250325 1 0/07/1 5 9,�'' ��'';"> CITY OF CARMEL, INDIANA VENDOR: 369940
® 'I ONE CIVIC SQUARE LAST CHANCE WRECKER & SALES INCCHECK AMOUNT: $"`***""50.00'
INDIANAPOLIS CARMEL, INDIANA 46032 1024 E MARKET ST CHECK NUMBER: 250325
or a� INDIANAPOLIS IN 46202 CHECK DATE: 10/07/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
911 4351000 50.00 AUTO REPAIR & MAINTEN
a Last Chance Wrecker & Sales Inc.
1024 E. Market Street
k• ,• , ; Indianapolis, IN 46202
_ 317 972 9651 Dispatch 1T'-"`�'-""�_`•Il7
( ) p
. ,. (317)972-9650 Fax
www. L 0476835
24 HOUR SERVICE
O - P.O.
.= r � .
Nth,. NAME ONE
�."-ADDRESS
t`
; .'CITY ST ZIP CODE
§�".;7-�LOCATION OF V - DRI CK NO.
E- KE/M C JOWMFf
EAR .I ••OWNER'S PHONE NO.
+'`• a
_ CONDITION OF VEHICLE: 1-MINOR 2-MODERATE 3-EXTREME PROPERTY:
• 3 q 5 g 7• 8
zc K LEFT, o 0
----------.
:z Y N 2 .17: ,18 :19; 9
R DIO
10
15 `"�'14 13 J 12
.. 20-Undercarriage
•REASON.FOR TOW/SERVICE. SPECIAL EQUIPMENT:
❑ACCIDENT ❑TA ❑LOCK OUT E)WINCH
l.Ft_
❑ARREST ❑ ❑JUMP START ❑DOLLY
>. ❑UNREGISTERED ❑STOLEN CAR ❑FLAT TIRE ❑GO-JACK
❑TOW ZONE ❑BREAKDOWN ❑OUT OF GAS OTHER:
'''•TYPE OE TOW: TOW PER,ORDER OF: !MPDnsP HOLD_#_ OFFICER__LOT LocarloN
gas_❑WHEEL LIFT ❑'MPD/ISP/
+ :Kc
❑MEDIUM DUTY ❑OWNER/DE LER 10:23 VP 10:08
,.
1 r.:
_E] HEAVY DUTY ❑PROPERTY OWNER .
CHARGE
'ACKNOWLEDGEMENT: TOWING
BY SIGNING BELOW,I ACKNOWLEDGE THAT THE INFORMATION
_�. . RECORDED ON THIS TICKET IN RELATIONSHIP TO A NOW
MILEAGE CHARGE
t=V; CONSENSUAL TOW IS TRUE AND ACCURATE.I ATTEST THAT I AM
x' THE PARKING LOT OWNER OR THE OWNER'S AUTHORIZED AGENT. LABOR CHARGE
I FURTHER UNDERSTAND THAT I WILL BE LIABLE FOR ANY DAMAGE
rer
`SUSTAINED BYTHE VEHICLE AS A RESULT OF IMPROPER TOWING. EQUIPMENT
LASTLY,I ACKNOWLEDGE THAT THIS TOW COMPLIES WITH THE
F
"REQUIREMENTS OF CHAPTER 995 OF THE REVISED CODE OF THE STORAGE CHARGE
ez N CITY OF INDIANAPOLIS AND MARION COUNTY.
DROP FEE
' AUTHORIZED DATE "OTHER'r•
r.'_'SIGNATURE '
'_
..-PRINTED - DATE
rt+"" .-PRINTED
SUB TOTAL
'=OPERATOR'S - E
TAX et .
SIGNATURE _
:4.�•- `
cL�`--;,r;VEHICLE - DATE
RELEASED TO TOTAL
Not respo.sible for loss or damage to vehicle in case of fire,theft or any other cause beyond dt frcontrol.
�,'aLC-TOWTKT
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))
09/03/15 047685 $50.00
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
VOUCHER NO. WARRANT NO.
ALLOWED 20
Last Chance Wrecker & Sales, Inc.
IN SUM OF $
1024 E. Market Street
Indianapolis, IN 46202
$50.00
ON ACCOUNT OF APPROPRIATION FOR
Proict 2015-911 Task 2015-2
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT
Board Members
911 047685 43-510.00 $50.00
I hereby certify that the attached invoice(s), or
I
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
Wednesday, September 30, 2015
Major
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund