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244466 04/21/15 ,QCITYOF CARMEL, INDIANA VENDOR: 00352042 g 21 ONE CIVIC SQUARE DON HINDS FORD CHECK AMOUNT: S""'1,017.76• ?� CARMEL, INDIANA 46032 12610 FORD DRIVE CHECK NUMBER: 244466 '9M,iTON. FISHERS IN 46038 CHECK DATE: 04/21115 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1120 4351000 18077 -63.37 AUTO REPAIR & MAINTEN 1120 4351000 343865 765.55 AUTO REPAIR & MAINTEN 651 5023990 344839 315.58 OTHER EXPENSES o � CUSTOMER #: CA2634 344839 ' CARMEL WASTEWATER UTILITIES INVOICE JOE FAUCETT 12610 Ford Drive Fishers, IN 46038 9609 HAZEL DELL PKWY Phone (317) 849-9000 * Fax (317) 849-0020 INDIANAPOLIS, IN 46280-2935 PAGE 1 1-800-64HINDS (1-800-644-4637) HOME:317-571-2$34 CONT:317-571-2634 www.donhinds.com BUS: 317-571-2645 CELL:317-716-3905 SERVICE ADVISOR: 7563 CHUCK CALLAHAN COLOiR YEAR MAKEfI�iiQQEL VIN' LICENSE MILEAGE IN/OUT. TAG 3 06 FORD F550 1FDAF56P96EB00349 33792/33792 T999G DEL:. EL DATE PROD DATE :NfARR EXP FR.OMISED_ PO NO , RATE PAYMENT INV. DATE 01JAN06 DE 17:00 09APR15 S15009 0 . 00 CHG 13APR15 R.O;.OPENED READY OPTIONS: W-COMP:G DLR: 47J034 ENG: 6 . 0 Liter 3 13 : 12 09APR15 11: 16 11APR15 LINE OPCODE TECH TYPE HOURS LIST NET TOTAL - A *zFLUID LEAK, POSSIBLY TRANSMISSION FLUID. L2 LEVEL 1 DIAG 8333 Griffin,DenniS 'LIC#: DENNIS CP 809 MOON,MARTY LIC#: 0 CP 39 . 50 39 . 50 1 3C3Z*7A098*AA SCREEN ASY 44. 64 41. 07 41.. 07 8 XT*10*13LV OIL - AUTOMATIC TRANSMISSION 3 . 60 3 . 60 28. 80 1 F6TZ*7A191*A GASKET 46 .37 42 . 66 42 . 66 1 7703199 HELICOIL 11.12 10 . 01 10 . 01 FMA161DP REMOVED TRANS PAN, REPLACED INTERNAL FILTER, CLEANED SEALING SURFACES 809 MOON,MARTY LIC#: 0 CP 117 . 00 117 . 00 M REPAIRED THREADS/INSTALLED HELI-COIL 809 MOON,MARTY LIC#: 0 CP 31. 50 31 . 50 33792 INSPECTED AND FOUND 1 PAN BOLT THREADS ARE STRIPPED OUT IN TRANSMISSION CASE AND GASKET HAS BEEN SIL'ICONED. REMOVED PAN, CLEANED SEALING SURFACE, DRILLED AND TAPPED NEW THREADS IN HOLE UNDER REAR COOLER LINE. INSTALLED NEW GASKET AND FILTER, REINSTALLED PAN AND TOPPED OFF FLUID LEVEL. CLEANED OFF RESIDUE AND TEST DROVE, REINSPECTED AND FOUND NO FURTHER SIGNS OF LEAKS. PTO HAD SOME RESIDUE ON IT, SUSPECT WILL LEAK FROM PTO, IF SO WILL NEED TO BE REPAIRED ELSEWHERE FOR PTO LEAK. B REPORT CARD INSPECTION 99P REPORT CARD INSPECTION 809 MOON,MARTY LIC#: 0 CP 0 . 00 0 . 00 GTIRE CHECK TREAD DEPTH. TREAD IS WEARING PROPERLY AT THIS TIME. 809 MOON,MARTY LIC#: 0 OUR NIGHT OWL DROP BOX, LOCATED AT THE DISCLAIMER OF WARRANTIES DESCRIPTION TOTALS ON THE SERVICE ENTRANCE, IS AVAILABLE DURING sow HEREBYTAREE THOSE PMADECTS BY LABOR AMOUNT . THSELLER, NON—BUSINESS HOURS. DON HIINDSACTUREFORDR INCE HEREBY PARTS AMOUNT SERVICE HOURS: MON — FRI 7:30 AM — 5:30 PM EXPRESSLY DISCLAIMS ALL GAS,OIL, LUBE WARRANTIES, EITHER EXPRESSED OR SAT 7:30 AM — 3:30 PM IMPLIED, INCLUDING ANY IMPLIED SUBLET AMOUNT WARRANTY OF MERCHANTABILITY OR FITNESS FORA PARTICULAR PURPOSE, MISC. CHARGES C AND DON HINDS FORD, INC. NEITHER ASSUMES NOR AUTHORIZES ANY TOTAL CHARGES OTHER PERSON TO ASSUME FOR IT ANY LIABILITY IN CONNECTION WITH LESS DEDUCTIONS THE SALE OF SAID PRODUCTS. SALES TAX CUSTOMER SIGNATURE PLEASE PAY THIS AMOUNT — CUSTOMER COPY — — = I CUSTOMER -#: CA2 6 3 4 344839 CARMEL WASTEWATER UTILITIES INVOICE JOE FAUCETT 12610 Ford Drive Fishers, IN 46038 960 HAZEL DELL PKWY Phone (317) 849-9000 * Fax (317) 849-0020 5 INDIANAPOLIS, IN 46280-2935 PAGE 2 1-800-64HINDS (1-800-644-4637) HOME:317-571-2634 CONT:317-571-2634 www.donhinds.com BUS: 317-571-2645 CELL:317-716-3905 SERVICE ADVISOR: 7563 CHUCK CALLAHAN COLQ:R YEAR {MAKE/MQDEL UIN LICENSE MILEAGE IN/OUT TAG00 - 3 106 � FORD F550 1FDAF56P96EB00349 33792/33792 T999G DEL.DATE,. PRQD :DATE �iV1�RR EXP PR.OMISED: . PO NO RATE PAYMENT.:. INV: DATE _ a OIJAN06 DEJ 17 : 00 09APR15 515009 0 . 00 CHG 13APR15 R,O;. OPEN D READY: OPTIONS: W-COMP:G DLR:47JO34 ENG: 6 . 0_Liter y 13 : 12 09APR15 11: 16 11APR15 LINE OPCODE TECH TYPE HOURS LIST NET TOTAL CP 0 . 00 0 . 00 GBK BRAKE LINING WEAR CHECKED.. BRAKES WEARING OK AT THIS TIME 809 MOON,MARTY LIC#,: 0 CP 0 . 00 0 . 00 GBATT BATTERY TEST. CRANK AMPS ARE FINE. NO PROBLEM FOUND. 809 MOON,MARTY LIC#: 0 CP 0 . 00 0 . 00 33792 GBK GTIRE GBATT ENVIRONMENTAL &SUPPLY FEES 5 . 04 receive a suN ,� , a �ompanY truR` yM. ' m Ford Sure. 1S for ae us the rea ou ca�n0t�,�SE1Ep, rCOM4�,r1 ctio AseN,rs90 or. P�EPSE c0�a�317-g49eturned Marago99 P"suNeys. fie.. EX�•aregr at�yapY�V 0��NDSFORO , OUR NIGHT OWL DROP BOX, LOCATED AT THE DISCLAIMER OF WARRANTIES pESCRIPTION TOTALS ANY WARRANTY ON THE PRODUCTS LABOR AMOUNT SERVICE ENTRANCE, IS AVAILABLE DURING SOLD HEREBY ARE THOSE MADE BY 188 . 00 NON-BUSINESS HOURS. DON HIINDSACTUREFORDR INCE HEREBY PARTS AMOUNT 122 . 54 EXPRESSLY DISCLAIMS ALL SERVICE HOURS: MON - FRI 7:30 AM - 5:30 PM WARRANTIES, EITHER EXPRESSED OR GAS, OIL, LUBE 0 . 00 SAT 7:30 AM - 3:30 PM IMPLIED, INCLUDING ANY IMPLIED SUBLET AMOUNT 0 . 00 WARRANTY OF MERCHANTABILITY OR FITNESS FOR A PA PURPOSE, MISC. CHARGES 5 . 04 AND DON HINDS FORD,ORD, INC.INNEITHER I ASSUMES NOR AUTHORIZES ANY TOTAL CHARGES 315 . 58 OTHER PERSON TO ASSUME FOR IT ANY LIABILITY IN CONNECTION WITH LESS DEDUCTIONS 0 . 00 THE SALE OF SAID PRODUCTS. SALES TAX 0 00 *ml CUSTOMER SIGNATURE PLEASE PAY THIS AMOUNT 315 : 5 8 I - - - ---- --CUSTOMER COPY - - - - VOUCHER # 155344 WARRANT # ALLOWED 00352042 IN SUM OF $ DON HINDS FORD 12610 FORD DRIVE FISHERS, IN 46038 Carmel Wastewater Utility ON ACCOUNT OF APPROPRIATION FOR Board members PO# INV# ACCT# AMOUNT 4 Audit Trail Code e 344839 01-7502-06 $315.58 I 1 i 'I I Voucher Total $315.58 Cost distribution ledger classification if claim paid under 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 of service rendered, by whom, rates per day, number of units, price per unit, etc. Payee 00352042 DON HINDS FORD Purchase Order No. 12610 FORD DRIVE Terms FISHERS, IN 46038 Due Date 4/15/2015 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) Amount 4/15/2015 344839 $315.58 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 Date Officer 12610 Ford Drive Fishers,c IN 46038 Phone (317) 849-9000 * Fax (317) 813-1306 Parts Direct (317) 813-1301 www.donhinds.com ALL RETURNED PARTS MUST BE RECEIVED WITHIN 30 DAYS, BE IN THE ORIGINAL PACKAGE, AND ACCOMPANIED BY THIS INVOICE. WE ARE NOT ALLOWED TO-ACCEPT RETURNS ON_ELECTRICAL-OR_SPECIAL ORDER.PARTS.-PLEASE PREPAY WHEN ORDERING SPECIAL ORDER PARTS. DATE ENTERED YOUR ORDER NO. DATE SHIPPED INVOICE DATE INVOICE 09 APR 15 32836 09 APR 15 - NUMBER 18077 o ACCOUNT NO. CA2600 H PAGE 1 OF 1 12 : 12 L CITY' OF CARMEL I D P 1 CIVIC SQ 0 CARMEL, IN 46032-2584 0 (317) S71-2417 SHIP VIA bLbm. [IL NU. F.O.13. POINT 2620 CHARGE FISHERS, IN 'DPD :.SHIP ao PART NO ,:': ' $ 0 AG1Z* CAN�TISTER. 185 .05: 117. :0.5 1.1...,05 P _ ARTS HOUR Mon Fri 0 G1Z*9D653*C CANNISTER - 84 . 87 53 .68 53 .68 7:30 - 5:30 Saturd ay 8:00 3:00 SERVICE HOURS 7.30 5.30 -<: ,, . . Saturday 8:00 - 3:00 :> CASHIER CLOSES Mon - Fri AT 5:30 AT300 BODY SHOP Mon - Fri 800 - 500 PARTS -63 .37 SUBLET FREIGHT 0 . 00 SALES TAX- 0 . 0 0 CUSTOMER'S SIGNATURE 11300 x T07AL -63 .37 *CREDIrbIttLAIMERS OF WARRANTIES Any warranties on the product sold hereby are those made by the manufacturer.The seller hereby expressly disclaims all warranties,either expressed or implied,including any implied warranty of merchantability or fitness for a particular purpose,and the seller neither assumes nor authorizes any other person to assume for it any liability in connection with the sale of said products. "'°"'°°' CUSTOMER COPY dp 100, CUSTOMER`#: CI4283 343865 CITY OF CARMEL FIRE DEPT. INVOICE _ JASON , 12610 Ford Drive Fishers, IN 46038 2 CIVIC SQ Phone (317) 849-9000 * Fax (317) 849-0020 CARMEL, IN. 46032-7543 PAGE `3 1-800-64HINDS (1-800-644-4637) HOME: CONT:317-69 0-42 83 www.donhinds.com BUS CELL 317 690 4283 SERVICE ADVISOR 7563 CHUCK CALLAHAN GOLDR YEAR MAKE/MODEL VIN LICENSE MILEAGE IN/OUT 12 FORD F450 PKUP 1FDUF4GT9CEC39654 28695 28695 T889G DEL.DRTE,,....,PRaD :DATE ..WARR EXP :. PROMISED.:: :PO NO RATE' PAYMENT; INV,DATE. 01JAN12 D 17 : 00 31MAR15 N 0 . 00 CHG OlAPR15 R 0 OPENE'b .. REA© ,., OPTIONS: DLR:47J034 ENG: 6 . 7 Liter 08 :21 31MAR15 10 :36 01APR15 LINE OPCODE TECH TYPE HOURS LIST NET TOTAL PROBLEM FOUND'. 7471 Horning,Andy LIC# : 0 CP 0 . 00 0 . 00 GBK BRAKE LINING WEAR CHECKED. BRAKES WEARING OK .,..AT THIS TIME 7471 Horning,Andy LIC# : 0 CP 0 . 00 0 . 00 ,28695 .INSPECTION GTIRE GBK GBATT ENVIRONMENTAL & SUPPLY FEES 20 . 95 You may receive a survey from Ford Motor Company in the near future. If for any reason y ou cannot grade us 'COMPLETELY SATISFIED - PLEASE con4act 317 849c9000r Marg Boggs� E'XT. 270. AI curve s returned are greatY apYml l . THAN DON HiNpS FORD a OUR NIGHT OWL DROP BOX, LOCATED AT THE DISCLAIMER OF WARRANTIES DESCRIPTION TOTALS SERVICE ENTRANCE, IS AVAILABLE DURING ANY WARRANTY ON THE PRODUCTS LABOR AMOUNT SOLD HEREBY ARE THOSE MADE 8Y 315 . 95 THE . THSELLER, NON-BUSINESS HOURS. DON HIINDSACTUREFORDR INCE HEREBY PARTS AMOUNT 428 . 65 SERVICE HOURS: MON - FRI 7:30 AM - 5:30 PM EXPRESSLY DISCLAIMS ALL Gas,OIL, LUBE WARRANTIES, EITHER EXPRESSED OR 0 . 00 SAT 7:30 AM - 3:30 PM IMPLIED, INCLUDING ANY IMPLIED SUBLET AMOUNT 0 WARRANTY OF MERCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE, MISC. CHARGES 20 95 AND DON HINDS FORD, INC. NEITHER ASSUMES NOR AUTHORIZES ANY TOTAL.CHARGES 765 . 55 OTHER PERSON TO ASSUME FOR IT ANY LIABILITY IN CONNECTION WITH LESS DEDUCTIONS 0 • 00 THE SALE OF SAID PRODUCTS. SALES TAX 0 . 00 CUSTOMER SIGNATURE PLEASE PAY THIS AMOUNT 765 .'55 -.--- - — ---CUSTOMER- COPY- CUST , ER W: - CI4283 343865 CITY OF. -CARMEL. F.IRE DEPT. INVOICE _ JASON „ 12610 Ford Drive Fishers, IN 46038 - 2 CIVIC ,SQ, Phone (317) 849-9000 * Fax (317) 849-0020 CARMEL, .IN:` 46032-7543 PAGE 2 1-800-64HINDS (1-800-644-4637) HOME: CONT: 317-6 9 0-4 2 8 3 www.donhinds.com - BUS: CELL: 317-690-4283 SERVICE ADVISOR: 7563 CHUCK CALLAHAN COLOR YEAR NYAI�E/MODEL VIN LICENISE MILEAGE IN/OUT TAG 12 FORD F450 PKUP 1FDUF4GT9CEC39654 28695/28695 IT8890 pl DEL.QATE :PROP DATE.WARR EXP . PROMISED;;; P:0 NO RATE>: PAYMENT <INV,DATE 01JAN12 I)LI, 17 : 00 311'4AR15 N 0 . 