308084 02/13/17 CITY OF CARMEL, INDIANA VENDOR: 362147
d ONE CIVIC SQUARE CUSTOM TRUCK &AUTO INC CHECK AMOUNT: $*******231.85*
CARMEL, INDIANA 46032 17134 WESTFIELD PARK ROAD CHECK NUMBER: 308084
WESTFIELD IN 46074 CHECK DATE: 02/13/17
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4351000 33630 231.85 AUTO REPAIR & MAINTEN
VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201(Rev.1995)
Vendor# 362147 ALLOWED 20 ACCOUNTS PAYABLE VOUCHER
CUSTOM TRUCK&AUTO INC IN SUM OF$ CITY OF CARMEL
17134 WESTFI ELD PARK ROAD 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.
WESTFIELD, IN 46074
Payee
$231.85
ON ACCOUNT OF APPROPRIATION FOR Purchase Order#
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
33630 43-510.00 $231.85 1 hereby certify that the attached invoice(s),or 2/2/17 33630 VIN 9654 $231.85
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
Friday, February 03,2017
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
20
Cost distribution ledger classification if claim paid motor vehicle highway fund. Clerk-Treasurer
t&e
17134 Westfield Park RdWestfield, IN 46074
®rruek� 317.896.5956 7invoice #33630
17
FIRE DEPARTMENT CARMEL Thursday,January 26,
9:15:299 AM AM
Ordered on
1 CIVIC SQUARE DSNYDER@CARMEL.IN.GOV Monday,January 23,2017
CARMEL IN 46032
Workorder#34976
ELEPT K10
2012 Ford Drw Super DutyXL BOB:664-0958 Dave Moffitt SDS Cash
NAI NA 1FDUF4GT9CEC39654
CATALOGDESCRIPTION
LABOR HEAVY DUTY TIRE INSTALL 4 45.00 $180.00 SAA-
TIRELARGE LARGE TIRE DISPOSAL 4 12.00 $48.00
ALL REAR MOUNT AND BALANCE CUSTOMER INSTALL
SS Shop Supplies $3.60
PAID.BY Parts $0.00 Taxable $3.60
Account$231.85 Labor $180.00 Non-Taxable $228.00
Freight $0.00 Local Tax $0.25
Other $48.00
Current Balance:$231.85 FET $0.00 TOTAL $231.85
Supplies $3.60
Any warranties on the demltems 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 andAuto,Inc.,neither assumes nor authorizes any other person to assume for it any liability in connection with the same of this
itemltems.
-PAYMENT IS DUE AT VEHICLE PICKUP"
THANK YOU FOR YOUR BUSINESS!
Print Name Signature Date
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