243493 03/24/15 CITY OF CARMEL, INDIANA VENDOR: 00351179
(9, )
ONE CIVIC SQUARE FIRESTONE TIRE&SERVICE CENTER CHECKAMOUNT: $*######321.24CARMEL, INDIANA 46032 PO BOX 403727 CHECK NUMBER: 243493
ATLANTA GA 30384-3727 CHECK DATE: 03/24/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1192 4351000 150826 321.24 AUTO REPAIR & MAINTEN
Customer Invoice FIRESTONE COMPLETE AUTO CARE Service Advisor:
150826 CARMEL 01 NICK
03/17/2015 1314 S RANGE LINE RD 317.848.5886
CARMEL, IN. 46032-2932
2008 FORD ESCAPE HYBRID
CITY OF CARMEL, BUILDING & CODE 2.3L L4 FI ELECTRIC/GAS VIN H DOHC
1 CIVIC SQ Lic#: 74797 IN Vin#: 1 FMCU59H48KB58554
CARMEL, IN 46032-2584 In: 03/16/15 2:03PM Mileage: 15,738
317.670.0114 xjim Out: 03/17/15 12:38PM
Store#020753 COMMERCIAL
Rev Hist Unit Extended Job
Description /Article# ID Qty Price Price Total
BRAKE INSPECTION 01
FRONT BRAKES GRINDING
NO CHARGE BRAKE INSPECTION 7001122 04NN 1 N/C N/C
COURTESY CHECK 01
COURTESY CHECK 7046930 04NN 1 N/C N/C
BRAKE ROTORS (Front-Both) 1,2,3 01 277.08
54123 BRAKE ROTOR 7009553 04NN 2 91.79 183.58
REMOVE & REPLACE DISC ROTOR - FRONT, BOTH 7016225 04NN 1 93.50 93.50
STANDARD WHEEL BALANCE (All 4) 3 01 44.16
ROTATE WHILE WHEELS ARE OFF
WHEEL BALANCE PARTS 7005989 04NN 4 2.54 10.16
WHEEL BALANCE LABOR 7003301 04NN 4 8.50 34.00
Technician(s):
04 CARL DESPAIN
Payment History: Summary:
Comm/Dir Acct 321.24 Parts 193.74
Total Tendered 321.24 Labor 127.50
Shop Supplies 0.00
Sub-Total 321.24
Tax Exempt(31201660) 0.00
Total $321.24
1 have received the above goods and/or services. If this is a credit
card purchase, I agree to pay and comply with my cardholder
agreement with the issuer.
Rev
Revision History: Amt Init
Customer Signature 1) 03/17/2015 09:14AM 277.08 CITY OF CAR 317.670.0114 Ext.jim
2) 03/17/2015 09:14AM -277.08 CITY OF CAR 317.670.0114 Ext.jim
-- 3) 03/17/2015 09.18AM 321.24 CITY OF CAR 317.670.0114 Ext.jim
All parts are new unless otherwise specified.
I acknowledge notice and oral approval of an
increase in the original estimated price.
Signature or Initials
PLEASE TELL US ABOUT YOUR SERVICE EXPERIENCE TODAY!
Get$10 off your next total purchase of$25 or more and be entered into a drawing for$500 in services
Call 1-800-859-9203 or go to www.FirestoneSurvey.com; Enter Code02O753-150826
Offer expires 15 days from date of invoice. Good at all participating locations. Redemption code:
Invt 140826.404001
VOUCHER NO. WARRANT NO.
ALLOWED 20
Firestone Complete Auto Care
IN SUM OF$
P.O. Box 403727
Atlanta, GA 30384
i
$321.24
ON ACCOUNT OF APPROPRIATION FOR
Carmel DOCS
PO#/Dept. INVOICE NO. I ACCT#(TITLE AMOUNT Board Members
1192_ I 150826 I 43-510.00 I $321.24 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
i
� I
Monday, March 23, 2015
� bf o
Directco
Title
I
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))
03/17/15 150826 Brake Repair#2 $321.24
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