220316 05/21/2013 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: $700.00
SHERIDAN IN 46069 CHECK NUMBER: 220316
CHECK DATE: 5/2112013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2201 4232000 5802-94729 700 . 00 TIRES & TUBES
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��� 516 S MAIN STREET REF# 1OD457
AUTO PARTS SHERIDAN, IN 46O69
(317 ) 758-4456
SERVING P, WORLD IN MO N ! ! !
58O2-94729 2O7O
ANY PART RETURNED FOR CREDIT MUST BE ACCOMPANIED BY THIS RECEIPT SEE CARQvsm STORE FOR DETAILS or THIS COAST ro COAST GUARANTEE.
ITY OF CARMEL TY OF CARM
4OO W 131ST OO W 131ST
|�ARMEL, IN 46O74 | �ARMEL , IN
58O2-94729 2O7O S/13/2O1 STREET DEPT TOM CHARGE ,
i k05 f t�—-G 4, )-1 � I I I
WARRANTY DISCLA ER rnanuracRu'rees warrmitX,If my.constitut"T"orAdylwarraWRithprospet to the safe of all goods.SELLER HEREBY EXPRESSLY DISCLAIMS ALL WARRANTIES,EITHER EXPRESSED OR IMPLIED,
INCLUDING ANY IM E RANTY OF MERCHAN-17 BIUTY OR FITNESS FOR ARTC UR OSE.Seller does not authorize any person to grant my warranty or assurne any liability by Seller.
6- PAY
IAMOUNT
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CASH A -,JFIUND-
Customer Name
Customer 'hone # { j
Customer Mailim-, Address .
Original Cash Sale Invoice #
Customer's Signature
t#unterpro S Sit"lutture — — -- - --- -- _.
Caunterpro's #
Manager's Initials
This is a company policy to help verify cash refunds and thus safeguard our assists.
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))
05/13/13 5802-94729 $700.00
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
VOUCHER NO. WARRANT NO.
ALLOWED 20
R & T Auto Supply
IN SUM OF $
516 S. Main Street
Sheridan, IN 46069
$700.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO#/Dept. INVOICE NO. I ACCT#/TITLE AMOUNT Board Members
2201 I 5802-94729 I 42-320.001 $700.00 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
A 11
F a 17 2013
St Issioner
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund