334090 01/04119 CITY OF CARMEL, INDIANA VENDOR: 358389
ONE CIVIC SQUARE JACK DOHENY COMPANIES CHECK AMOUNT: $*******731.82*
CARMEL, INDIANA 46032 L-3846 CHECK NUMBER: 334090
COLUMBUS OH 43260-3646 CHECK DATE: 01/04119
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2201 4351000 W985282 731.82 AUTO REPAIR & MAINTEN
VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201(Rev.1995)
Vendor# 358389 ALLOWED 20 ACCOUNTS PAYABLE VOUCHER
JACK DOHENY COMPANIES IN SUM of$ CITY OF CARMEL
L-3846 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.
COLUMBUS, OH 43260-3846
Payee
$731.82
Purchase Order#
ON ACCOUNT OF APPROPRIATION FOR
Street Department 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
W95282 43-510.00 $731.82 1 hereby certify that the attached invoice(s),or 12/21/18 W95282 Repairs $731.82
2201 2201 Prior Year 2201 2201
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
Wednesday, January 02,2019
Huffman, Dave
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
Remittance Address:
Jack Doheny Companies,Inc. Phone(248)349-0904
L-3846 ,lack Doheny► Fax(248)349-2774
Columbus,OH 43260-3846 COMPANIES www.DohenyCompanies.com
us Omer nvolce Pg
CA 002 CARME01: W95282 1.
' .e 12/21/18
Sold. To Ship To
CITY OF CARMEL STREET DEPT. . CITY OF CARMEL, STREET DEPT.
3400 WEST 131ST STREET 3400'.WEST 131ST STREET
WESTFIELD IN 46074 WESTFIELD IN 46074
317-733-2001 317-733=2001
FOB JDC WHITESTOWN IN FACILITY
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Br Trk Make Model Serial. Equipment Meter Sls Customer P.O.
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007 SE 800HPR 790 DD
--- -- ----- ----------- {'-- -- y4 -- ---------- - ----
Ordr Ship B/0 Descrip;tion List Each Amount
-------------- --------------------;----------------------------------------------
Taken ByKELLY HART'-- Clos`ed- ----12-/-2-1/.18
SECA` 800HPR SN- 790 HOURS : 3189 MILEAGE: 180"64
.- -I'SSUE REPORTED: CHECK RODDER PUMP/
SERVICE PERFORMED: CHECKED OUT: .REPLACED CAP,. & CAGE,-'GASKETS,
REMOVED AND REPLACED CUSTOMER.,-_SUP:PLIED CABLE FOR_WATER PUMP,
l REMOVED PUMP HEAD. INSP-ECTED.: °REPLACED`-SEALS ON-'CYLINDERS
'. - -AND`CAPS-.---REASSEMBLED ~AND TESTED UNIT. =''
1 1 -_VA 41271
4 ._27- 4 .27 4 . 27
CAP GASKET /-,...FOR 3"
1 1 VA 41.272 5. 40 5. 40 5. 40
CAGE_.:GASKET_,./...FOR 3" -
TOTAL PARTS 9. 67
- - 650 - LABOR �} -- -- ----101 . 00 - -6-56. 50
SHOP SUPPLIES 65. 65
INDIANA GOVERNMENTAL• ',UNIT 0% . 00
0031201550
* Interested in receiving your invoices by email
* For details call 800-336-4369 and ask for A/R
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Total 731. 82
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SEE REVERSE SIDE FOR SALE TERMS AND CONDITIONS
PLEASE NOTE NEW REMITTANCE ADDRESS