HomeMy WebLinkAbout324877 5/9/2018 CITY OF CARMEL, INDIANA VENDOR: 00350363
CHECK AMOUNT: $********62.78*
;.� � �;• ONE CIVIC SQUARE PETTY CASH
CARMEL, INDIANA 46032 C/O MAYOR'S OFFICE CHECK NUMBER: 324877
C/0 MAYOR'S OFFICE CHECK DATE: 05/09/18 •
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1160 4351000 62.78 AUTO REPAIR & MAINTEN
VOUCHER NO. WARRANT NO. Prescribed by state Board of Accounts City Form No.201(Rev.1995)
Vendor# 00350363 ALLOWED 20 ACCOUNTS PAYABLE VOUCHER
PETTY CASH IN SUM OF$ CITY OF CARMEL
C/O MAYOR'S OFFICE 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.
C/O MAYOR'S OFFICE
Payee
$62.78
ON ACCOUNT OF APPROPRIATION FOR Purchase Order#
Mayor's Office 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
RECEIPT 43-510.00 $62.78 1 hereby certify that the attached invoice(s),or 4/20/18 RECEIPT $62.78
1160 101 1160 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
Tuesday, May 08,2018
Kibbe, Sharon
Executive Office Manager
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
Jiffy Lube#660 WORK ORDER#:25
Indiana Lubricants,Inc. DATE:04/20/18 03:06 PM
* jiffylube@
1270 S.RANGELINE RD. INVOICE#:2643851 Q
CARMEL,IN 46032 C\f �Oh ' \1 had 6A �®, 0
WWW.JIFLUBE com (317)843-9222 C%-\a no on vol % dym
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CUSTOMER INFORMRTIOtl V }iICLE INFR`,lATIONZ :"A.
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CLAYTON BELL 2017 LICENSE PLATE:IN-HR322708
1 CIVIC SQ FORD VIN:3FA6PORU1HR322708
CARMEL,IN,46032 FUSION MILEAGE:10,373
CBELL@CARMEL.IN.GOV 2.01-4Cyl Alternate Fuel([U])Fuel Injected OIL CHANGE INTERVAL:7000
(317)571-2448
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®ECRIPTIO�1 t
SIGNATURE SERVICE BLEND 59.99
OIL FILTER#M3614 1.00
PZL GLD SAE OW20 SN/GF5 DEXOS1 4.50
SHOP SUPPLY FEE 1.00 2.79
�,.-- �' '•'-',"-'--g"` ia�� ,sz.� v � f,�.a�--^c a s.-•..-.._�.,s�,„y� ` T vet "" '.�-?."�` ,�. � 'k "."�-'.-r•- ; "" -:-3
CHANGE OIL CHANGED CHANGE OIL FILTER CHANGED
CHECK AIR FILTER OK CHECK WIPER BLADES CHECKED
VACUUM FLOORS COMPLETED WASH EXTERIOR WINDOWS COMPLETED
LUBRICATE CHASSIS ZERO FITTINGS TRANSMISSION/TRANSAXLE INACCESSIBLE
DIFFERENTIAL FLUID__ _ _ N/A POWER STEERING FLUID N/A _
WINDSHIELD WASHER FLUID ADDED BATTERY WATER INACCESSIBLE
INFLATE TIRES TO PRESSURE F34 R34 FRONT DIFFERENTIAL N/A
TRANSFER CASE N/A BRAKE FLUID CHECK SENSOR OK
WINDOW STICKER REPLACED LIGHTS OK
ANTIFREEZE/COOLANT OVERFLOW LEVEL OK PCV VALVE INACCESSIBLE
PLEASE CHECK YOUR OIL REGULARLY
FREE REFILLS FOR THE NEXT 3000 MILES
UP TO 2 QTS INCL.IN SIGNATURE SVC ONLY
GSA: SHERRI C. UPPER BAY: JESUS R.
LOWER BAY: ADRIAN S. CT: JEREMY L.
CT: JEREMY L. TL: JESUS R.
CASHIER: SHERRI C.
G?Rol%T INFQRMA I„ON r .. '
TAXABLE 28.55
NONTAXABLE 34.23
- - - - - _ GROSS SALES 62.78
NET SALES 62 ZB,
SATISFACTION GUARANTEED STATE 2.00
TOTAL DUE USD$64.7878
CONTACT U3 AT 500.543.5323 CASH USD$70.00
or www.jiflube.com CHANGE USD$-5.22
41
n .ef .
AUTHORIZED AND RECEIVED BY
Cardholder acknowledges receipt of goods and/or services In the amount of the Total shown here on
and agrees to perform the obligations set forth in the Cardholders agreement with the issuer
MESSA 5 a r x F r u w :..
6,t
.. ..r Nb<*�k
THANK YOU FOR YOUR BUSINESS
HAVE A WONDERFUL WEEKI
2643651
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