250184 1 0/07/1 5 �% F, CITY OF CARMEL, INDIANA VENDOR: 362147
® 1 ONE CIVIC SQUARE CUSTOM TRUCK & AUTO INC CHECK AMOUNT: $"*****300.46`
CARMEL, INDIANA 46032 17134 WESTFIELD PARK ROAD CHECK NUMBER: 250184
�M<:���:� WESTFIELD IN 46074 CHECK DATE: 10/07/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4351000 27964 300.46 AUTO REPAIR & MAINTEN
CUSTOM TRUCK AND AUTO, INC
17134 WESTFIELD PARK ROAD
WESTFIELD IN 46074
317-896-5956
page 1
Invoice#27964
FIRE DEPARTMENT CARMEL
1 CIVIC SQUARE
CARMEL IN 46032
-fold here-
Vehicle : 2002 FIRE TRUCK ENGINE 41 KME CUMMINS ISM 380
VIN : 1 K9AF42822NO58489 Color : Red-White
Fleet# : 40
Created : 6/l/2015 12:26:38 PM Odometer In : 0
Complete : 6/10/2015 11:20:04 AM Odometer Out: 83758
Invoiced : 9/30/2015 11:01:50 AM
Contact : BOB(664-0958)
Sry Writer: DM
Labor/Notes
Codelrech' Description Price
TZ. GENERAL USE LABOR $240.00
Parts
Qty Codefrech• Description Condition Unit Price Price
3 TZ' 5 STAINLESS LAP JOINT TORCA New $10.42 $31.26
2 TZ' Exhaust Clamp-Universal $8.82 $17.64
Labor ..................................................... $240.00
Parts $50.14 less discount:$1.24 $48.90
Sublet/Misc. ....................................................... $0.00
SHOP SUPPLIES ....................................................... $11.56
Charges ....................................................... $0.00
Sales Tax Tax Exempt#0031201550020 $0.00
Total Due $300.46
Tech Certification
TZ
III II l�lll IIIA I I Ill VIII lull Ill/I[U
CUSTOM TRUCK AND AUTO, INC
17134 WESTFIELD PARK ROAD
WESTFIELD IN 46074
317-896-5956
page 2
Invoice#27964
Vehicle : 2002 FIRE TRUCK ENGINE 41 KME CUMMINS ISM 380
Any warranties on the item/items sold are those made by the manufacturer. The seller, Custom Truck
and Auto, Inc., hereby expressly disclaims all warranties, either express or implied, including any
implied warranty of merchantability or fitness for a particular purpose, and Custom Truck and Auto,
I Inc., neither assumes nor authorizes any other person to assume for it any liability in connection with
the same of this item/items.
PAYMENT IS DUE AT TIME OF REPAIRS UNLESS OTHER ARRANGEMENTS HAVE BEEN MADE
WITH MANAGEMENT.
THANK YOU FOR YOUR BUSINESS!
I
i
I{11111[1 ll[II[I Illll fll�lll�IIII illl
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))
27964 VIN 8489 $300.46
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
Custom Truck & Auto, Inc.
IN SUM OF $
17134 Westfield Park Road
Westfield, IN 46074
$300.46
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1120 27964 43-510.00 $300.46 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
OCT 5 20,15
1
Fire Chief
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund