319889 12/21/17 CITY OF CARMEL, INDIANA VENDOR: 305700
ONE CIVIC SQUARE TOM WOOD FORD INC CHECK AMOUNT: 5f......601.10
CARMEL, INDIANA 46032 3130 E 96TH ST CHECK NUMBER: 319889
INDPLS IN 46240 CHECK DATE: 12/21/17
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2200 4351000 101013 FOCS400020 601.10 CITY VEHICLE REPAIRS
VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201(Rev.1995)
Vendor# 305700 ALLOWED 20 ACCOUNTS PAYABLE VOUCHER
TOM WOOD FORD INC IN SUM OF$ CITY OF CARMEL
3130 E 96TH ST 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.
INDPLS, IN 46240
Payee
$601.10
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
101013 FOCS400020 43-510.00 $601.10 1 hereby certify that the attached invoice(s),or 12/6/17 FOCS400020 Repairs for E-1 Engineering vehicle $601.10
2200 2200 2200 2200
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, December 12,2017
=-�__�
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
TOM W®® D GENUINE
PARTS S. SERVICE
FORD
3130 E. 96th Street - Indianapolis, IN 46240 P.o, o oi3
(800) 423-4646 - (317) 846-4241 2200 —y 3 3(rpll
www.tomwoodford.com
- - s
CUST.NUMBER ADVISOR TAG NO. INVOICE DATE INVOICE NO.
162583 DEWAYNE HUDSON 7517 1348 12/06/17 FOCS400020
LICENSE NO. ODOMETER COLOR STOCK NO.
CITY OF CARMEL ENGINEERING109 196 HITE/
YEAR/MAKE/MODEL DELIVERY DATE DELIVERY ODOMETER
1 CIVIC SQ 10 FORD TRUCK/ESCAPE 4DR 4WD HYBRID
CARMEL, IN 46032-2584 VIN SELLING DEALER NO. MANUFACTURED DATE
1 F M C U 5 K 3 X A K B 4 0 8 0 7
F.T.E.NO. I P.O.NO. R.O.DATE
klusti @carmel.in. OV 0031201550-020 12/05/17
HOME PHONE BUSINESS PHONE INSTRUCTIONS
317-571-2441 1 MO: 109197
JOB# 1 CHARGES--------------------------------------------------------------------------------- Disclaimer of Warranties Any warranties on
the products sold hereby are those made by
LABOR-.7%.-7.7.7_7 --- - -r ---
_____________________________________ the manufacturer. The Seller, TOM WOOD
J# 1 1OFOZO6 CHECK ENGINE LIGHT:. .. TECH(S):7226 337.32.. FORD, Inc. hereby expressly disclaims all
CUSTOMER STATES CHECK ENGINE LIGHT ON VEHICLE SEEMS TO RUN warranties,either express or implied,including
ROUGH any implied warranty of merchantability or
CYLINDER 4 COIL FAILED fitness for a particular purpose. TOM WOOD
REPLACED CYLINDER 4 COIL AND ALL SPARK PLUGS FORD, Inc., neither assumes nor authorizes
any other person to assume for it any liability
PARTS------ TY---FP-NUMBER---------------DESCRIPTION---------LIST PRICE-UNIT PRICE- I hereconnby
ogree thesaleTom Wood
Q I hereby agree to pay Tom Wood Ford
1 9E5Z-12029-A COIL ASY - I Y 89.99 89.99 89.99 attorney's fees if collection hereof becomes
4 SP-530 SPARK PLUG Y 13.46 13.46 53.84 necessary.
TOTAL - PARTS 143.83 Not responsible for car or contents in case of
fire or theft or freezing or any other cause.
JOB# 1 TOTALS------------------------------------------------------------ Storage will be charged 48 hours after repairs
LABOR 337.37 are completed.
PARTS 143.83
JOB# 1 JOURNAL PREFIX FOCS JOB# 1 TOTAL 481.20
JOB# 2 CHARGES---------------------------------------------------------------------------------
LABOR-------.----- - 777-7 - --- ---- -
J# 2..99FOZ99P, MULTI-POINT INSPECT _ TECH(S).:.7226 0.0.0..
PERFORM MULTI-POINT INSPECTION.
PUT INSPECTION REPORT IN CUSTOMER VEHICLE
MAINT SERVICE
PERFORM MULTI-POINT INSPECTION.
IN CUSTOMER VEHICLE.
JOB# 2 TOTALS------------------------------------------------------------
JOB# 2 JOURNAL PREFIX FOCS JOB# 2 TOTAL 0.00
WJOB# 3 CHARGES---------------------------------------------------------------------------------
LABOR7777- -
J# 3+45FOZ03 ALIGNMENT_SPECIAL; -.,-. _TECH(S):7226;--. 99.9.5.-
'6 Added Operation (8DHUDSON2 @ 12/06/2017 09:48)
ALIGN SUSPENSION PER CUSTOMER REQUEST.
ALIGNED SUSPENSION TO SPECIFICATIONS
JOB# 3 TOTALS------------------------------------------------------------
LABOR 99.95
(J
JOB# 3 JOURNAL PREFIX FOCS JOB# 3 TOTAL 99.95
� JOB# 4 CHARGES---------------------------------------------------------------------------------
0
0
W LABOR--- ..-- - --
o J# 4+02FOZGBATT -._ ,GREEN-BATTERY .. --.TECH(S):7226- _. _ _ 0:00
aAdded Operation (8DHUDSON2 @ 12/06/2017 12:43)
BATTERY TEST OK-COLD CRANKING AMPS,TERMINALS CLEAN-OK
a
TEST BATTERY
a GOOD BATTERY
a
°c
PAGE 1 OF 2 CUSTOMER COPY [CONTINUED ON NEXT PAGE] 12:51pm TWF-4020
TOM W D o GENUINE
®® PARTS & SERVICE
T
F ® RD
3130 E. 96th Street • Indianapolis, IN 46240
(800) 423-4646 0 (317) 846-4241
www.tomwoodford.com
-71 A-30r,8
CUST.NUMBER ADVISOR TAG NO. INVOICE DATE •INVOICE NO.
162583 DEWAYNE HUDSON 7517 1348 12/06/17 FOCS400020
LICENSE NO. ODOMETER COLOR STOCK NO.
CITY OF CARMEL ENGINEERING YEAR/MAKE/MODEL DELIVERY DATE DELIVERY ODOMETER
1 CIVIC SQ 10 FORD TRUCK/ESCAPE/4DR 4WD HYBRID
CARMEL, IN 46032-2584 VIN SELLING DEALER NO. MANUFACTURED DATE
F.T.E.NO. I P.O.NO. R.O.DATE
klustig@carmel.in.gov 0031201550-020 12/05/17
HOME PHONE BUSINESS PHONE INSTRUCTIONS
317-571-2441 1 MO: 109197
JOB# 4 TOTALS------------------------------------------------------------ Disclaimer of Warranties Any warranties on
the products sold hereby are those made by
JOB# 4 JOURNAL PREFIX FOCS JOB# 4 TOTAL 0.00 the manufacturer. The Seller; TOM WOOD
JOB# 5 CHARGES--------------------------------------------------------------------------------- FORD, Inc. hereby expressly disclaims all
warranties,either express or implied,including
LABOR:-,,- -:r -- any implied warranty of merchantabilityor
"" "" 0 �• ` fitness for a particular purpose. TOM WOOD
J# 5+02F02GBK r , -GREEN'BRAKES „ . TECHS)c722b_, ._ �, A` FORD, Inc., neither assumes nor authorizes
Added Operation (81)HUDSON2 @ 12/06/2017 12:43)
BRAKES CHECK -OK (DISC OVER SMM,DRUM OVER2MM) any other person tassume for it any liability
in connection with the
e sale of said products.
ATW BRAKE CHECK-OK
BRAKES OK I hereby agree to pay Tom Wood Ford
attorney's fees if collection hereof becomes
necessary.
JOB# 5 TOTALS------------------------------------------------------------ Not responsible for car or contents in case of
fire or theft or freezing or any other cause.
JOB# 5 JOURNAL PREFIX FOCS JOB# 5 TOTAL 0.00 Storage will be charged 48 hours after repairs
JOB# 6 CHARGES--------------------------------------------------------------------------------- are completed.
LABOR
J# 6+02FOZGTIRE GREEN TIRES. TECH(5) `Z226,. 0:00
Added Operation (8DHUDSON2 @ 12/06/2017 12:43)
TIRES CHECKED OK-ATW INSPECTION
TIRES OK X
GREEN (OK) TIRE INSPECTION
JOB# 6 TOTALS------------------------------------------------------------
JOB# 6 JOURNAL PREFIX FOCS JOB# 6 TOTAL 0.00
MISC------CODE--------DESCRIPTION-------------------------------CONTROL NO---------
JOB # A Al SHOP SUPPLIES 19.95
TOTAL - MISC 19.95
TOTALS------------------------------------------------------------------------------------------
M ***REQUEST AN INSURANCE QUOTE FROM ONE OF OUR ONSITE AGENTS TOTAL LABOR.... 437.32
YOU MAY DISCOVER SOME GAPS IN COVERAGE OR IDENTIFY SOME TOTAL PARTS.... 143.83
OPPORTUNITIES FOR SAVINGS! TOTAL SUBLET... 0.00
TOTAL G.O.G.... 0.00
g CALL WOOD GROUP INSURANCE AT 317-805-5509 TOTAL MISC CHG. 19.95
TOTAL MISC DISC 0.00
TOTAL TAX...... 0.00
Z TOTAL INVOICE$ 601.10
16
0 THANK YOU FOR YOUR BUSINESS!
o WE WANT YOU COMPLETELY SATISFIED, NOT VERY SATISFIED. IF YOU
w RE NOT "COMPLETELY" SATISFIED, PLEASE CALL TOM AT TOM WOOD
FORD. THERE'S NOTHING WE WON'T DO TO INSURE YOUR HAPPINESS!
TOM
c�
a
CUSTOMER SIGNATURE
a
PAGE 2 OF 2 CUSTOMER COPY [ END OF INVOICE ] 12:51pm TWF-4020