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319481 12/12/2017 r C.1q' CITY OF CARMEL, INDIANA VENDOR: 00351 179 _ b ONE CIVIC SQUARE FIRESTONE TIRE&SERVICE CENTER CHECK AMOUNT: S......**76.92* CARMEL, INDIANA 46032 PO BOX,403727 CHECK NUMBER: 319481 9.y,roN..o; ATLANTA;GA,30384-3727 CHECK DATE: 12/12/17 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 651 5023990 181522 16.99 OTHER EXPENSES 2200 4231500 181643 34.45 OIL 2200 4237000 181643 25.48 REPAIR PARTS VOUCHER NO. 176894 WARRANT NO. ALLOWED 20 Prescribed by State Board of Accounts City Form No.201(Rev 1995) Vendor # 00351179 IN SUM OF$ ACCOUNTS PAYABLE VOUCHER FIRESTONE COMPLETE AUTO CARE CITY OF CARMEL PO BOX 403727 An invoice or bill to be properly itemized must show: kind of service, where performed, ATLANTA, GA 30384-3727 dates service rendered, by whom, rates per day, number of hours, rate per hour, numbers of units, price per unit, etc. Payee 16.99 00351179 Purchase Order No. ON ACCOUNT OF APPROPRATION FOR FIRESTONE COMPLETE AUTO CARE Terms Carmel Wasterwater Utility PO BOX 403727 Due Date BOARD MEMBERS I hereby certify that that attached invoice(s), ATLANTA, GA 30384-3727 or bill(s)is(are)true and correct and that PO# ACCT# the materials or services itemized thereon for DATE INVOICE# Description DEPT# INVOICE# Fund# AMOUNT which charge is made were ordered and DEPT# FUND# (or note attached invoice(s)or bill(s)) AMOUNT 181522 01-7500-08 $16,99 and received except 12/1/2017 181522 $16.99 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 Cost distribution ledger classification if claim paid motor vehicle highway fund. 20_ Clerk-Treasurer Customer Invoice FIRESTONE COMPLETE AUTO CARE Service Advisor: 181522 CARMEL 05 TISH 11/30/2017 _ 1314 S RANGE LINE RD 317.848.5886 CARMEL, IN. 46032-2932 Re-Printed on 11/30/2017 10:22 AM DUPLICATE INVOICE 2005 CHEVROLET EQUINOX LT CITY OF CARMEL. UTIL 3.4L V6 FI GAS VIN F OHV 9609 HAZEL DELI_ PKWY Lic#: INDY IN Vin#: INDIANAPOLIS, IN 46280-2935 In: 11/30/17 9:16AM Mileage: 80,831 317.571.2648 Out: 11/30/17 10:21 AM Store# 020753 COMMERCIAL Rev Hist Unit Extended Job _Description _ _ _ _ /Article# ID Qty Price Price Total FLAT REPAIR& BALANCE55 SERIES-AND ABOVE 05 16.99 (Front-Right)- WENT Front-Right)WENT COMPLETELY FLAT IN AN�HOUR FLAT REPAIR- PATCH-PLUG t 7020060 ry79NN' '1` ' 1 69' _ 1-.69 _ _ 7013645 79NN 1' 5.95 FLAT REPAIR BALANCE_LABOR t' _ --5'.65 "c 701'9488 79N Nt i 1'# 9 35 1:9:35 FLAT REPAIR IABORf i ( t �E''' � 'e JY� _` '.- I i ' 't iti 1` , [ = COURTESY`CHE,C'K t - 05 �- -- dw COURTESY CFIECK _ _-_— 7046930 79NN 1 N/C N/C ORDER NOTES BEAD LEAK Technician(s): 79 JUSTIN Payment History: Summary: 16.99 Parts 1.69 Total Tendered 16.99 Labor 15.30 Shop Supplies 0.00 Sub-Total 16.99 Tax Exempt(0031201550) 0.00 Tota 1 $16.99 I have received the above goods and/or services. If this is a credit card purchase, I agree to pay and comply with my cardholder agreement with the issuer. Customer Signature All parts are new unless otherwise specified. ,HOW AREWE DOING?—' ` Tell us about your,experience today! Complete a 4-minute�survey for a chance to win $500 in store services Visit www.FirestoneSurvey.com withim 4 days and en-ter Code 020753-1,81522 www.FirestoneCompleteAutoCare.com AY 's..J° IS 1Y 9¢3yt�or! ,5.E } - STD FCAC LASER 7008335-48110392 REV 11/11PROGRAM ` Page 1=ofttt` '^°' 1603 4503°°' P;O"AUTOEUOTEV�RZPAM `dee reverse side for Warranty Information , ,� VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201(Rev.1995) vendor# 00351179 ALLOWED 20 ACCOUNTS PAYABLE VOUCHER FIRESTONE TIRE&SERVICE CENTER IN SUM OF$ CITY OF CARMEL PO BOX 403727 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. ATLANTA, GA 30384-3727 Payee $59.93 ON ACCOUNT OF APPROPRIATION FOR Purchase Order# Engineering 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 181643 42-370.00 $25.48 1 hereby certify that the attached invoice(s),or 12/4/17 181643 Parts for City vehicle $25.48 2200 2200 2200 2200 181643 42-315.00 $34.45 bill(s)is(are)true and correct and that the 12/4/17 181643 Oil Change for City Vehicle $34.45 2200 2200 materials or services itemized thereon for 2200 1 2200 which charge is made were ordered and received except Thursday, December 07,2017 Jeremy Kashman Director 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 Customer Invoice FIRESTONE COMPLETE AUTO CARE Service Advisor: 181643 CARMEL 01 NICK 12/04/2017 1314 S RANGE LINE RD 317.848.5886 CARMEL, IN. 46032-2932 2010 FORD ESCAPE LIMITED HYBRID CITY OF CARMEL, BUILDING &CODE 2.5L L4 FI ELECTRIC/GAS VIN 3 DOHC 1 CIVIC SQ Lic#: 67111 IN Vin#: 1 FMCU5K3XAKB40807 CARMEL, IN 46032-2584 In: 12/04/17 2:30PM Mileage: 63,407 317.571.2441 xcaleb Out: 12/04/17 3:59PM Store# 020753 COMMERCIAL Rev Hist Unit Extended Job Description _ _ ______________ /Article# ID___ Qty _ Price Price STANDARD OIL CHANGE UP TO 5 QTS 01 G ZZ-00-L4 z 3 Iso 0 34.45 5.3 QTS. SAE 5W-20 Premium Synthetic Blend Motor Oil PZ2.1-OIL.:FILTER-- 7058149 04NN _ 1 _.- 4.24.,_ , 4.24 5W-.2068_,-ADV DUR GF5 OIL:UP T0;,5-QTS 7034653-04NN 1 22 10" 22.10. ADDITIONAL OIL REQUIRED 0.3QTS @$0.44 PER 1/10 703465404NN I 3. .� 0.44 �� 1-.32 QTS f USED q FILTER RECYCLING-04b, (1)v ' r -7 x7075051 04NNi �I 11 2 54,�,�, - 12:54�0 OIL CHANGE ,-) E �f-' I " s ( "��T-,1 ; 7029718 04NN` i 1 COURTESY CHECK`-; 01 COURTESY CHECK 7046930 04NN 1 N/C N/C FLAT REPAIR& BALANCE55 SERIES AND ABOVE W/TPMS 1 01 O 2-'L00- '4229"4000 25.48 (Rear-Right) 6-207A TPMS VALVE VS-950-15 7009357 04NN 1 5.95 5.95 FLAT REPAIR - PATCH-PLUG 7020060 04NN 1 1.69 1.69 TPMS VALVE SERVICE KIT LABOR 7008190 04NN 1 2.54 2.54 FLAT REPAIR BALANCE LABOR 7013645 04NN 1 5.95 5.95 FLAT REPAIR LABOR 7019488 04NN 1 9.35 9.35 Technician(s): 04 CARL Payment History: Summary: 59.93 Parts 35.30 Total Tendered 59.93 Labor 24.63 Shop Supplies 0.00 Sub-Total 59.93 Tax Exempt(31201660) 0.00 Total $59.93 1 have received the above goods and/or services. If this is a credit card purchase, I agree to pay and comply with my cardholder agreement with the issuer. ._......... Rev Revision History: Amt Init Customer Signature 1) 12/04/2017 03:36PM 25.48 CITY OF C 317.571.2441 Ext.caleb All parts are new unless otherwise specified. I verbally approved any change to the original estimate, including price or services. ____ ..__, e Signature or Initials . www.FirestoineCompleteAutoCare.com� - �� r ��,I �i�®-r�l�i.�-r � �11Dp(,,1 rl. . @ tZ L3�� 41li� M STD FCAC LASER 7008335-48110392 REV 11/11 E }'1.128 nct i - 4 _ �, Pae I oN2-1=- [PROGRAM � t.-: - r, Lii 3:c24.attr In,,1�x160503m001 STAP6RFaSDS PDG;AUTOMOTIVE gErIA113 See reverse side for Warranty'Information_-' 7J�'.�� Customer Invoice FIRESTONE COMPLETE AUTO CARE Service Advisor: 181643 CARMEL 01 NICK 12/04/2017 1314 S RANGE LINE RD 317.848.5886 CARMEL, IN. 46032-2932 2010 FORD ESCAPE LIMITED HYBRID CITY OF CARMEL, BUILDING &CODE 2.5L L4 FI ELECTRIC/GAS VIN 3 DOHC 1 CIVIC SQ Lic#: 67111 IN Vin#: 1 FMCU5K3XAKB40807 CARMEL, IN 46032-2584 In: 12/04/17 2:30PM Mileage: 63,407 317.571.2441 xcaleb Out: 12/04/17 3:59PM Store# 020753 COMMERCIAL Rev Hist Unit Extended Job Description /Article# ID Qty Price Price Total 1 Fc � � eft , �� Fz— t �4#I .'.' - d a r° _ ! ' t�^ P .a- ,._ .. ...� _. ✓„ �;1 e. �'U I �... i�.::-...:1`2 I._.. 2 -- , _- ;.... '' `� '�::_.. L.r- °�U ...a 3 HOW ARE WE DOING?" Tell,us about,your experience today! ' Complete'a 4-minute survey for a chance to win $500 in store"services Visit www.F�irestoneSurvey.com within 4 days and ente'r..Code-020753=.181643 _ .FlrestcneCompleteAutoCarexom MOTORIST T � 3 We St E'p: s i?5 Lt -L,, AssURANC E STD FCAC LASER 7008335-48110392 REV 11/11 f c` TStidtf h a Pa�e2of2� PROGRAM �' b P See reverse side for Warranty Information ` �� '`�� °324fs°3°°' sTa�as�a��a��a�Al��r�r�a�°�a��.�a�� CourtesV Check Inspect All Items in . . Section L1 SOHC ❑OHV ❑DIESEL Trans. Auto - Model C, Eng.size ❑ooHc ❑HYBRID Year0 . Make Type (]Manua V N I I I I I I 1LI-1 1-1-171-1-71-1 Hubcap Missing Y Windshield Cracked Y Scratches/Dents N MILEAGE: State Inspection Due Month Year Maintenance Services I Starting Tires and Tire Maintenance Visual Schad. Inspect + Why Recommended + Tire Size: Satire Run Flat Y OK SUG REO Maint. /) Wiper Blades �_ ❑Front ❑Rear F 2,1 C 11 /f R J U`/ D TPMS N -lead Lights Tread Depth Visual FWD ❑RWD ❑4WD/AWC Mini Lights I Turn License Inspect 32nds g rL ❑.Brake ❑Si nal ❑Plate ❑Parking oK SUG REO Outer inner Air Filter �I Lek Front -�' ,� I ❑ Edgewear ❑ Crack!* abin PSI In: PSI Out: ti Y ❑ Cupping Nails 4ir Filter `3 ❑ cuts ❑ Repairable PCV Valve { - T_-�IV- r-7 trregmadry ❑ Non_ Right Front ~ r a'�r ❑ Edgewear ❑ Cracking Washer Fluid I_; 1, PS In: PSI Out: I Y d ❑ Cupping FN ails '7 ❑ Cuts eairable Oil Level IPower Str. nIrregularity on-Repairable- =1uid Level I Right Rear 1� �I3t Y,-1 ''.,� ❑ Etlgawear Cracking , blaster Cyl.Fluid PSI In: PSI Out: ❑ Cupping Nails '_evel �I ke Inspection 06:Ate. ` r.(� ❑ Cuts Repairable ,`�,.� ❑ Irregularity ❑ Non-Repairable 3rake Fluid Flush — �..� n �111�_" Co er arts er mil ion ' - / rrans.Service I ❑ Flush Left Rear t u ' I ' l f ❑ Edge ear ❑ cracking 4uto/Manual' L__I ❑ Pan Service PSI In: PSI Out: 1 1. ❑ Cupping Nails 'oolant f V ❑ cuts ❑ Ripa rale -evel/Flush t Type 5 I � ��; I +': ❑ Irregularity ❑ Non-Repairable 'oolanf Hbses ❑i Upper El Lower El Bypass El Heater_i Spare t ❑ Edgewear ❑ Cracking Salts ❑"V" -- ❑ALT ❑PS Belts PSI In: PSI Out: /" `` ❑ Cupping Na is ❑Ser -_ I ❑A/C ❑AP 1 2 3 4 f` ^ ❑ cuts ❑ Repa able 3attery / ❑ Irregularity ❑ Non-Re =D-18Test __I Good El Marginal El Replace /, pa ratite 3attery ❑Pos Tire Maintenance El Balance accessories ❑ Cable Ends/Cables ❑Ne ❑Hold Downs ❑Rotation 3attery Gard; ❑ Corrosion ❑Preventive Alignment Check ❑Maintenance ❑Tire Wear I I I Maintenance Services/Starting • Visual Sched. MV P ds reaterthari'6mm Disc or Shoes reatertFian2.4mm Drum M fpspecir OK SUG REO Maint. + Why Recommended + 0e g = (Disc) g ( ) p hart/Charge i i Pads!g�ier than 3rrxn or kes'tlmr 6mm(Disc)or Shoes greallerthi n li rmi or lass 2 Qrnm(Drum)i -est l I i Document vehrcie sjiecitic.measurements&minitarimIgs Tications below Salt Tensioner Pad'lase than Smut{Disc)or Shoes lesliltmm -- - s Doo ms t vehicles ecific measurements&rtiinirneciti a o 'park Plugs LF Pad RF Pad =uel Filter I� Actual ®�OActual =uel System — Meas. Meas. Service �_I ,,-•�,{,MM Actual Machine Machine MMActral gnition Wires �� [Li� To To Jalve.CoYer._ --1 Discard Discard "as et i MM Spec. At At MM Spec. 'ower SteeringL ;— R Pad/Shoe ■ lose ,l [:3Pressure El ■ RR Pad/Shot Timing Belt n Meas 13 Mean MM AExhaustctual Machine ®� To chine MMAdual Exhaust System ❑Intermediate Pipe El Muffler ❑Tailpipe Discard Discard MM Spec. At At MM Spec. SuspensionSteering and Rear Clean/Adj U-Joint H11 ❑Front ❑Rear Brake Hose(s) Idler/Pitman Arm ❑Idler ❑Pitman ( Parking Cables Center Link r Other Brake Wheel Bushings ❑Front Services Hardware Caliper C tinder Repack ❑Control Arm Sway Bar ❑Rear= ❑Front Leh ❑Right Notes: n Link Pins El Rear Leh ❑Ri ht Tie Rod Ends ❑L Out ❑L In ❑R In ❑R Out ❑Sleeve(s) C Q Ball Joints ❑L Upper ❑R Upperppr, r�/t❑L Lower ❑R Lower Sec _ Actual lll///CCC///(((///J V IVwRack&PinionAssembly CV Boots ❑L Out ❑L In ❑R In ❑R Out CV Joints ❑L Out ❑L In ❑R In ❑R Out Struts ❑Front ❑Left ❑Right ❑Rear ❑Leh ❑Ri ht Shocks ❑Fmnt ❑Left ❑Right I ❑Rear Left ❑Rt ht Q RepairIReplacementSuggested RWair/ReplacemsnlReguired & 1) Close to end of useful lite A No lorger erforms intended pu ose 2)Address customer request/'need/convenience B D s t d sig sp at n 3) Comply with manufacturer recommendation ) sing STEP 5 STEP 7 4)Technician recommendation from experience INSPECTED BY RE-INSPECTED BY