183957 03/29/2010 CITY OF CARMEL, INDIANA VENDOR: 305700 Page 1 of 1
4I ONE CIVIC SQUARE TOM WOOD FORD INC CHECK AMOUNT: $433.70
CARMEL, INDIANA 46032 4150 E 96TH ST
�M oµ INDPLS IN 46240 CHECK NUMBER: 183957
CHECK DATE: 3/29/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4237000 21826 335413 433.70 REPAIR PARTS
i
�s 4150 EAST 96TH STREET
M Ni INDIANAPOLIS, IN 46240
6 r OD TELEPHONE (317) 848 -8888
CUST. NO. T.I.D. CUST. P. 0. NO. SHIP VIA PAYMENT TYPE PARTS REPRESENTATIVE DA TE INVOICE
0031201550 -020 21826 CHARGE MIKE 03/01/10
733 4600 NIR
B s
I T H T
CARMEL POLICE DEPARTMENT p SEND FOR PAINT
3 CIVIC SQUARE QX3
CARMEL, IN 46032 1N4AA5AP7AC- 808054
SHIP QTY S QTY ITEM I D ESCRIPTION
1 0 96302 -9N80A MIRROR ASSY -OUT TEST 301.59 301.59 301.59
1 0 96374 -9N80A COVER MIRROR BO TEST 37.11 37.11 37.11 DISCLAIMER OF WARRANTIES
_1 0 509394 PAINT 95.00 95.00 95.00 TOM WOOD. NISSAN. INC.
hereby expressly disclaims all
warranties, either express or
implied, including any implied
warranty of merchantability or
fitness for a particular purpose,
and TOM WOOD NISSAN, INC.
neither assumes nor authorizes
any other person to assume for it
any liability in connection with the
sale. Customer agrees to pay
433.70 reasonable attorney's fees if
"CA DIRECT 317-688 SUBTOTAL collection hereof is necessary.
NOTE: A10°Io 'c MyagA�LTREi�:1P.'V�T NAQJ AND
ALL CLAIMS ANDW, FINEtFq 63A WI @N]1�Egq[pR"A1163IFL.
NO REFUNDS AF7TEERR 3 DAAYYSS
P5. RLS ftETUSiN POLICY ALL RETURN PARTS MUST CONFORM TO THE NISSAN TAX .00
FREIT
AX
PACKAGING AND RETURN STANDARDS, THOSE STANDARDS SHOWN UPON REQUEST. 0.
RECEIVED BY: 433.
''Thank You" AMOUNTDUE
�II��lI�II�I�I���11 ur Link fo OE Nis san Collision Parts 17:51:47 PAGE 1 OF 1
PARTS INVOICE NET501
0 INDIANA RETAIL TAX EXEMPT PAGE
uny of Carmel CERTIFICATE NO. 003120155 002 0
PURCHASE ORDER NUMBER
Police Department FEDERAL EXCISE TAX EXEMPT
35- 60000972 71 R9 K
322 CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES, A/P
CARMEL INDIANA 46032 -2554 VOUCHER, DELIVERY MEMO, PACKING SLIPS,
FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL 1997 SHIPPING LABELS AND ANY CORRESPONDENCE.
PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION
Februar y 18. 2010 repair part
VENDOR Tom Wood Ford flarmel, SHIP City of Carmel Police Department.
3300 Fast 96th Street TO 3 Civic Square
Indianapolis, IN 46240 Carmel, IN 46032
covFlflMAnoN BLANKET CONTRACT PAYMENTTERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
1 Rt outer mirror 301.59
1 Mirror cover 37.11
paint 95.00
Estimate #3276 w
Ede are instal]
r 1
A,
eta w
City of Carmel Po er e ar
Send Invoice To:
ATTN: Teresa An
3 Civic Square
Camel, IN 46032
PLEASE INVOICE IN DUPLICATE 433.790
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
1110 370 repair parts PAYMENT
A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O.
NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND
VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED.
SHIPPING INSTRUCTIONS I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN
THIS APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER.
SHIP REPAID.
C.O.D. SHIPMENTS CANNOT BE ACCEPTED. ORDERED BY
PURCHASE ORDER NUMBER MUST APPEAR ON ALL fJ /7 5
SHIPPING LABELS.
THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945 TITLE Chief of Police
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
CLERK TREASURER
DOCUMENT CONTROL NO. COPY SIGN AND RETURN TO CLERK'S OFFICE
VOUCHER NO. WARRANT NO,__
ALLOWED 20
IN THE SUM OF
ON ACCOUNT OF APPROPRIATION FOR
Board Members
PO# or INVOICE NO. ACCT #/TITLE AMOUNT
DEPT. 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_-
20
Signature
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
Prescritred 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
T Wood Nissan Purchase Order No- 21826F
4 150 East 96th Street Terms
I ndianapolis, IN 46240 Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
311/10 335413 payment for mirror 433,70
I
Total
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
Clerk- Treasurer
VOUCHER NO. WARRANT NO.
ALLOWED 20
Tom Wood
IN SUM OF
4150 East 96th Street
Indianapolis, IN 46240
433.70
ON ACCOUNT OF APPROPRIATION FOR
police general fund
Board Members
PO# or D PT. INVOICE NO. ACCT #/TITLE AMOUNT I hereby certify that the attached invoice(s), or
21826F 335413 370 433.70 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
March 25 20 10
Signature
Chief of POlice
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund