240846 01/07/15 f CITY OF CARMEL, INDIANA VENDOR: 368892
b ONE CIVIC SQUARE U-HAUL CHECK AMOUNT: $**.....295.49*
CARMEL, INDIANA 46032 7027 E.86TH STREET CHECK NUMBER: 240846
INDIANAPOLIS IN 46250 CHECK DATE: 01/07/15
>ON�
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 R4351000 32212 83508646 295.49 HITCH
Work Order Page 1 of')
11U-Haul Sales Item Invoice Hitch Reservation
Contract Number: 83508646 U-HAUL MOVING & STORAGE 7027 E 86TH ST (317) 849-9614
Monday 12/15/2014 10:49:08 OF CASTLETON INDIANAPOLIS, IN
AM (764073) 46250
Customer Name: Cust Ph - Email:
mike mabie (317) 460-9361 - mmabie@carmel.in.gov
Hitch Type: Round Tube Rec.
Max Towing Weight: 6000 lbs.
With Weight Distribution: 0 lbs.
Vehicle Type: 2014 Chevrolet Tahoe PPV Rear Wheel Drive
Installation Date: 12/15/2014 10:00:00 AM
NOTE: The installed price is for your hitch only. Other Items such as
hitch balls and wiring vary depending on the application.
Part Code Description Item Cost Quantity Line Cost
Hitch Labor $60.00 0.50 hr. $30.00
13111 75001b Ball Mount $19.95 1 ea. $19.95
30955 VEHICLEEND7ROUND/4FLAT $27.95 1 ea. $27.95
3131 PIN&CLIPASSY.2"RECV $1.69 1 ea. $1.69
4944 BALL 2X1X23/16 5000LB $10.95 1 ea. $10.95
78589 Tahoe Police Pursuit Vehicle Only $199.95 1 ea. $199.95
HTHW Hitch warranty $5.00 1 ea. $5,00
Subtotal:~y^$295.49
Taxes•�8
Total Charges Including Tax: $314.09
Net Paid Today: $0.00
Installer Note(s):
This product complies with safety specifications and requirements for connecting devices and towing systems
of the state of New York V.E.S.C. Regulation V5 and SAE J684.
Tell your customer:
This product complies with safety specifications and requirements for connecting devices and towing systems
of the state of New York V.E.S.C. Regulation V5 and SAE 1684.
https:Hpos.uhaul.net/secure/hslconsole/(S(dku3 aa220bfeneoinfvwosai))/Pages/WorkOrde... 12/15/2014
INDIANA RETAIL TAX EXEMPT PAGE
Cit of Carmel CERTIFICATE NO.OU3120155 002 0
�� i` PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 32292
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
92d94
U44mui Czfm0l Police Dopartmont
VENDOR
SHIP 3 Civic squm
7028 S. 68th 19l:. TO
CzmoI, IN 4
Indimapolls, IN 4620 (W)5792
CONFIRMATIO,�W%:4f%gehONTRACT PAYMENTTERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Account 43.610.00
9 Each Hfic t $329.47 $329.47
Sub Total: $329.47
t 4
a
� P� ° '�
g
Send Invoice To:
for Tahoe
Camel Police DopartmGnt
Attn: Pat Young
3 CIVIC squa>r+a
Carmel, IN - PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
Camel Police Dept, PAYMENT M9.47
• A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O.
NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND
VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED.
SHIPPING INSTRUCTIONS i HEREBY CERTI TFfAT THERE IS AN UNOBLIGATED BALANCE IN
THIS APPRO R5�S�UF
TO PAY FOR THE ABOVE ORDER.
SHIP REPAID. /
•.C.O.D.SHIPMENTS CANNOT BE ACCEPTED. / A
•PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY //
/ !I
SHIPPING LABELS. I�I�o0 Police
•THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
CLERK-TREASURER
DOCUMENT CONTROL NO. 3 2%212 A.P.V. COPY-SIGN AND RETURN TO CLERK'S OFFICE
VOUCHER NO._____ WARRANT NO.
____
ALLOWED 20___
|NTHE SUM OF$
`.
ON ACCOUNT OF APPROPRIATION FOR
'
Board Members
PO#or INVOICE NO. ACCT#/TITLE AMOUNT
DEPT# | hereby certify that the attached invoine(s), or
biU(a) ia (ave) true and correct and that the
materials orservices itemized thereon for
which charge ismade were ordered and
received except
'
�
. 20___- .
.
Signature
-
Tide .`
Cnmdistribution ledger
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))
01/02/15 83508646 trailer hitch $295.49
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
U-Haul
IN SUM OF $
7027 E. 86th St.
Indianapolis, IN 46250
$295.49
ON ACCOUNT OF APPROPRIATION FOR
Carmel Police Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
Encumbered I hereby certify that the attached invoice(s), or
32212 83508646 43-510.00 $295.49
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,,gecember 31, 2014
Chief of Police
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund