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HomeMy WebLinkAbout322814 03/12/18 CITY OF CARMEL, INDIANA VENDOR: 358894 i ONE CIVIC SQUARE SAFEL.IT_ETULFILLMENT INC CHECK AMOUNT: $********74.94* CARMEL, INDIANA 46032 Po Box',633197 CHECK NUMBER: 322814 CINCINNATI OH 45263-3197 CHECK DATE: 03/12/18 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 911 4351000 903485 74.94 AUTO REPAIR & MAINTEN VOUCHER NO. WARRANT NO. Prescribed by state Board of Accounts City Form No.201(Rev.1995) Vendor# 358894 ALLOWED 20 ACCOUNTS PAYABLE VOUCHER SAFELITE FULFILLMENT INC IN SUM OF$ 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 whom,rates per day,number of hours,rate per hour,number of units,price per unit,etc. CINCINNATI, OH 4526373197 Payee $74.94 ON ACCOUNT OF APPROPRIATION FOR Purchase Order# id Terms Pro'ect#2018-911 and Task 2018-12 Date Due PO# ACCT# DATE INVOICE# DESCRIPTION DEPT# INVOICE# Fund# AMOUNT Board Members DEPT# FUND# (or note attached invoice(s)or bill(s)) AMOUNT 903485 43-510.00 $74.94 1 hereby certify that the attached invoice(s),or 3/1/18 903485 $74.94 911 911 911 911 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, March 02, 2018 Frost, Dwight Major 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 SAFELITE FULFILLMENT,INC. Saf r/ifey CUSTOMER SER111Y CE CENTER 1-800-835-2257 eAutoGlass IF YOU HAVE QUESTIONS REGARDING PAYMENT OF TRIS INVOICE: 1-800-835-2092 INVOICE 01830-299974 INVOICE: 03/01/18 BD ORDERED: 02/28/18 INSTALLED: 03/01/18 PLEASE REMIT PAYMENT TO: W.O. # : 903485 REFERRAL#: 000000 SAFELITE FULFILLMENT, INC INSURED: P.O. BOX 633197 CARMEL POLICE DEPT CINCINNATI, OH 45263-3197 3 CIVIC SQ PLEASE WRITE INVOICE NUMBER ON CHECK CARMEL IN 46032-0000 PH1:317-408-8467 PH2: CARMEL POLICE DEPT Acct #: 40587 3 CIVIC SQ CARMEL IN 46032 POLICY# PO#/REF CLAIM ## LOSS LOC: AUTH/VER: JOSH LOSS DATE/CAUSE: 03/01/18 2017 CHRYSLER PACIFICA MINI VANR EXTENME WTIONAONANA ARR: INSTORE MILEAGE: 4,444 VIN: 2C4RC1BG7JR149253 LICENSE/ST: FNF IN STOCK #: QTY PART ## LIST SELLING LABOR KIT MATERIAL EXTENSION 1 WSREPAIR .01 .00 69.95 .00 .00 69.95 IN-STORE W/S REPAIR 1 SUPPLIES-REPAIR 4.99 4.99 .00 .00 .00 4.99 REPAIR SUPPLIES PART TOTAL 4.99 LABOR TOTAL 69.95 SUB-TOTAL 74.94 SALES ,TAX 0.00 P A Y T H I S A M 0 U N T 74.94 TERMS: ADDITIONAL INFO/CLAIMANT SERVICED BY: COUNTY/A SAFELITE AUTOGLASS # 01830 INDIANAPOLIS IN 46268-0000 STORE LIC #: SAFELITE TAX ID #: 36-4523816 022818-405879-405879 00669- 05879-299974 CARMEL POLICE DEPT 3 CIVIC SQ CARMEL IN 46032 0000000020180301742