331154 10/17/18 `%��,A,,f. CITY OF CARMEL, INDIANA VENDOR: 362147
i ONE CIVIC SQUARE CUSTOM TRUCK&AUTO INC CHECK AMOUNT: $*******283.66*
r, �� CARMEL, INDIANA 46032 17134 WESTFIELD PARK ROAD CHECK NUMBER: 331154
9'�IFUN_i4 WESTFIELD IN 46074 CHECK DATE: 10/17/18
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4351000 39469 283.66 AUTO REPAIR & MAINTEN
VOUCHER NO. WARRANT NO. Prescribed by state Board of Accounts City Form No.201(Rev.1995)
ALLOWED 20 ACCOUNTS PAYABLE VOUCHER
Vendor# 362147
CUSTOM TRUCK&AUTO INC IN SUM OF$ CITY OF CARMEL
17134 WESTFI ELD PARK ROAD 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.
WESTFIELD, IN 46074
Payee
$283.66
Purchase Order#
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire 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
39469 43-510.00 $283.66 1 hereby certify that the attached invoice(s),or 10/10/18 39469 VIN 8435 $283.66
1120 101 1120 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
Friday, October 12,2018
David Haboush
Fire Chief
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
17134 Westfield Park Rd
Lrs � Westfield, IN 46074
317.896.5956 Invoice #39469
custom truck & auto
FIRE DEPARTMENT CARMEL Tuesday,October :201
Ordered on
1 CIVIC SQUARE DSNYDER@CARMEL.IN.GOV Friday, October 5,2018
CARMEL IN 46032
Workorder#41893
008 GMC Truck C4500 11/2 Ton Truck 6.6 L 403 CID V8 E41 BOB:664-0958 1 Scott Sedwic SDS Cash
94838 1GDE4V1978F418435 16.6 L 403 CID V8 DIES RED
CATALOG—T---- DESCRIPTION T
LABOR REPAIR COOLANT LEAK AND TOP OF WITH COOLANT 1.5 110.00 $165.00 CJB
RADIATOR CAP 1 25.88 $25.88 CJB
50/50 RECYCLED RED ANTIFREEZE(BULKIGAL) 3.5 7.65 $26.78 CJB
AMBULANCE TOWED IN.MISSING RADIATOR CAP ON ARRIVAL AND 3.5 GALLON LOW ON COOLANT.
FOUND MISSING CLAMP ON LOWER RADIATOR HOSE AS THE CAUSE FOR THE COOLANT LOSS.FILLED
SYSTEM WITH COOLANT,INSTALLED NEW CAP ON EXPANSION TANK AND HOSE CLAMP ON LOWER
HOSE.RAN ENGINE AND FOUND NO LEAKS.BELT HAD A CHIRP AT TIMES AND THIS WAS PROBABLY
CAUSED BY COOLANT ON THE BELT.I APPLIED A LITTLE BELT DRESSING ON THE BELT AND NOISE
SUBSIDED.DRIVE BELT MAY NEED TO BE REPLACED IF CHIRP SOUND RE-EMERGES
LABOR RE-INSTALL DRIVESHAFT AFTER UNIT WAS TOWED 0.5 110.00 $55.00 CJB
SS Shop Supplies $11.00
PAID.. Parts $52.66 Taxable $63.66
Account$283.66 Labor $220.00 Non-Taxable $220.00
Freight $0.00 Resale $0.00
Other $0.00
Current Balance:$283.66 FET $0.00 TOTAL $283.66
Supplies $11.00
Any warranties on the itemfitems sold are those made by the manufacturer. The seller,Custom Truck and Auto,Inc.,hereby expressly disclaims all warranties,either express or implied,including any implied
warranty ofinerchantabilily or fitness for a particular purpose,and Custom Truck and Auto,Inc.,neither assumes nor authorizes any otherperson to assume for it any liabilityin connection with the same of this
iternfitems.A finance charge of 1 Y2%per month will be added to any unpaid balance over 30 days past due,an annual percentage rate of 18%.
Print Name Signature Date
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