180950 12/30/2009 CITY OF CARMEL, INDIANA VENDOR: 00352236 Page 1 of 1
t i� 1 ONE CIVIC SQUARE SAMS AUTO SERVICE
4 31 WEST CARMEL DRIVE CHECK AMOUNT: $197.90
I CARMEL, INdIANA 46032 CHECK NUMBER: 180950
i; CARMEL !N 46032
CHECK DATE: 12130/2009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
911 4351000 50389 197.90 AUTO REPAIR MAINTEN
SAMS AUTO SERVICE
431 W. CARMEL DR. CARMEL, IN 46032
(317) 843 -1334
CARMEL POLICE DEPT. 2005 BMW INVOICE
745I NO. 0050389
10 -28 -2009
V.I.N. LEE GOODMAN
Unit No.
PAGE 1 OF 1
DONE BY SONNY
LABOR /SERVICE
HOURS RATE AMOUNT
DETAIL INSIDE AND OUT. 150.00
CHECK OVER.TOP OFF ALL FLUIDS AND CHECK OVER FOR LEAKS.
TOTAL LABOR /SERVICE 150.00
PARTS
PART DESCRIPTION PART NO. QTY. AMOUNT
COOLANT 2 17.95 35.90
TOTAL PARTS 35.90
OTHER CHARGES
AMOUNT
Misc cleaners and shop supplies 12.00
TOTAL OTHER 12.00
SUB TOTAL 197.90
SALES TAX 2.51
AMOUNT DUE 200.41
*INVOICE IN PROCESS
Prescribed by State Board of Accounts City Form No. 201 (Rev. 1995)
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
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.
Payee
r
vl L Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
/a/ 9 S1) 3S9 De aLp f. ✓Af1,'a)
Total 9
1 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
Clerk- Treasurer
VOUCHER NO. WARRANT NO.
ALLOWED 20
1 vi IN SUM OF
Li i Vi/_ CQ.c� t
G Ooh
ON ACCOUNT OF APPROPRIATION FOR
-4tgL CC) 9 q/) /ate 0o0
Board Members
PO or INVOICE NO. ACCT #/TITLE AMOUNT certify invoice(s),
T I hereby certif that the attached or
So rg 5'o o /91
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
%a //cp 20 09'
Signature
M A-r
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund