246756 06/30/15 4�pi C�q�F
CITY OF CARMEL, INDIANA VENDOR: 362147
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ONE CIVIC SQUARE CUSTOM TRUCK &AUTO INC CHECK AMOUNT: $*****1,554.47*
�_�; CARMEL, INDIANA 46032 17134 WESTFIELD PARK ROAD CHECK NUMBER: 246756
.y TON�, WESTFIELD IN 46074 CHECK DATE: 06/30/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4351000 28233 1,554.47 AUTO REPAIR & MAINTEN
CUSTOM TRUCK AND AUTO, INC
17134 WESTFIELD PARK ROAD
WESTFIELD IN 46074
317-896-5956
page 1
Invoice#28233
FIRE DEPARTMENT CARMEL
1 CIVIC SQUARE
CARMEL IN 46032
-fold here-
Vehicle : 2009 Ford Truck F250 Super Duty 3/4 Ton - Pickup 5.4 L
VIN : 1FTSX21579EA85476 Color : White
Created : 6/23/2015 1:40:49 PM Odometer In : 71567
Complete : 6/26/2015 8:58:51 AM Odometer Out: 71567
Invoiced : 6/26/2015 8:58:51 AM
Contact : BOB (664-0958)
Sry Writer: GG
Labor/Notes
Code/Tech* Description Price
GG* CHECK EXHAUST LEAK-??? $810.00
!!!-CALLED JASON AT 2:50 PM ON TUES 6-23-15&ADVISED--HE GAVE OK FOR BOTH EXHAUST MANIFOLDS
REPLACED AT COST OF$1560
GG* GENERAL USE LABOR $0.00
Parts
Qty Code/Tech* Description Condition Unit Price Price
1 GG* EXHAUST MANIFOLD $0.00 $0.00
1 GG* EXHAUST MANIFOLD $0.00 $0.00
1 GG* MANIFOLD New $196.49 $196.49
1 GGA___ _ KIT-M _ New _ $221.30 $221.30
16 GG* STUD New $7.28 $116.48
16 GG* NUT New $2.84 $45.44
4 GG* STUD New $13.05 $52.20
4 GG* NUT New $6.26 $25.04
4 GG* GASKET New $14.38 $57.52
Labor ....................................................... $810.00
Parts $1,153.53 less discount:$439.06 $714.47
Sublet/Misc. ....................................................... $0.00
SHOPSUPPLIES ....................................................... $30.00
Charges ....................................................... $0.00
Sales Tax Tax Exempt#0031201550020 $0.00
Total Due $1,554.47
Tech Certification#
GG
I VIII II III VIII VIII VIII I III IIII III
r .
VOUCHER NO. WARRANT NO.
ALLOWED 20
Custom Truck &Auto, Inc.
IN SUM OF $
17134 Westfield Park Road
Westfield, IN 46074
$1,554.47
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO#/Dept. INVOICE NO. ACCT#!TITLE AMOUNT Board Members
1120 28233 43-510.00 $1,554.47 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 Ap N 2 9 20S
i
r
VVIW ,
Fire Chief
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
i
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))
28233 VIN 5476 $1,554.47
I
I
i
I
I
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