HomeMy WebLinkAbout233343 06/04/14 '' �,qMf CITY OF CARMEL, INDIANA VENDOR: 358894
j; i ONE CIVIC SQUARE SAFELITE AUTOGLASS CHECK AMOUNT: $*******537.78*
?�; CARMEL, INDIANA 46032 PO BOX 633197 CHECK NUMBER: 233343
�M,��ON�p� 1 CINCINNATI OH 45263-3197 CHECK DATE: 06/04/14
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
601 5023990 586482 266.89 OTHER EXPENSES
601 5023990 586483 270.89 OTHER EXPENSES
SAFELITE 'FULFILLMENT, INC: CUSTOMER-SERVICE—CENTER 800 835"=22 7
dba: Safelite AutoGlass Elxte Auto. G]ass,.
Auto 'Glass. Specialists, andIF YO.0 HAVE .ANY QUESTIONS REGARDING
Diamond Triumph Glass PAYMENT OF THIS INVOICE1-800-83+5-2092
INVOICE 0283D62199.07 INVOICE 05/23/14 BD
ORDERED: 05/19/14' INSTALLED 05f23/14
PLEASE. REMIT :PAYM1.ENT TO . W: O. # 5,86482: REFERRAL.Q#_ 00'0000
SAFELITE' FULFILLM,ENT, INC INSURED::
P O BOX 633197 CARMEL, CITY •QF .
CINCINNATI;:. OH 45263-3:197 WATER DISTRIBUTION
PLEASE 'WRI'T'E INVOICE NiJMBER_ON CHECKCARMEL TN .460:74=0:.000`
P41-.>317`7i33-2855 PH2:
CARMEL-, CITY OF Acc-t # 371835
WATER, DISTRIBUTION
3. 8.0 W 131ST
CARMELIN 46;0.7.4
POLICY# PO#/REF 26
CLAIM # 'c LOSS LOC-:
AUTH'/VER. TRENT LOSS DATE/CAUSE: 05•/23/.14:
200T.:FORD F SERIES F150 .2 DOOR STAN. ARR ;MOBILE
MILEAGE: 12;.3 45
VIN: 1FTRF,12W!7KC61349 LICENSE/ST: '3737RV IN STOCK #; 26•
QTY.
PART .:#: LIST SELLING. LABOR KIT MATERIAL EXTENSION
1 DWO.15:51 GBY' 20.3.37 194:36 50._00 .;00 .00 244.36
SOLAR-W/THIRD VI90R FRIT.AFTERMARKET'
1. PCK.152.5-0,4: 17.65' 10.59 ..00. ..0.0 .00 10.59:
kiT ,8PCS
1 DISPOSAL F'EE.. 4.9;5' 00 7.95 _•00 .00 7..95
DISPOSAL FEE
`1 .FUEL SURCHARGE :3::.9 9' :4 0 .3.9.9 .0 0 ..0'0: 3-55
FUEL SURCHARGE:.
PART TOTAL 204.95
LAB:QR:`TOTAL 61.9'4
SUB:=TOTAL 266 89
SALES TAX
FP' A Y T "H I S A M O U' N. -T :266,89
TERMS—NET 3.0
ADDITIONAL 'INFO/CLAIMANT SERVICED BY: COUNTY.
/A'
SAFELITE AUTOGLASS # 01830
INDIXNAPOLIS IN 46268-00:00
SAFELITE TAX. ID #: 3.6 4523.816:
052:314-37]835 371835 Ofl60.9-3718.3.5_-,21990.7.
CARMEL,, CITY :OF
WATER.D-ISTRIBUTION
3456 W 131ST' 00.00;00002.014.0523.7.42
CARMEL IN 46-074
SAFELITE FULFILLMENT, :INC CUSTOMER SERVLCE CENTER . 1;-:806:-835-2257
`
dba. Safelite' AUtoGlass;� Elite :Alpo. Glass.
Auto Glass Speci.alis:ts, aid IF YOU' HAVE,ANY QUESTIONS,REGARDING.,.
Diamond Ttlim) Glass QAYMENT: OF THIS INVOICE: 1`-800-835-209:2
INVOICE -0:1830-21990`8 INVOICE 05/23/14 Bb
ORDERED 05/19/14 INSTALLED 05:/23/14
PLEASE REMIT PAYMENT TO: W.O :# 586483 REFERRAI;##e 000;000,.
SAFELZTE FULFILLMENT, INC INSURED
P O BOX 63.3197 CARMEL,_ CITY OF
CINCINNATI;. OH '45263-,3197 WATER DISTRIBUTION
PLEASE UIRITE INVOICE NUMBER, ON. ,CHECK. CARMEL: . IN 4 6 0:7.4--.0 0 0 0-
PHI. 17-M=285.5 :PH2e`
CARMEL, CITY OF Acct k: 371835
W4TER, DISTRIBU'T'ION
3450' W..131ST
CARMEL" IN 46074
POLICY . PO##/REF : 147
#
CLAIM' # = LOSS LOC
AUTH/VER: TRENT LOSS DAT E/CAUSt;:. :05/23/14
2008 FORD, F SERIES F150 2 DOOR STAN ARR. MOBILE
MILEAGE 123,-4.56
VIN: 1FTRF12W88KD60436 LICENSE/ST:. 272828: IN STOCK #.' 147
QTY PART.Ai LIST SELLING. LABOR KIT MATERIAL EXTENSION.
1 DWO155'1 GBY 203.3.7 198.16 50.00 .00 .00 248.3:6
SOLAR-W%THIRD VISOR. FRIT-AFTERMARKET
3 :PCK 3.512.9-;,041 17 65 10.59 _0.0 .00' .00 10:59
KIT 8.PCS
1 DISPOSAL:,.FEE 4.9:5 -0,6 7.95 _00 _00 7:95
DISPOSAL FEE
1 FUEL SURCHARGE 3..99 .00 3.99 .0'0 .00 3:99
FUEL SURCHARGE
PART TOTAL 208:9.5
LABQR:: TOTAL" 6`1.-94
SUBTOTAL: 270.89
SALES TAX. 0.-0.0
P A Y T H I S A, M O 'U N`T 270.:89
TERM$:: NET 30:
ADDITIONAL INFO/CI;AIMANT SERVICED BY;.,.. COUNTY_/A
SAPtLITE: 'AUTOGLASS #..0183;0: _
INDIANA=POLIS.. 2N 46268=0`00`0
SAFELITE. TAX ID #: 36,:-452381.6
0.52334-97.1835-37.1'835 00609-371835-21990"8
CARMEL,: CITY OF
.WATER DISTRIBUTION.
3450 W 131ST 000`0000201405237-42
CARMEL .-IN. 4.647.4
VOUCHER # 135215 WARRANT# `t ALLOWED
358894 ; IN SUM OF $
SAFELITE FULFILLMENT INC
PO BOX 633197
CINCINNATI, OH 45263-3197
Carmel Water Utility j
ON ACCOUNT OF APPROPRIATION FOR !
Board members
'f
PO# INV# ACCT# AMOUNT 'i Audit Trail Code
586482 01-6500-04 $266.89 ?
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Voucher Total 53� 7
Cost distribution ledger classification if
claim paid under vehicle highway fund
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Prescribed by State Board of Accounts City Form No.201 (Rev 1995)
ACCOUNTS PAYABLE VOUCHER
CITY OF,tARMEL
An invoice or bill to be properly itemized must show, kind of service, where
performed, dates of service rendered, by whom, rates per day, number of units,
price per unit, etc.
Payee
358894
SAFELITE FULFILLMENT INC Purchase Order No.
PO BOX 633197 Terms
CINCINNATI, OH 45263-3197 Due Date 5/24/2014
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
5/24/2014 586482 $266.89
I,
1
r
I hereby certify that the attached invoice(s), or bill(s) is(are)true and
correct and I have audited same in accordance with I.0 5-11-10-1.6
Date Officer