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