00 CHG 01APR15 N R o; (JI?EEtIED ... ... .. FiEAt�Y; OPTIONS: DLR:47J034 ENG: 6 . 7 Liter 3 08 :21 31MAR15 110 : 36 01APR15 LINE OPCODE .TECH TYPE HOURS LIST NET TOTAL 28695 VERIFY CONCERN DRIVERS SEAT BELT WILL NOT RETRACT REPLACED SEAT BELT ASSEMBLY , HAD TO REMOVE BOX AND WIRES FOR AMBULANCE CONTROL LABOR OPPS . 61108A . 9 MT FOR AMBULANCE CONTROL . 5 D N99 ISS09 PCM RECALIBRATION CAUSE "15509 15509B Reprogram PCM/TCM: 7471 Horning,Andy LIC#: 0 WP94 (NIC) FC: PART#:, COUNT: CLAIM TYPE: 15509 AUTH CODE: 007471-- 2869S 'REPROGRAMMED MODULES PER .,15SO9 E DIESEL OIL AND FILTER CHANGE, LUBE. (NO DEF) 'OFDG.7 6 . 7 LITER DIESEL OIL AND FILTER CHANGE 7471 Horning,Andy LIC# : 0 CP 35 . 00 35 . 00 1 BC3Z*6731*B KIT - ELEMENT & GASKET - OIL F 24 . 38 24. 38 24 .38 13 XO*1OW30*BSD .1OW30DSL 2 . 90 2 . 90 37 . 70 HWC HAZARDOUS WASTE CHARGE ' 9999 CHW 0 . 95 0 . 95 28,695`DIESEL OIL AND FILTER CHANGE LUBED RESET MINDER F REPORT CARD INSPECTION 99P. REPORT .CARD INSPECTION 7471 Horning,Andy LIC# : 0 CP 0 . 00 0 . 00 GTIRE CHECK TREAD DEPTH. TREAD IS WEARING PROPERLY AT THIS TIME. 7471 Horning,Andy LIC# : 0 CP 0 . 00 0 . 00 GBATT BATTERY TEST. CRANK AMPS ARE FINE. NO OUR NIGHT OWL DROP BOX, LOCATED AT THE DISCLAIMER OF WARRANTIES DESCRIPTION TOTALS SERVICE ENTRANCE, IS AVAILABLE DURING ANY WARRANTY THE PRODUCTS LABOR AMOUNT SOLD HEREBY AREE THOSE MADE BY i THSELLER NON-BUSINESS HOURS. DON HIINDSTHE MANUFAFORDCTURER INCE HEREBY PARTS AMOUNT SERVICE HOURS: MON - FRI 7:30 AM - 5:30 PM EXPRESSLY DISCLAIMS ALL Gas,OIL, LUBE WARRANTIES, EITHER EXPRESSED OR IMPLIED, INCLUDING ANY IMPLIED SUBLET AMOUNT SAT 7:30 AM -'3:30 PM WARRANTY OF MERCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE, MISC. CHARGES E AND DON HINDS FORD, INC. NEITHER ASSUMES NOR AUTHORIZES ANY TOTAL CHARGES OTHER PERSON TO ASSUME FOR IT ANY LIABILITY IN CONNECTION WITH LESS DEDUCTIONS ' THE SALE OF SAID PRODUCTS. SALES TAX CUSTOMER SIGNATURE PLEASE PAY THIS AMOUNT a - - CUSTOMER COPY - - -- CUSTOMER 1#.: CI4283 343865Tot CITY OF CARMEL FIRE DEPT. INVOICE JASON 12610 Ford Drive Fishers, IN 46038 2 CIVIC.. SQ - Phone (317) 849-9000 * Fax (317) 849-0020 CARMEL, IN 46032-7543 PAGE 1 1-800-64HINDS (1-800-644-4637) HOME. CONT:317-690-4283 www.donhinds.com BUS: CELL:317-690-4283 SERVICE ADVISOR: 7563 CHUCK CALLAHAN OLOR YEAR 1VIAKE/MODEL VIN; LICENSE MILEAGE INfOUT. :; TAG:::::: - _ _ 3 12 FORD F450 PKUP 1FDUF4GT9CEC39654 28695 28695 T889G C?EL D1ATE. ..; PR4p DATE WARR EXP PRQM(SEQ PAYMENT; <INV. p;ATE PO NO RATE 01JAN12 DIJ 17 : 00 31MAR15 N 0 . 00 CHG OlAPR15 ROfJPENEp READY. OPTIONS: DLR:47J034 ENG: 6 . 7_Liter 08 :21 31MARlS ' 10:36 01APR15 LINE OPCODE TECH TYPE HOURS LIST NET TOTAL A *L87- SEEING COOLANT NEAR LEFT FRONT CORNER NPF NO •PROBLEM FOUND ..7471 Horning,Andy LIC#: 0 CP 0 . 00 0 . 00 28695 'INSPECT BOTH COOLING SYSTEMS LEVELS ARE NORMAL NO LEAKS FOUND AT THIS TIME B CHECK:,BRAKES, .IF NEEDED ROTATE TIRES/SET PRESSURES BR2F`REPLACE 'FRONT 'PADS AND ROTORS 7471 Horning,Andy LIC#: 0 CPBT 280 . 00 280 . 00 2 .5C3Z*1125*CA ROTOR ASY 133 . 30 133 .30 266 . 60 l 9C3.Z*2001*A KIT - BRAKE LINING 99 . 97 99 . 97 99 . 97 28695 INSPECT BRAKES REPLACED FRONT PADS AND ROTORS DUE TO PADS LOW AND ROTORS HEAT CRACKED ROAD TEST VERIFY REPAIRS **************************************************** ,C_.S25 DRI-VERS SEAT BELT WILL NOT RETRACT WELL CAUSE:_'�,25611B09 61108A-SEAT BELT RETRACTOR ASSY - FRONT - REPLACE (.611B08/611B09) - L 7471 Horning,Andy LIC#: 0 WP94 (NIC) MTWIRE TIME FOR AMBULANCE CONTROL WIRING 7471 Horning,Andy LIC#: 0 WP94 (NIC) 1;B=*25611B09*BB PRETENSIONER - SEAT BELT RETRA (N C) SNR 0401 FC: S25 42 PART#: BC3Z*25611B09*BB COUNT. CLAIM 'TYPE: AUTH CODE: 007471' OUR NIGHT OWL DROP BOX, LOCATED AT THE DISCLAIMER OF WARRANTIES pESCRIPTION "TOTALS SANY WARRANTY ON THE PRODUCTS LABOR AMOUNT SERVICE, ENTRANCE, IS AVAILABLE DURING SOLD HEREBY ARE THOSE MADE BY NON-BUSINESS HOURS. DON HINDS DONCTUREFORDR INCE HEREBY PARTS AMOUNT SERVICE HOURS: MON - FRI 7:30 AM - 5.30 PM EXPRESSLY DISCLAIMS ALL GAS,OIL, LUBE WARRANTIES, EITHER EXPRESSED OR o IMPLIED, INCLUDING ANY IMPLIED SUBLET AMOUNT SAT 7:30 AM - 3:30 PM WARRANTY OF MERCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE, MISC. CHARGES AND DON HINDS FORD, INC. NEITHER i ASSUMES NOR AUTHORIZES ANY TOTAL CHARGES OTHER PERSON TO ASSUME FOR IT ANY LIABILITY IN CONNECTION WITH LESS DEDUCTIONS THE SALE OF SAID PRODUCTS. SALES TAX CUSTOMER SIGNATURE PLEASE PAY - THIS AMOUNT - ;. . CUSTOMER COPY - -- - - VOUCHER NO. WARRANT NO. ALLOWED 20 Don Hinds Ford IN SUM OF $ l 12610 Ford Drive Fishers, IN 46038 $702.18 ON ACCOUNT OF APPROPRIATION FOR Carmel Fire Department PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members 1120jeo83� 43-510.00 ($63.37) I hereby certify that the attached invoice(s), or 1120 343865 43-510.00 $765.55 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 APR 2 0 2015 -Fire Chief 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)) 32836 CREDIT ($63.37) 343865 VIN 9654 $765.55 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