184903 04/27/2010 CITY OF CARMEL, INDIANA VENDOR: 353947 Page 1 of 1
ONE CIVIC SQUARE PREFERRED TOWING RECOVERY CHECK AMOUNT: $125.00
CARMEL, INDIANA 46032 16567 RIVER AVE
NOBLESVILLE IN 46060 CHECK NUMBER: 184903
CHECK DATE: 4/27/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4358200 38739 125.00 SPECIAL INVESTIGATION
PREFERRED TGUNG
RLeCOC7SIlySUp ONCe
ROAD
I
16567 River Ave. S ERVICE
NQBLESdPLLE, IN 46062
-(3Il7) 773 -YSSD
TIME OF CALL DATE I DATE OUT TIME START TIME FINISH REQU ST
P. ED BY P.O. /CASE OFFICER NAME
A.M. Z J A.M. A.M. ll ..�i
M. P.M. P.M.
NAME PHONE#
2 D.
ADDRESS
CITY STATE ZIP
YEA MAKE /MODEL COLOR ODOMETER DRIVER
O loy0T
MARKER PLATE STATE VIN REGISTERED OWNER
s IAl j T,) d E9 L .$"7886
LOCATION OF VEHICLE
as E 9 Gf
TOWED TO
INSPECTED BY INSURANCE CO. APPRAISER NAME DATE DRIVER
RELEASED BY DATE PHONE
REASON FOR TOW TYPE OF TOW PERSONALS TAKEN BY DATE PHONE#
ACCIDENT BREAK DOWN (3 SLING /HOIST
VEHICLE STORAGE TIME
ABANDONED UNREGISTERED Z VIFLAT BED /RAMP FROM TO DAYS
NO START OUT OF GAS WHEEL LIFT INDICATE DAMAGED AREA(S) ON VEHICLE:
FLAT TIRE FIRE LANE KEYS LEFT
❑LOCK OUT NO TRESPASS TOWED PER ORDER O
TOW ZONE ARREST STATE POLICE RADIO
LOCAL POLICE Y N
STOLEN }$IIIMPOUNDED MILEAGE CHARGE
REMOVAL OWNER OF A CAR FINISH
SPECIAL EQUIPMENT USED DEALER START MILEAGE
WINCH C3 FLARES OTHER SERVICES ND �S Fa"
SCOTCH 11 SWEEP AID F IRST TOTAL /c LABOR
DOLLIES BLOCKS r
(t vlll NCI AXnLnE FINISH
REMOVE LABOR TIME PERSON
RAMPS
SECURE
BLOCKS C A LOOSE PARTS SPECIAL
lrV/r'S<i9.9? ti START EQUIPMENT
METHOD OF PAYMENT STORAGE
CASH CHECK DRIVER'S LIC. TOTAL
F (3 EXP. DATE EXTRA PERSON
CREDIT FINISH
CARD I I I I I I I I I I I I SUBT TAL i aU
AUTHORIZED SIGNATURE DATE START
X a ee m Hold mss cam as na�miess iw as dams es dae ro co.. ,aadwad TOTAL TAX
DRIVER SIGNATURE RRIVER# TRUCK
TOTAL
We cannot be responsible for damages caused by faulty titer, bumper brackets, etc. This company assumes no responsibility 01996 AW Direct, Inc.
for loss or damage by theft, fire or any other cause beyond our control, to any vehicle placed with them for storage or repair. THANK YO
P LL �C r� PRODUCT 8760
3 9
w
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aaa�oaar� G° 3aDaaaa C�or���a
MM[Munv Mob mo(3 [pa ?un
I have Taquested toar+ Mg, recovery or roadside services
that are not recommended by the company Mow.
N damage or theft of my vehicles) occurs because of
this request, I release the company below of all
responsibility, both civil and crimr inN, in a court of law.
Date
Driver's License
Vehicle ID
Authorising Signature
Operator Signature
Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City f=orm No_ 201 (Rev. 1995)
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
Preferred towing Recovery, Inc. Purchase Order No.
16567 River Avenue Terms
Noblesville, IN 46062 Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
2/7/10 38739 payment for towing vehicle 125.00
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.
24
Clerk- Treasurer
VOUCHER NO. WARRANT NO.
ALLOWED 20
Preferred Towing Recovery, Inc. IN SUM OF
16567 River Avenue
Noblesville, IN 46062
125.00
ON ACCOUNT OF APPROPRIATION FOR
police general fund
Board Members
Po# or INVOICE NO. ACCT /TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
1110 38739 582 125.00 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
April 23 20 10
A4�4� -b 40&,
Signature
Chief of Police
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund