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Home My WebLink About301230 07/28/16 (9, CITY OF CARMEL, INDIANA VENDOR: 00351564 ONE CIVIC SQUARE GARY CARTER CHECKAMOUNT: $********30.00* CARMEL, INDIANA 46032 4748 BISHOPSGATE DR CHECK NUMBER: 301230 CARMEL IN 46032 CHECK DATE: 07/28/16 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1120 4358300 072116 30.00 OTHER FEES & LICENSES VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201 (Rev.1995) GARY CARTER ALLOWED 20 ACCOUNTS PAYABLE VOUCHER 4748 BISHOPSGATE DR IN SUM OF$ CITY OF CARMEL An invoice or bill to be properly itemized must show:kind of service,where performed,dates service CARMEL, IN 46032 rendered,by whom,rates per day,number of hours,rate per hour,number of units,price per unit,etc. $30.00 Payee Purchase Order# ON ACCOUNT OF APPROPRIATION FOR Carmel Fire Terms Date Due PO# ACCT# DATE INVOICE# DESCRIPTION DEPT# INVOICE# Fund# AMOUNT Board Members DEPT# FUND# (or note attached invoice(s)or bill(s)) AMOUNT. ^ 0 43-583.00 $30.00 1 hereby certify that the attached invoice(s),or 7/26/16 0 New Engines $30.00 0-72,11(o � 1120 /K [Zl j(p 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,July 26, 2016 V4.'®r '_Z�_ David Haboush Fire Chief 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 5-11-10-1.6 120 Cost distribution ledger classification if claim paid motor vehicle highway fund. Clerk-Treasurer Bureau of Motor Vehicles * * • I I IIIIII III VIII IIII IIII IIII I III VIII VIII IIII III � .**� ►*'. Customer Transaction Receipt •BMV• State Form 51717 (R/ 4-16) Branch: VEHICLE SERVICES- REGISTRATIONS(803) Date: 7/21/16 Time: 11:51:33 am EDT 100 N SENATE AVE INDIANAPOLIS, IN 46204-2273 Visit ID: 212213626 Visit Customer: CITY OF CARMEL Transactions Trans ID (PIN) Trans Type Trans Subtype Amount 266587453 Title- Initial Title Issuance New $15.00 266587878 Registration - New Motor Vehicle Registration New $0.00 266588013 Title- Initial Title Issuance New $15.00 266588216 Registration - New Motor Vehicle Registration New $0.00 Subtotal: $30.00 Sales/Use Tax: $0.00 Credit Applied: $0.00 Totat $30.00 Payment Method CREDIT Amount $ 30.00 Merchant ID 803BMV Card Type MASTERCARD Authorization Number 03941B Terminal ID 2UA52319GZ Entry Method K Trans Sequence No 64282458 Batch No 0 Account Number ************7551 TotalDue: $30.00 Amount Paid: $30.00 Change Due: $0.00 Within 10 business days, you will receive your registration or title through the United States mail. Please allow 30 days to receive an approved Personalized License Plate. You will be able to track the progress of your registration or title by using your PIN number listed above when calling the BMV Customer Service Center at 888-myBMV-411 (888-692-6841). If you have questions or comments, please call our Customer Service Center at 888-myBMV-411. Please help us improve our service by completing a one-minute customer satisfaction survey. Your responses are completely confidential. Visit http://www.in.gov/bmvsurvey/start and enter the survey code 212213626 to get started. Thank you. www.Facebook.com/inbmv �� - www.Twitter.com/inbmv `77`°x)www.myBMV.com IIIIIIIIIIIIIIIIIIIIIIIII IIIIIIIIIVIIIIIIIIIIIIIIIIIIIIIIIIIIIII Customer Copy 5 1 7 1 7 2 6 6 5 8 8 2 1 6 Page 1 of 1 Bureau of Motor Vehicles .`*�*►*`, Customer Registration Fees Detailed Receipt i -BMV- State Form 51718 (4-04) Branch:VEHICLE SERVICES- REGISTRATIONS Date:07/21/2016 Time: 1137 EDT Visit ID: X812213626 Tran ID: 266587878 Visit Customer: CITY OF CARMEL STARS Trans# 07211680300016 Transaction Type: New Motor Vehicle Registration Registration License Type: MUNICIPAL OWNED PlatelPermitlRegistration Number: Vehicle Identification Number: 4P1BAAFF5GA016715 Vehicle Year: 2016 Vehicle Make: PIERCE MFG. INC. Vehicle Model: PIERCE Registration Year Fee Type Subtotal Total 2016 Total for 2016: 2015 NONE (NONE) 2015 $0.00 CITY OF CARMEL Total NONE(NONE) 2015: $0.00 Total for 2015: 0.00 Transaction Totak 0.00 Charges to your credit card will appear as a line item charge not as a total transaction charge. Page 1 of 1 Bureau of Motor Vehicles IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII Customer Detailed Transaction Receipt * T * .B V* State Form 51714 (4-04) Branch: VEHICLE SERVICES- REGISTRATIONS Date: 07/21/2016 Time: 11:51 EDT Visit ID: (212213626 CSR: LA Visit Customer: CITY OF CARMEL Transactions Trans ID Trans Tvi3e Trans Subtvoe Amount 266587453 Title- Initial Title Issuance New Title Fee-Vehicle $15.00 Vehicle: 4P1BAAFF5GA016715 2016 PIE PIE FT Lien Holder: THE HUNTINGTON NATIONAL BANK 525 VINE ST CINCINNATI, OH 45202-3121 Customer: CITY OF CARMEL Purchase Date: 06/16/2016 266588013 Title- Initial Title Issuance New Title Fee-Vehicle $15.00 Vehicle: 4P1 BAAFF3GA01 6714 2016 PIE PIE FT Lien Holder: THE HUNTINGTON NATIONAL BANK 525 VINE ST CINCINNATI, OH 45202-3121 Customer: CITY OF CARMEL Purchase Date: 06/16/2016 $30.00 r'.hornoc fn vni it rroriif rrarrl will nnnoar me n line item rrhomm nnf me n fnfol fronconfinn nhorne � r � Bureau of Motor Vehicles Customer Registration Fees Detailed Receipt * T * «BMV h State Form 51718 (4-04) Branch:VEHICLE SERVICES- REGISTRATIONS Date: 07/21/2016 Time: 1137 EDT Visit ID: X812213626 Tran ID: 266588216 Visit Customer: CITY OF CARMEL STARS Trans#. 07211680300017 Transaction Type: New Motor Vehicle Registration Registration License Type: MUNICIPAL OWNED PlatelPermit\Registration Number: Vehicle Identification Number: 4P16AAFF3GA016714 Vehicle Year: 2016 Vehicle Make: PIERCE MFG. INC. Vehicle Model: PIERCE Registration Year Fee Type Subtotal Total 2016 Total for 2016: 2015 NONE (NONE)2015 $0.00 CITY OF CARMEL Total NONE(NONE)2015: $0.00 Total for 2015: 0.00 Transaction Totat 0.00 Charges to your credit card will appear as a line item charge not as a total transaction charge. Page 1 of 1 State Form 48099(R2/14-10) 1 Approved by State Board of INDIANA CERTIFICATE OF VEHICLE REGISTRATION ' Accounts 2010 CLASS JAGEIISSUEDATE PUR DATE COUNTY TP PL YR PLATE PL TP WEIGHT I PR YR ILS I TYPE 07/21/2016 06/16/2016 29-HAMILTON N 2015 MO N EXPIRATION DATE I PRIOR PLATE I VEHICLE YEAR MAKE TYPE MODEL COLOR VEHICLE IDENTIFICATION NUMBER NO EXP 2016 PIE TK PIE RED/ 4P1BAAFF5GA016715 CURRENT EX TAX EX CREDIT DAV CREDIT EX TAX DUE WHEEL/SUR STATE REG FEE ADMIN FEE TOTAL DUE YEAR TAX 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 PRIOR EX TAX EX CREDIT DAV CREDIT EX TAX DUE WHEEUSUR STATE REG FEE ADMIN FEE TOTAL DUE YEAR TAX 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 CITY OF CARMEL N 2 CIVIC SQ LA CARMEL,IN 460322584 IMPORTANT REGISTRATION INFORMATION The registrant acknowledges that the information provided on the front of this form is correct. The registrant understands that proof of financial responsibility(insurance)for this vehicle will be continuously maintained during the registration period. Additional taxes and/or fees may be due if an error or an adjustment to the amount due is made. CUSTOMER COPY State Form 48099(R2/11.10) za Approved by State Board of INDIANA CERTIFICATE OF VEHICLE REGISTRATION Accounts 2010 CLASS I AGE I ISSUE DATE PUR DATE COUNTY TP PL YR PLATE PL TP WEIGHT PR YR LS TYPE 07/21/2016 06/16/2016 29-HAMILTON N 2015 MO N EXPIRATION DATE I PRIOR PLATE VEHICLE YEAR MAKE TYPE MODEL COLOR VEHICLE IDENTIFICATION NUMBER NO EXP 2016 PIE TK PIE RED/. 4P1BAAFF3GA016714 CURRENT EX TAX EX CREDIT DAV CREDIT EX TAX DUE WHEEUSUR STATE REG FEE ADMIN FEE TOTAL DUE YEAR TAX 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 PRIOR EX TAX EX CREDIT DAV CREDIT EX TAX DUE WHEEUSUR STATE REG FEE ADMIN FEE TOTAL DUE YEAR TAX 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 CITY OF CARMEL N 2 CIVIC SQ LA CARMEWN 460322584 IMPORTANT REGISTRATION INFORMATION The registrant acknowledges that the information provided on the front of this form is correct. The registrant understands that proof of financial responsibility(insurance)for this vehicle will be continuously maintained during the registration period. Additional taxes and/or fees may be due if an error or an adjustment to the amount due is made. CUSTOMER COPY APPLICATION FOR CERTIFICATE OF TITLE FOR A VEHICLE -.;<�• �-I 1': State Form 205(R9 17-16) " ~'. _ Approved by State Board of Accounts,2016 �;.....•_.---=f INDIANA BUREAU OF MOTOR VEHICLES e 'This agency is requesting disclosure of your Social Security Number/Federal Identification Number in accordance with IC 4-1-8-1;disclosure is mandatory,and this record cannot be processed without it To be completed by a police officer, BMV official,or BMV certified I swear and affirm that I am authorized to perform this transaction, and dealer signee for out-of-state titles.I hereby certify that I personally I agree to indemnify and hold harmless the Indiana BMV from any and examined the following vehicle and find the identification number to all liability arising from this transaction. be as follows. I swear and affirm that the information that I have entered on this form Vehicle Identification Number is correct.I understand that making a false statement on this form may constitute the crime of perjury. Applicant Signature: Year Make — ! Model TType Date(maVdd/yyyy) Printed Name: Inspector's Printed Name and Title City Applicant Signature: I _I— Printed Name: Inspector's Signature Badge,Branch,or Dealer Plate Number Date(mm/dd/yyyy): Transaction NumberI Branch Number I Invoice Number ' BMV Use Only I 07211680300080 803 I MV-GOVERNMENT-CERTIFICATE OF ORIGIN Social ecurity Number/Federal Identification NumberName of Applicant BMV Use Only CITY OF CARMEL Residence Address(number and street) City State ZIP Code 1 CIVIC SQUARE CARMEL IN 46032 iVehicle Identification Number Vehicle Year Vehicle Make Vehicle Model Vehicle Type Odometer ACTUAL 4P1 BAAFF5GA016715 2016 PIE PIE TK 235 M Former Title Number Purchase Date(mm/dd/yyyy) l Lien(YAN) I Speed(Y/IV) Dealer Number BMV Use Only C OF O 06/16/2016 1 No Holder of First Lien,Mortgage,or Other Encumbrance/Special Mailing Address I Mailing Address(number and street) THE HUNTINGTON NATIONAL BANK 525 VINE ST City State ZIP Code BMV Use Only CINCINNATI OH 45202-3121 Holder of Second Lien,Mortgage,or Other Encumbrance Mailing Address(number and street) City State ZIP Code ! License Number License Year Forms Use BMV Use Only LA Gross Retail and Use Tax Affidavit-I/We hereby certify that sales or use tax on this vehicle was paid as indicated below. �t Selling Price Less Trade-In/Discount Amount Subject to Tax Amount of Tax Dealer Branch Exempt Exemption Code I_$ 0.00 $ 0.00 0.00 $ 0.00 X 1 IIIIIIIIIIIIII �IIIDIIIIVIIIVIIIIIIIIIIIIIIIIIIIIIII 2 0 5 2 6 6 5 8 7 4 5 3 CUSTOMER COPY l`sTars \1 APPLICATION FOR CERTIFICATE OF TITLE FOR A VEHICLE ^ �q State Form 205(R9 17-16) j'� Approved by State Board of Accounts,2016 INDIANA BUREAU OF MOTOR VEHICLES .,,1916 r "This agency is requesting disclosure of your Social Security Number/Federal Identification Number in accordance with IC 4-1-8-1;disclosure is mandatory,and this record cannot be processed without it To be completed by a police officer, BMV official,or BMV certified I swear and affirm that I am authorized to perform this transaction,and dealer signee for out-of-state titles. I hereby certify that I personally I agree to indemnify and hold harmless the Indiana BMV from any and examined the following vehicle and find the identification number to all liability arising from this transaction. be as follows. I swear and affirm that the information that I have entered on this form Vehicle Identification Number is correct.I understand that making a false statement on this form may constitute the crime of perjury. Year Applicant Signature: Make Model I Type i Date(mm/dd/yyyy) ! Printed Name: Inspector's Printed Name and Title City Applicant Signature: Printed Name: Inspector's Signature Badge,Branch,or Dealer Plate Number Date(mm/dd/yyyy): j Transaction Number 1 Branch Number 1 Invoice Number i BMV Use Only 07211680300083j 803 i I MV-GOVERNMENT-CERTIFICATE OF ORIGIN Social Security Number/Federal Identification Number` Name of Applicant ! BMV Use Only CITY OF CARMEL Residence Addressstreet I number and ( ) City State ZIP Code 1 CIVIC SQUARE j CARMEL_ I IN I 46032 Vehicle Identification Number Vehicle Year i Vehicle Make Vehicle Model Vehicle Type Odometer ACTUAL 4P1 BAAFF3GA016714 2016 PIE PIE TK 1185 M Former Title Number Purchase Date(mm/dd/yyyy) Lien(Y/7V) Speed(YIN) Dealer Number BMV Use Only C OF O 06/16/2016 1 f No I Halder of First Lien,Mortgage,or Other Encumbrance/Special Mailing Address Mailing Address(number and street) THE HUNTINGTON NATIONAL BANK 525 VINE ST _C��Y _F State ZIP Code BMV Use Only CINCINNATI _ �OH i 45202-3121 Holder of Second Lien,Mortgage,or Other Encumbrance Mailing Address(number and street) ! I _ I City i State I ZIP Code I License Number License Year Forms Use( BMV Use Only I i LA Gross Retail and Use Tax Affidavit-I/We hereby certify that sales or use tax on this vehicle was paid as indicated below. Selling Price Less Trade-In/Discount I Amount Subject to Tax Amount of Tax Dealer Branch i Exempt ; Exemption Code $ 0.00 $ 0.00 0.00 j $ 0.00 x ! 1 II ILII IIIII III II ILII II I II IIIII IIIII IIIII IIIII IIIII IIIII III 2 0 5 2 6 6 5 8 8 0 1 3 CUSTOMER COPY