249389 09/09/15 i CAA
CITY OF CARMEL, INDIANA VENDOR: 237560
® a ONE CIVIC SQUARE PEARSON FORD,INC CHECK AMOUNT: $**.....862.07"
=4 CARMEL, INDIANA 46032 10650 N MICHIGAN RD CHECK NUMBER: 249389
�,,oN�� ZIONSVILLE IN 46077 CHECK DATE: 09/09/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2201 4351000 304866 862.07 AUTO REPAIR & MAINTEN
7332001
Dealer No:06761
Invoice No: 304866 Pearson Ford, Inc.
10650 North Michigan Road
Zionsville, IN 46077
CITY OF CARMEL STREET DEPT INVOICE 317.873.3333
3400 W 131ST ST PAGE 1 www.mylndyford.com
CARMEL, IN 46074-8267 PARTS&SERVICE HOURS
Home-317-733-2001 Email: Monday-Friday7:00 am-6:00 pm
Bus:
SERVICE ADVISOR: 2100 SCOTT KROUSE
COLOR YEAR MAKE/MODEL VIN LICENSE MILEAGE IN /OUTTAG
F1 RED CLE 09 FORD F550 1FDAF57R19EA02257 72657 72657 T804
DEL.DATE . PROD. DATE WARR, EXP. PROMISED PO NO. RATE 1. PAYMENT INV. DATE
170CT08 D 22SEP08 17:00 21AUG15 BILL UG 15
R.O. OPENED READY OPTIONS:w-COMP:G STK:14995 ENG:99R_6.4L V-8_DIESEL
TRN:44B TORQSHIFT(TM)_5-SPD_AUTO_TRANS A (More. . .)
08 : 59 21AUG15 14 : 54 25AUG15
LINE OPCODE TECH TYPE HOURS LIST NET TOTAL
A CUST STATES THAT THE REDUCED ENG POWER LIGHT COMES ON AND WHITE SMOKE
FROM EXHAUST
DIESEL DIESEL PERFORMANCE / HARD START / NO-START
DIAGNOSIS
9422 CFL 89 . 00 89 . 00
3 VC*7*B ANTI-FREEZE 16 . 47 14 . 82 44 .46
3 DISTILLEDWATER WATER 1 . 95 1 . 75 5 . 25
1 8C3Z*8575*D THERMOSTAT ASY 38 . 00 34 . 20 34 . 20
, , , , 72657 FAILED COMPONENT 1 . 00 DIESEL DIAGNOSIS POOB7 PINPOINT
THERMOSTATS BAD ENGINE TEMP LOW AT 134 DEG DPF LOAD HIGH HAS BEEN 700
, , , , ML. SINCE REGEN ENGINE OIL LEVEL 3 QTS OVER VEHICLE HAS 4800 ENGINE
, , , , OPERATING HRS . EQUAL TO 120K MLS HAS EXTENDED IDLE TIMES RECOMMEND OIL
, , , , CHANGE EVERY 200 HRS .
****************************************************
B ENGINE FLUSH: REMOVE BLOCK DRAINS FLUSH ENGINE (204763895)
R5M ENGINE FLUSH: REMOVE BLOCK DRAINS FLUSH
ENGINE (204763895)
9422 CFL 178 . 00 178 . 00
, , , , 72657 MAINT. 2 . 00 520 :REMOVED ENGINE BLOCK PLUGS FLUSHED COOLING
, , , , SYSTEM REFILL WITH EXTENDED LIFE GOLD COOLANT AND DISTILLED WATER
****************************************************
C THERMOSTAT REPLACEMENT (204764008)
R5M THERMOSTAT REPLACEMENT (204764008)
9422 CP 267 . 00 267 . 00
, , , , 72657 MAINT. 3 . 00 278 :REPLACED THERMOSTATS
****************************************************
D OIL CHANGE - DIESEL (204764121)
R5M OIL CHANGE - DIESEL (204764121)
9422 CP 19 . 41 19 . 41
1 FL*2016* KIT - ELEMENT & GASKET - OIL F 29 . 43 29 . 43 29 .43
15 XO*15W40*QSD MOTORCRAFT SAE 15W-40 API CJ-4 4 . 79 4 . 79 71 . 85
, , , , 72657 MAINT. 0 . 40 779 :CHANGED ENGINE OIL AND FILTER 6 . 4 LITER
, , , ,DIESEL
****************************************************
`r
DISCLAIMER OF WARRANTIES
ON BEHALF OF SERVICING DEALER, I HEREBY CERTIFY THAT THE AND LIMITATIONS OF LIABILITY DESCRIPTION TOTALS
INFORMATION CONTAINED HEREON IS ACCURATE UNLESS OTHERWISE TI,<fa wy.arra.., if-Y. ihn„aly warramy LABOR AMOUNT
SHOWN. SERVICES DESCRIBED WERE PERFORMED AT NO CHARGE TO will,� pml .n 1hi., sale. SELLER MAKES NO
OWNER. THERE WAS NO INDICATION FROM THE APPEARANCE OF THE WARRANTY WHATSOEVER AND EXPRESSLY PARTS AMOUNT
VEHICLE OR OTHERWISE, THAT ANY PART REPAIRED OR REPLACED DISCLAIMS ALL WARRANTIES EITHER
UNDER THIS CLAIM HAD BEEN CONNECTED IN ANY WAY WITH ANY EXPRESS WARRANTYFD IMPLIED, INCLUDING ANN' GAS,OIL, LUBE
1M PF TNESFORAOFMCULAR TABI LITE' SUBLET AMOUNT
AC'%IDENT, NEGLIGENCE OR MISUSE. RECORDS SUPPORTING THIS OR FITNESS FOR A PARTICULAR PURPOSE.
CLAIM ARE AVAILABLE FOR (1) YEAR FROM THE DATE OF PAYMENT SELLER'S MAXIMUM LIABILITY HEREUNDER MISC. CHARGES
NOTIFICATION AT THE SERVICING DEALER FOR INSPECTION BY IS LIMITED TO THE ORIGINAL SALES PRICE
MANUFACTURER'S REPRESENTATIVE. AND SELLER SHALL HAVE NO LIABILITY TOTAL CHARGES
FOR ANN'INCIDENTAL OR CONSEQUENTIAL
DAMAGES FOR LOST SALES,LOST PROFITS, LESS INSURANCE
INJURIES TO PERSONS OR PROPERTY OR
OTHER INJURIES OR DAMAGES. SALES TAX
(SIGNED) DEALER,GENERAL MANAGER OR AUTHORIZED PERSON (DATE) CUSTOMER SIGNATURE PLEASE PAY
THIS AMOUNT
CUSTOMER COPY
7332001 Dealer No:06761
Invoice No: 304866 Pearson Ford, Inc.
10650 North Michigan Road
Zionsville, IN 46077
CITY OF CARMEL STREET DEPT INVOICE 317.873.3333
3400 W 131ST ST PAGE 2 www.mylndyford.com
CARMEL, IN 46074-8267 PARTS&SERVICE HOURS
Home-317-733-2001Monday-Friday17-733-2001 Email: 7:00 am-6:00 pm
Bus:
SERVICE ADVISOR: 2100 SCOTT KROUSE
COLOR YEAR MAKE/MODEL VIN LICENSE MILEAGE IN /OUT TAG
F1 RED CLE 09 FORD F550 1FDAF57R19EA02257 72657 72657 T804
DEL. DATE PROD. DATE WARR. EXP. PROMISED PO N0. RATE PAYMENT INV. GATE
170CT08 D 22SEP08 17:00 21AUG15 BILL 25AUG15
R,O. OPENED READY OPTIONS:w-COMP:G STK:14995 ENG:99R_6.4L_V-8_DIESEL
TRN:44B_TORQSHIFT(TM)_5-SPD_AUTO_TRANS A (More. . .)
08 : 59 21AUG15 14 : 54 25AUG15
LINE OPCODE TECH TYPE HOURS LIST NET TOTAL
E MAINTENANCE: MANUAL REGEN AND PCM UPDATES .(204764342)
R5M MAINTENANCE: MANUAL REGEN AND PCM UPDATES
(204764342)
9422 CP 89 . 00 89 . 00
, , , , 72657 MAINT. 1 . 00 3394 : PERFORM MANUAL REGEN PCM UPDATES
****************************************************
CUSTOMER PAY SHOP SUPPLIES FOR REPAIR ORDER 34 .47
*********** ATTENTION CUSTOMER **************
MAKE A SERVICE APPOINTMENT FROM THE COMFORT
OF YOUR HOME OR OFFICE ANYTIME, JUST GO TO
MYINDYFORD. COM AND CLICK ON THE SERVICE TAB
IT' S QUICK, EASY AND AVAILABLE 24 HOURS A DAY
*********************************************
DISCLAIMER OF WARRANTIES
ON BEHALF OF SERVICING DEALER, I HEREBY CERTIFY THAT THE DESCRIPTION TOTALS
qND LIMITATIONS OF LIABILITY
INFORMATION CONTAINED HEREON IS ACCURATE UNLESS OTHERWISE Tnr r,,,y ua«a.,y, ,I a-y, „a,r,,,,ly..,r y LABOR AMOUNT
SHOWN. SERVICES DESCRIBED WERE PERFORMED AT NO CHARGE TO wan rrr, ,�tni sale. SELLER MAKES No 642 41
OWNER. THERE WAS NO INDICATION FROM THE APPEARANCE OF THE WARRANTY WHATSOEVER AND EXPRESSLY PARTS AMOUNT 8 19
VEHICLE OR OTHERWISE, THAT ANY PART REPAIRED OR REPLACED DISCLAIMS ALL WARRANTIES EITHER
UNDER THIS CLAIM HAD BEEN CONNECTED IN ANY WAY WITH ANY EXPRESS A IMPLIED, INCLUDING ANY GAS, OIL, LUBE0 00
IMPLIED SS FOR A PARTICULAR PURPOSE.
SUBLET AMOUNT
ACCIDENT, NEGLIGENCE OR MISUSE. RECORDS SUPPORTING THIS OR FITNESS FOR A PARTICULAR PURPOSE. n on
CLAIM ARE AVAILABLE FOR (1) YEAR FROM THE DATE OF PAYMENT SELLER'S MAXIMUM LIABILITY HEREUNDER MISC. CHARGES
NOTIFICATION AT THE SERVICING DEALER FOR INSPECTION BY IS LIMITED TO THE ORIGINAL SALES PRICE
34 47
MANUFACTURER'S REPRESENTATIVE. AND SELLER SHALL HAVE NO LIABILITY TOTAL CHARGES
FOR ANY INCIDENTAL OR CONSEQUENTIAL
DAMAGES FOR LOST SALES,LOST PROFITS. LESS INSURANCE
INJURIES TO PERSONS OR PROPERTY OR n nn
OTHER INJURIES OR DAMAGES SALES TAX
(SIGNED) DEALER,GENERAL MANAGER OR AUTHORIZED PERSON (DATE) CUSTOMER SIGNATURE PLEASE PAY
THIS AMOUNT 862 07
CUSTOMER COPY
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))
08/25/15 304866 $862.07
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
Pearson Ford
IN SUM OF $
10650 N. Michigan Road
Zionsville, IN 46077
$862.07
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO#/Dept. INVOICE NO. ACCT#/TITLE I AMOUNT Board Members
2201 I 304866 I 43-510.001 $862.07 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
6
ursday ept 5
S>%Rq6&RfflrSjti er
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund