181665 01/20/2010 E CITY OF CARMEL, INDIANA VENDOR: 354836 Page 1 of 1
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ONE CIVIC SQUARE TOUCH 'N GO COLLISION CENTERS INC
CARMEL, INDIANA 46032 902 3RD AVE SW CHECK AMOUNT: $408.11
CARMEL IN 46032 CHECK NUMBER: 181665
CHECK DATE: 1/20/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2201 4351000 102901 408.11 AUTO REPAIR MAINTEN
1/ 8/2010 REPAIR ORDER: 102902
Estimate ID: 5488
FINAL BILL
Touch N Go Collision
902 THIRD AVE S.W.
CARMEL, IN 46032
Tax ID 200403841
Owner: STREET DEPARTMENT CITY OF CARMEL
Address: 3400 WEST 131ST STREET Telephone:
WESTFIELD, IN 46074
Work Phone: (317) 733 -2001
Vehicle: 2003 GMC Pickup Sierra K2500 HD 2D Pkup
Insurer: TRAVELERS INSURANCE Claim EGV4048001
Cycle Time Information
Drop Off Date and Time: 11/3/2009 Vehicle Pick Up Date and Time: 11/19/2009
Promise Date: 11/23/2009 Is Vehicle Driveable (Y /N) N
Repair Dates: Assisted With Rental (Y/N1?:
Start Date: 11/5/2009
Completion Date: 11/18/2009
Original Insurance Total: $6,349.18
insurance Supplement: $408.11 Y
Customer Deductible: $1000.00 v.,
Total Repair Cost: $7,757.29
Payment Received: $7,349.18
Total Amount Due: $408.11
PAST DUE AMOUNT: $408.11
According to our records, the insurance supplement in the amount
of $408.11 was issued directly to the City of Carmel. The
supplement was for additional damage repairs approved by
Travelers Insurance. Please make payment ASAP. Contact our
office for any information or questions.
Thanks!
UltraMate is a Trademark of Mitchell International
Copyright (C) 1994 2009 Mitchell International Page 1
All Rights Reserved
VOUCHER NO. WARRANT NO.
ALLOWED 20
Touch 'N Go Collision Center Inc
IN SUM OF
902 3rd Ave. S. W.
Carmel, IN 46032
$408.11
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO# Dept. INVOICE NO. J CCT#/TITLE AMOUNT Board Members
2201 102901 43 510.00 $408.11 I hereby certify that the attached invoice(s), or
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
f
/�y Thu r s day, J 14, 2010
P f 's j 1, 1i .l ,.e1 n
1 .1 1 -41t../ f,_-,j:/ „1,4-17/
EStceet:Commiss aAer
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
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
Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
01/08/10 102901 $408.11
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