HomeMy WebLinkAbout232722 05/21/14 CITY OF CARMEL, INDIANA VENDOR: 367104
® i ONE CIVIC SQUARE ABRA AUTO BODY & GLASS CHECK AMOUNT. $*****1,014.23*
CARMEL, INDIANA 46032 503 W CARMEL DRIVE CHECK NUMBER: 232722
CARMEL IN 46032 CHECK DATE: 05/21114
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4351000 31972 4165 1,014.23 VEHICLE REPAIR
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Date: 05/13/2014
ABRA HE Carmel INVOICE
503 West Carmel Drive
AUTiO ®DY&GI�SS Carmel, IN 46032 RO #: 4165
(317) 569-9884, (317) 569-9885 (fax) Est: Eric Tobolski
CARMEL PD UNIT#115
12 CHEV IMPALA POLICE �—
, Color:WHITE Customer Pa
3 CIVIC SQUARE Type: PC 4D SED Adjustor: y
CARMEL, 46VIN: 2G1 WD5E30C1 154126 Phone:
Home: 123--456--7878 90 Prod Date:0911 Plate: IN 6360 Claim#: N/A Deductible:0
Work: Mileage: 36655 Loss Type:Collision
Fax: _ En ine:6-3.6L-FI
_. P=Who Pays? I=Insurance,C=Customer
up
oty Type Description Part# Amount SLabor Paint
Labor Op P
_ # Units Units P
Parts Other REAR BUMPER R&I bumper cover I !Body R&I 1.5 C
Parts Other a EAR BUMPER Bumper cover w/dual Body Rpr 8.0 3.0 C
REAR BUMPER Add for Clear Coat 1.2 C
1 Pnt Mat 'Flex Additive/Adhesion Promoter 8.50 Body Repl C
I Stock Parts REAR BUMPER A/M'Bumper Repair 26.95 1 Body Repl i C
Kit1 Parts OEM REAR BUMPER Energy absorber 20759789 176.98 1 Body Repl 0.1 C
1 Haz Waste 'Hazardous Waste 5.00 Body C
Pnt/Mat I MISC Paint&Materials 134.40
4.2 C
SubTotal 1,014.23
Taxes 0.00
Grand Total 1,014.23
Due from Insurance Due from Customer
Sub-Total 0.00 Sub-Total 1,014.23
Tax 0.00 Tax 0.00
Total 0.00 Total 1,014.23
IF Total Amount 1,014.23
INVOICE #22 05/13/2014 12:15:24 PM RO#4165 ABRA HE-Carmel
Pagel
f�° C����� INDIANA RETAIL TAX EXEMPT PAGE
City ®,Jjr CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 3`1972
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
Gfl M2 `14
Abba HE Caini@l P611ce Depa1tFA@nt
VENDOR SHIP 3 Civic squaro
603 welt CaFlylel DOVA TO Carmel, IN 4 032
Camhol„ IN 40-32 (317)57192559
CONFIRMATION BLANKET CONTRACT PAYMENTTERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Account 43,6 0,00
9 Each vehicle repairs $973.30 $973.30
Sub ToW: $973.313
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hu il
3f .•rile I$`, x '�^pjj. lFJgA• ','iI
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Vehicle 955 -Pool Vain �`� , a °, I; r
Send Invoice To: �
Carmel Police Department
Attn: Pat Young
3 Civic Square
Caffnei, IN 46032- PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT I PROJECTACCOUNT AMOUNT
Carmel Police Dept. PAYMENT $973.30
• A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O.
NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND
VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED.
SHIPPING INSTRUCTIONS I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN
SHIP REPAID. THIS APPROPRIATION SUFFICIENTTO PAY FOR THE ABOVE ORDER.
•
•C.O.D.SHIPMENTS CANNOT BE ACCEPTED.
• ORDERED BY
PURCHASE ORDER NUMBER MUST APPEAR ON ALL
SHIPPING LABELS. CII f o9 Police
•THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE 0.a 9
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
CLERK-TREASURER
DOCUMENT CONTROL NO. 319 7 2 A.P.V. COPY-SIGN AND RETURN TO CLERK'S OFFICE
VOUCHER NO. WARRANT NO.
ALLOWED 20
IN THE SUM OF$
ON ACCOUNT OF APPROPRIATION FOR
f
Board Members
PO#or DEPT# INVOICE NO. ACCT#/TITLE AMOUNT 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
Abra HE Carmel
IN SUM OF $
503 West Carmel Drive
Carmel„ IN 46032
$1,014.23
ON ACCOUNT OF APPROPRIATION FOR
Carmel Police Department
PO#/Dept. INVOICE NO. JACCT#I-rITLEI AMOUNT Board Members
I hereby certify that the attached invoice(s), or
31972 4165 43-510.00 $1,014.23
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 ay 14, 2014
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))
05/13/14 4165 vehicle repairs $1,014.23
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