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Home My WebLink About235486 07/30/14 CITY OF CARMEL, INDIANA VENDOR: 358894 " c ONE CIVIC SQUARE SAFELITE AUTOGLASS CHECK AMOUNT: $*******529.70* CARMEL, INDIANA 46032 PO BOX 633197 CHECK NUMBER: 235486 CINCINNATI OH 45263-3197 CHECK DATE: 07/30/14 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1110 4351000 32084 01830-222806 266.85 WINDSHIELD REPLACEMEN 1110 4351000 32088 01830-223237 262.85 WINDSHEILD SAFELITE FULFILLMENT, INC CUSTOMER SERVICE CENTER 1-800-835-2257 dba: Safelite Auto Glass, Elite Auto Glass, Auto Glass Specialists, and IF YOU HAVE ANY QUESTIONS REGARDING Diamond Triumph Glass PAYMENT OF THIS INVOICE: 1-800-835-2092 INVOICE 01830-223237 INVOICE: 07/18/14 BD ORDERED: 07/16/14 INSTALLED: 07/18/14 PLEASE REMIT PAYMENT TO: W.O. # : 599662 REFERRAL#: 000000 SAFELITE FULFILLMENT, INC INSURED: P.O. BOX 633197 CARMEL POLICE DEPT CINCINNATI, OH 45263-3197 3 CIVIC SQ PLEASE WRITE INVOICE NUMBER ON CHECK CARMEL IN 46032-0000 PH1:317-571-2546 PH2:317-999-9999 CARMEL POLICE DEPT Acct #:, 405879 3 CIVIC SQ CARMEL IN 46032 POLICY# : PO#/REF . CLAIM # : LOSS LOC: AUTH/VER: ED ALVAR.EZ LOSS DATE/.CAUSE: 07/18/14 ------------------------------------------------------------------------------------ 2010 CHEVROLET IMPALA 4 DOOR SEDA ARR: MOBILE MILEAGE: 1 VIN: 2G1WD5EMXA1222745 LICENSE/ST: 620UD IN STOCK #: 148 ------------------------------------------------------------------------------------ QTY PART # I LIST SELLING LABOR KIT MATERIAL EXTENSION 1 'DW01640 GTY 207.74 194.95 50.00 .00 .00 244.95 SOLAR_W/THIRD VISOR FRIT 1 DISPOSAL FEE 4.95 .00 7.95 .00 .00 7.95 DISPOSAL FEE 1 FUEL SURCHARGE 3.99 .00 9.95 .00 .00 9.95 FUEL SURCHARGE PART TOTAL 194.95 LABOR TOTAL 67.90 SUB-TOTAL 262.85 SALES TAX 0.00 P A Y T H I S A M O U N T 262.85 TERMS: NET 30 ADDITIONAL INFO/CLAIMANT SERVICED BY: COUNTY/A SAFELITE AUTOGLASS # 01830 INDIANAPOLIS IN 46268-0000 SAFELITE TAX ID #: 36-4523816 071814-405879-405879 00669-405879-223237 CARMEL POLICE DEPT 3 CIVIC SQ CARMEL IN 46032 0000000020140718742 SAFELITE FULFILLMENT, INC CUSTOMER SERVICE CENTER 1-800-835-2257 dba: Safelite Auto Glass, Elite Auto Glass, Auto Glass Specialists, and IF YOU HAVE ANY QUESTIONS REGARDING Diamond Triumph Glass PAYMENT OF THIS INVOICE: 1-800-835-2092 INVOICE 01830-222806 INVOICE: 07/11/14 BD ORDERED: 07/10/14 INSTALLED: 07/11/14 PLEASE REMIT PAYMENT TO: W.O. # : 598376 REFERRAL#: 000000 SAFELITE FULFILLMENT, INC INSURED: P.O. BOX 633197 CARMEL POLICE DEPT CINCINNATI, OH 45263-3197 3 CIVIC SQ PLEASE WRITE INVOICE NUMBER ON CHECK CARMEL IN 46032-0000 PH1:317-571-2546 PH2:317-571-2546 CARMEL POLICE DEPT Acct #: 405879 3 CIVIC SQ CARMEL IN 46032 POLICY# : PO#/REF : 32079 CLAIM # : LOSS LOG AUTH/VER: ED LOSS DATE/CAUSE: 07/11/14 ------------------------------------------------------------------------------ 2012 CHEVROLET IMPALA 4 DOOR SEDA ARR: MOBILE MILEAGE: 1 VIN: 2G1WD5E38C1152365 LICENSE/ST: 6310 IN STOCK #: 103 ------------- -- ----- -- -- - ------- - -------- ----- - ---------- ----- ---------------------- QTY PART # LIST SELLING LABOR KIT MATERIAL EXTENSION 1 DW01640 GTY 207.74 198.95 50.00 .00 .00 248.95 SOLAR-W/THIRD VISOR FRIT 1 DISPOSAL FEE 4.95 .00 7.95 .00 .00 7.95 DISPOSAL FEE 1 FUEL SURCHARGE 3.99 .00 9.95 .00 .00 9.95 FUEL SURCHARGE PART TOTAL 198.95 LABOR TOTAL 67.90 SUBTOTAL 266.85 SALES TAX 0.00 P A Y T H I S A M O U N T 266.85 TERMS: NET 30 ADDITIONAL INFO/CLAIMANT SERVICED BY: COUNTY/A SAFELITE AUTOGLASS # 01830 INDIANAPOLIS IN 46268-0000 SAFELITE TAX ID #: 36-4523816 071114-405879-405879 00669-405879-222806 CARMEL POLICE DEPT 3 CIVIC SQ CARMEL IN 46032 0000000020140711742 of INDIANA RETAIL TAX EXEMPT PAGE C�itCarmel CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER FEDERAL EXCISE TAX EXEMPT 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 7i14t2014 Safolite Auto Glass Carmel Police Department VENDOR SHIP 3 Civic Square ISO Pox 6331!97 TO Carmel, IN 40032 Cinainnatl, OH 45263-3197 (317)571 2S CONFIRMATION BLANKET CONTRACT PAYMENTTERMS FREIGHT QUANTITY I UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION Account 43-510.00 1 Each Windshield replacement $273.78 $273.78 Sub Total: $273.73 ' t f li rig= A. tt :^ t't£tlt x ' • d r'�Ir 103 Dunlap Send Invoice To: Carmel Police Department Attn: Pat Young 3 Civic Square Carmel, IN 40632- PLEASE INVOICE IN DUPLICATE DEPARTMENT ACCOUNT PROJECT PROJECTACCOUNT AMOUNT C;a mel Police Dept. ; PAYMENT $273.70 • A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O. NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED. SHIPPING INSTRUCTIONS I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN SHIP REPAID. THIS APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER. • •C.O.D.SHIPMENTS CANNOT BE ACCEPTED. • PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY f SHIPPING LABELS. •THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE Chief of police AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. CLERK-TREASURER DOCUMENT CONTROL NO. 3 2 0 4 A.P.V. COPY-SIGN AND RETURN TO CLERK'S OFFICE VOUCHER NO. WARRANT NO. ALLOWED 20 IN THE SUM OF$ 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 i 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 INDIANA RETAIL TAX EXEMPT PAGE City of !,.,Carmel CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER FEDERAL EXCISE TAX EXEMPT 32 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 711692014 Safelite Auto Class Carmel Police Department VENDOR SHIP 3 Civic squam PO Box 633197 TO Carmel, IN 46032 Ciricinnaiti, OH 46263-3197 (317)071 2669 CONFIRMATION BLANKET CONTRACT PAYMENTTERMS FREIGHT ' QUANTITY I UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION Account 4MI0.00 1 Each 'windshield replacement $252.90 $252.90 Sul•,Total: $252.90 �. t Asa 7"41t c-1aQp ° yV + f� `1a 1 i Ll Send Invoice To: _✓ )�� Carinal Police Department Aft. Pat Young 3 Civic Squara Carmel, IN 46032. PLEASE INVOICE IN DUPLICATE DEPARTMENT ACCOUNT PROJECT I PROJECT ACCOUNT AMOUNT Carmel Police Dept. PAYMENT FZ*2.!du • A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O. NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED. SHIPPING INSTRUCTIONS I HEREBY CERTIFY THAT T,HERE IS AN UNOBLIGATED BALANCE IN THIS APPROPRIATIONjSG SHIP REPAID. FICIENT TO PAY FOR THE ABOVE ORDER. • •C.O.D.SHIPMENTS CANNOT BE ACCEPTED. • PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY SHIPPING LABELS. Id of Poilce •THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE / AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. CLERK-TREASURER DOCUMENT CONTROL NO. 3 2 0 8 A.P.V. COPY-SIGN AND RETURN TO CLERKS OFFICE VOUCHER NO. WARRANT NO. ALLOWED 20 IN THE SUM OF$ 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 except 20 Signature Title Cost distribution ledger classification if claim paid motor vehicle highway fund VOUCHER NO. WARRANT NO. ALLOWED 20 Safelite Auto Glass IN SUM OF$ PO Box 633197 Cincinnati, OH 45263-3197 2c ON ACCOUNT OF APPROPRIATION FOR Carmel Police Department PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members 32084 I 01830-222806 I 43-510.00 I $266.85 1 hereby certify that the attached invoice(s), or CN g30 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 Wednes y, July 23, 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)) 07/14/14 01830-222806 windshield replacement $266.85 it 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