247034 06/30/15 (9-
CITY OF CARMEL, INDIANA VENDOR: 360694
ONE CIVIC SQUARE WESTFIELD AUTOMOTIVE LLC CHECK AMOUNT: $*******198.34*CARMEL, INDIANA 46032 17534 WESTFIELD PARK ROAD CHECK NUMBER: 247034
WESTFIELD IN 46074 CHECK DATE: 06/30/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4351000 69734 198.34 AUTO REPAIR & MAINTEN
Westfield Automotive LLC
�/ /) 17534 Westfield Business Park Ct
'JJ-Y J /T Westfield, IN 46074
Phone(317)867-5500- Fax(317)867-1588
{ LIKE US ON FACEBOOK }
6/1/2015 xxxx R.O. #66893 OF ESTIMATE #69734 X*** Page 1 of 1
Customer: CARMEL FIRE DEPARTMENT Vehicle: 2007 Chevrolet Impala LTZ
Address: 2 CIVIC SQUARE License 15055
CARMEL, IN 46032 Current Mileage: 76120- In: 0
Home Phone: V.I.N.: 2G 1 WS55R979337428
Work Phone: 571-2600 Engine: 3.9L V6(R)
Cellular Phone (3 17)664-0958BOB Prod. Date:
Email: Color: white
Service Writer: Vic Next Service 9/1/2015, Mileage: 79120
LABOR COMPLETED
TITLE TECH. TOTAL$
REPLACE PEDAL ASSEMBLY NEAL 33.60
SCAN PCM FOR DTC'S NEAL 39.95
&CLEAR P02138
PARTS ISSUED
QTY. PART# DESCRIPTION TECH. EACH$ TOTAL$
1 25830023 PEDAL ASSEMBLY NEAL 120.38 120.38
Payment Type: TOTAL Labor 73.55
Amount$: TOTAL Parts 120.38
Date: TOTAL Shop Supplies 4.41
Employee SUBTOTAL 198.34
TAX 0.00
** TOTAL ** $198.34
Balance Due $198.34
parts and labor are warranted for 90 days or 4,000 miles
WESTFIELDA UTO@COM CAST.NET-www.westfieldautol.com
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))
69734 B304A $198.34
1 hereby certify that the attached invoice(s), or bill(s), is(are)true and correct and I have audited same in accordance
with IC 5-11-10-1.6
20
Clerk-Treasurer
VOUCHER NO. WARRANT NO.
ALLOWED 20
Westfield Automotive, LLC.
IN SUM OF$
17534 Westfield Park Road
Westfield, IN 46074
$198.34
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO#/Dept. INVOICE NO. ACCT#/TITLE I AMOUNT Board Members
1120 69734 43-510.00 $198.34 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
Fire Chief
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund