYEAR TIRE & SERVICE NETWORK** 317-733-4600
Qty Shp B/O Item Number Description S/W FET Price Amount Init's
40 GY732354500 P225/60R16 97V S2 EAG RS-A 65. 00 2600 . 00 5
--------------------
V/Inf.o:
------------------------------------------------------------------------------------------------
Sub-Total
$2600 .00
IN GOV'T, 0 . 000%
$0 .00
Total: $2600 .00
NewPymt: $0. 00
Total Due: $2600 . 00
Received By: SP:Chuck Godby
INDIANA RETAIL TAX EXEMPT PAGE"City ®f Carmel CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 2M
35-60000972
ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES,A/P
CARMEL, INDIANA 46032-2584 VOUCHER, DELIVERY MEMO, PACKING SLIPS,
FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL- 1997 SHIPPING LABELS AND ANY CORRESPONDENCE.
PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION
31412 013
R&T Tire and Auto Camel Police Dopar-tmant
VENDOR TO 13
HIP 3 CIVIC q
97096 Clover Road Carmel, IN 4
Noblesville, IN 46M (397)6711 g
CONFIRMATION BLANKET CONTRACT PAYMENTTERMS FREIGHT
Account
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Account 42 a .06
40 Each tires $65.00 $2.600.00
Sub Total: $2,600.00
i
Send Invoice To:
Cartel Police Depadment
Attn: Temsa Anderson
3 Civic Square
Carmel, IN 400- PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
Cannel Police Dept. �' PAYMENT
• A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O.
NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND
VOUCHER HASTHE PROPER SWORN AFFIDAVIT ATTACHED.
SHIPPING INSTRUCTIONS I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN
THIS APPROPRIATIO SUFFICIENT TO PAY FOR THE ABOVE ORDER.
•SHIP REPAID. / 2,//
•C.O.D.SHIPMENTS CANNOT BE ACCEPTED. ORDERED BY / .�
•PURCHASE ORDER NUMBER MUST APPEAR ON ALL
SHIPPING LABELS.
•THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE _ Ief Q P®IIC@
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
215 6 6® CLERK-TREASURER
DOCUMENT CONTROL NO. A.P.V. COPY-SIGN AND RETURN TO CLERK'S OFFICE
VOUCHER NO._-..-----.---.__:WARRANT:NO.__.__-...--.._._
ALLOWED 20
___. --------_—--_ ------.-. IN THE SUM OF$
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
20
........... ................................................................................................................... .
Signature
............................................................. .......... ..........................................................................
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
I
VOUCHER NO. WARRANT NO.
ALLOWED 20
R & T Tire and Auto
IN SUM OF $
17016 Clover Road
Noblesville, IN 46060
$2,600.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel Police Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
25660 I NOOGY5 I 42-320.00 I $2,600.00 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
Wednesday, March 20, 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))
03/05/13 NOOGY5 tires $2,600.00
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