226449 11/19/2013 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: $22.00
SHERIDAN IN 46069 CHECK NUMBER: 226449
CHECK DATE: 11/19/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2201 4232000 5802-103272 22 . 00 TIRES & TUBES
Customer Name
Customer Phone # ( }
Customer Mailing-Add.rew
a ..
Original Cash Sale Invoice #
Customer's Signature
Counte.rpro's Signature
Counterpro's # _
Manager's Initials
This is a company police to help verify cash refunds and thus safeguard our assets.
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))
10/29/13 5802-103272 $22.00
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
VOUCHER NO. WARRANT NO.
ALLOWED 20
R & T Auto Supply
IN SUM OF $
516 S. Main Street
Sheridan, IN 46069
$22.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO#/Dept. INVOICE NO. I ACCT#/TITLE I AMOUNT Board Members
2201 1 5802-103272 1 42-320.001 $22.00 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
'I /
LAYThursaSi N 013
tWh5orgAiRs'Mer
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund