HomeMy WebLinkAbout258516 05/10/16 0CITY OF CARMEL, INDIANA VENDOR: 358894
® ONE CIVIC SQUARE SAFELITE AUTOGLASS CHECK AMOUNT: $*******302.85*
r• _�; CARMEL, INDIANA 46032 PO BOX 633197 CHECK NUMBER: 258516
9M«oN. CINCINNATI OH 45263-3197 CHECK DATE: 05/10/16
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4351000 01830259347 302.85 AUTO REPAIR & MAINTEN
VOUCHER NO. WARRANT NO. Prescribed by state Board of Accounts City Form No.201(Rev.1995)
ALLOWED 20 ACCOUNTS PAYABLE VOUCHER
SAFELITE AUTOGLASS
IN SUM OF$ CITY OF CARMEL
PO BOX 633197
An invoice or bill to be properly itemized must show:kind of service,where performed,dates service rendered,by
CINCINNATI,OH 45263-3197 whom,rates per day,number of hours,rate per hour,number of units,price per unit,etc.
$302.85 Payee
Purchase Order No.
ON ACCOUNT OF APPROPRIATION FOR
Terms
Carmel Fire
Date Due
Invoice Date Invoice# Description Amount
PO#/Dept. INVOICE NO. ACCT#/Fund AMOUNT Board Members Dept. Fund# (or note attached invoice(s)or bill(s))
01830-259347 I 43-510.00 I $302.85 1 hereby certify that the attached invoice(s),or 05/03/16 01830-259347 VIN 1817 $302.85
1120 101 1120 101
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
Tuesday,May 03,2016
David Haboush
Fire Chief
Cost distribution ledger classification if I hereby certify that the attached invoice(s),or bill(s),is(are)true and correct and I have audited same in accordance
claim paid motor vehicle highway fund with IC 5-11-10-1.6
.120—
Clerk-Treasurer
SAFELITE FULFILLMENT, INC CUSTOMER SERVICE CENTER 1-800-835-2257
dba: Safelite Auto Glass, Elite Auto Glass,
Auto Glass Specialists, and IF YOU HAVE ANY QUESTIONS REGARDING
Diamond Triumph Glass PAYMENT OF THIS INVOICE: 1-800-835-2092
INVOICE 01830-259347 INVOICE: 04/27/16 BD
ORDERED: 04/25/16 INSTALLED: 04/27/16
PLEASE REMIT PAYMENT TO: W.O. # : 742790 REFERRAL#: 836639
SAFELITE FULFILLMENT, INC INSURED:
P.O. BOX 633197 VANVOORST, BOB
CINCINNATI, OH 45263-3197 2 CIVIC SQUARE
PLEASE WRITE INVOICE NUMBER ON CHECK CARMEL IN 46032-0000
PH1:317-664-0958 PH2:
CARMEL FIRE DEPT Acct #: 160295
2 CIVIC SQUARE
CARMEL IN 46032
POLICY# : FDO1817 PO#/REF : FDO1817
CLAIM # : LOSS LOC:
AUTH/VER: BOB LOSS DATE/CAUSE:
------------------------------
-----------------------------------------------------------------------------------
2012 FORD F SERIES F150 4 DOOR CREWTANENAN ARR: MOBILE
MILEAGE: 99,999
VIN: 1FTFW1ET3CFD01817 LICENSE/ST: 12870 IN STOCK #: CAR 48
----.--------------------------------------------------------------------------------
QTY PART # LIST SELLING LABOR KIT MATERIAL EXTENSION
1 DWO1747 GTY 229.35 223.42 50.00 .00 .00 273.42
SOLAR-W/THIRD VISOR FRIT
1 MWD1529 19.21 11.53 .00 .00 .00 11.53
UPPER
1 DISPOSAL FEE 4.95 .00 7.95 .00 .00 7.95
DISPOSAL FEE
1 FUEL SURCHARGE 3.99 .00 9.95 .00 .00 9.95
FUEL SURCHARGE
PART TOTAL 234.95
LABOR TOTAL 67.90
SUBTOTAL 302.85
SALES TAX 0.00
P A Y T H I S A M O U N T 302.85
TERMS: NET 30
ADDITIONAL INFO/CLAIMANT SERVICED BY: COUNTY/B
SAFELITE AUTOGLASS # 01830
INDIANAPOLIS IN 46268-0000
SAFELITE TAX ID #: 36-4523816
042716-160295-160295 00513-160295-259347
CARMEL FIRE DEPT
2 CIVIC SQUARE
CARMEL IN 46032 20160427 0000000020160427742