185705 05/26/2010 CITY OF CARMEL, INDIANA VENDOR: 00352730 Page 1 of 1
ONE CIVIC SQUARE DAN YOUNG TIPTON, LLC
CHECK AMOUNT: $24,914.00
ra CARMEL, INDIANA 46032 875 E JEFFERSON ST
PO BOX 398 CHECK NUMBER: 185705
TIPTON IN 46072
CHECK DATE: 5/26/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 R4351000 21243 10,837.54 REPAIRS TO CAR 19
1110 4465001 21831 13,998.46 NEW VEHICLES
1110 4239099 4938 78.00 OTHER MISCELLANOUS
What drives ou?
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I B rc I'+ONTIAC v p1EVf�ET
STATE ROAD 28 (PO BOX 398) a TIPTON, IN 46072
765 -675 -7491 765 -675 -8799 (fax) 0 1 800 -489 -USA 1
(8721)
THANK YOU FOR CHOOSING DAN YOUNG GM CENTER
WHERE COMPLETE SATISFACTION IS #1.
YOUR GM ACCESSORY DEALER
"ALL GM BED LINERS 229.00 INSTALLED
*BOBBY* *CLYDE* *JULIE MARIE
r n m
29519 xxxxxxxxxxxx CHARGE BOB POE 05/10/10 4938
CVW
B S
I H
L I
L CITY OF CARMEL POLICE DEPARTMENT P
T2 CIVIC SQUARE T
0 CARMEL, IN 46032
2 0 15824471 KEY 2.187 55 49.46 39,00 78.00
DISCLAIMER OF A WARRANTIES
SUBTOTAL 78.00
Any warranties on the products sold hereby are those made by the manufacturer. The seller, DAN YOUNG, INC.,
hereby expressly disclaims all warranties, either express of implied, including any implied warranty of merchantability
or fitness for a particular purpose, and DAN YOUNG, INC. neither assumes nor authorizes any other person to assume
for it any liability in connection with the sale of said products.
RETURNED PARTS MUST BE IN ORIGINAL UNDAMAGED CONTAINER. AX 0.00
NO REFUNDS WITHOUT THIS INVOICE,
NO REFUNDS AFTER 30 DAYS.
ELECTRICAL PARTS ARE NOT RETURNABLE.
SPECIAL ORDER PARTS ARE NOT RETURNABLE.
RECEIVED BY:
FREIGHT PAYTHISAMOUNT 0.00
78.00
13:23:46 CUSTOMER COPY NET504 PAGE 1 OF 1
Prescribed by State Board of Accounts City Form No. 201 (Rev. 1995)
ACCOUNTS PAYABLE VOUCHER
y 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
Dan Young Chevrolet Purchase Order No.
SR 28, P.O. Bo x398 Terms
Tipton, IN 46072 Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
5/10/10 4938 payment for key for new vehicle 78.00
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.
20
Clerk- Treasurer
VOUCHER NO. _WARRANT NO.
ALLOWED 20
Den Young Chevrolet IN SUM OF
SR 28; P.O. Box 398
Tipton, IN 46072
78.00
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 4938 390 -99 78.00 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
M 0 20 10
Signature
Assistant Chief of Poli
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund
Another quality design by GRAPHIC RESOURCES, INC. 317 865.9200 1.800. 792 -3311 (Rev-3/10) DYG -2010
What driver, you? 875 E. JEFFERSON STREET
YOU NG TIPTON, IN 3 9 8
6072
765- 675 -7491
�IVtc. o K 1- 800 489 -USA1 (8721) STOCK NO.
FAX 765 -fi75 -3737
DATE
PURCHASER /M vlee PHONE (J 7 1 7 1"'
EMAIL CELL
ADDRESS G CITY STATE ZIP
NEW
USED YEAR /D MA' v y MODEL TYPE
SERIAL NO. /L� /V I t�lr �P COLO MILES
DEALER INSTALLED EQUIPMENT LIST PRICE OF VEHICLE
4 91F Y_f
TOTAL PRICE
TRADE -IN ALLOWANCE
TRADE -IN CERTIFICATION THE CUSTOMER CERTIFIES HIS TRADE -IN VEHICLE TOTAL SELLING AMOUNT
HAS NEVER BEEN TITLED UNDER A STATE OR FEDERAL "BRAND" SUCH AS SERVICE CONTRACT
DEFECTIVE', "REBUILT "SALVAGE "FLOOD ETC-
(initial) r.ALE. TAX (EXEMPTION
MANUFACTURER'S REBATE
VIN
#1 IS THERE A LIEN ON THE TRADE -IN?
LIENHOLDER
ACCOUNT'NUMBER GAP INSURANCE
CREDIT LIFE
CREDIT DISABILITY
VIN ENVIRONMENTAL PACKAGE
#2 IS THERE A LIEN ON THE TRADE -IN? DOCUMENT FEE
LIENHOLDER TIRE TAX
ACCOUNT NUMBER SUB TOTAL DUE JL acs
SOLD AS IS WITH ALL FAULTS
I hereby make this purchase knowingly without any guarantee,
expressed or implied, by this dealer or his agent. PAYOFF ON TRADE -IN
X PURCHASER'S SIGNATURE CASH DEPOSIT REC.#
Credit Life Waiver. SUB -TOTAL DUE
I have been advised and understand that in the event of my death, Credit Life benefits would
pay in full the balance of my installment contract; I hereby decline and waive such benefits.
TOTAL BALANCE DUE ON DELIVERY
X
Creditor Disability Waiver AMOUNT FINANCED
I have been advised and understand that in the event of my disability to work due to sickness
or injury, the Creditor Disability benefits would make the payments on my installment contract,
notwithstanding I hereby decline and waive such benefits.
X
Declination of Coverage WILL THERE BE A LIENHOLDER ON THIS CAR? YES NO
The Mechanical has been explained to me in conjunction with my automobile purchase.
I choose not to purchase the protection at this time with the full understanding that any repairs NAME
after the expiration of the ongl al factory warranty period shall be completely at my expense.
Confirmation of Accidental /Physical Damage Insurance ADDRESS
I have made arrangements through my insurance company to provide insurance protection on
before mentioned vehicle relieve Dan Young Tipton LLC against any financial loss
Should an accident or damage occur. r CITY/STATE ZIP
4,, Cpl:.
"The information you see on the window form for this vehicle is part of this contract. Information on the window form overrides any contrary
provisions in the contract of sale."
NO WARRANTIES expressed or implied, of MERCHANTABILITY or FITNESS or otherwise, are made by the Selling Dealer, Dan Young GM, with
respect to any used vehicle or chassis described on the front of this order except such warranty, if any, as may be expressed completely in writing f
by the Selling Dealer, Dan Young GM, on this order or separate instrument delivered to the purchaser. The applicability of any such
warranty shall be subject to all the terms and conditions therein stated.
The sales personnel of the seller are not authorized to make warranties about the merchandise described in this contract. SELLER'S
EMPLOYEES' ORAL STATEMENTS DO NOT CONSTITUTE WARRANTIES, shall not be relied upon by the buyer and are not part of the contract
for sale. The entire contract is embodied in this writing and NO OTHER WARRANTIES ARE GIVEN BEYOND THOSE SET FORTH IN THIS
WRITTEN CONTRACT. This writing constitutes the final expression of the parties' agreement and it is a complete and exclusive statement of the
terms of that agreement. THIS ORDER SHALL NOT BECOME BINDING UNTIL ACCEPTED BY DEALER OR HIS AUTHORIZED
REPRESENTATIVE AND IN THE EVENT OF A TIME SALE DEALER SHALL NOT BE OBLIGATED TO SELL UNTIL APPROVAL OF THE
TERMS HEREOF IS GIVEN BY A BANK OR FINANCE COMPANY WILLING TO PURCHASE A RETAIL INSTALLMENT CONTRACT
BETWEEN THE PARTIES HERETO BASED ON SUCH TERMS. Purchaser by his execution of this Order certifies that he is 18 years of age or
older and acknowledges that he has read its terms and conditions and has received a true copy of this Order.
X
;I
NAME
PUfCHASER'S SIGNATURE DATE SALESMAN'S
X J Accepted By:5��
PURCHASER'S SIGNATURE DATE DEALER OR HIS AUTHORIZED REPRESENTATIVE
,tom.. .•a' r',�'t 4
Cit INDIANA RETAIL TAX EXEMPT PAGE
II CERTIFICATE NO. 003120155 002 0 1 of 1
Ji x PURCHASE ORDER NUMBER
Police Department FEDERAL EXCISE TAX EXEMPT
35- 60000972 2183
3 ONE {CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES, A/P
CARMEL INDIANA 46032 -25$4 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 I ATE REQUIRED REQUISITION NO. VENDOR NO, DESCRIPTION
Pkruary 23, 21110 new vehicle
I
VENDOR Dan Young Tipton SHIP City of Carmel Police Department
875 E. Jefferson Street TO 3 Civic Square
Tipton, IN 46072 Carmel, IN 46032
ATTN: Jim Goodson ATTN: Major Jim Barlow
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREI
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
1 2010 Fleet /Non retail. Chevrolet Tahoe 2WD 4dr 24,836.00
1500 Police CC10706 whiee in color
_k 2
•x
e_
Send Invoice To: City of Carmel 'Pol�
ATTN; Teresa Andersol� _1
3 Civic 9quzre
Carmel, IN 46032
Y�
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
1110 650 -01 cars and trucke 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. a
C.O.D. SHIPMENTS CANNOT BE ACCEPTED. ORDERED BY
PURCHASE ORDER NUMBER MUST APPEAR ON ALL r
SHIPPING LABELS. t
THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945 TITLE Chief of P o ll
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO-
DOCUMENT CONTROL NO.
A`.P. COPY SIGN AND RETURN TO CLERK'S OFFICE
VbUCHER NO._ WARRANT NO..
ALLOWED 20
IN THE SUM OF
ON ACCOUNT OF APPROPRIATION FOR
Board Members
PO# or INVOICE NO. ACCT #MILE 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
INDIANA RETAIL TAX EXEMPT PAGE
Ci t y oCERTIFICATE NO.Ofl3120155 002 0 PURCHASE ORDER NUMBER
Police Department FEDERAL EXCISE TAX EXEMPT
35- 160000972 124
.IIONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES, A/P
CARMEL INDIANA 46032-2584 VOUCHER, DELIVERY MEMO, PACKING SLIPS,
SHIPPING LABELS AND ANY CORRESPONDENCE.
FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL 1997
PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION
aov6mber 3 200 vehicle veDairs
VENDOR XIKKUM SHIP City of Carmel Police Department
Carmel Auto Refinishing TO 3 Civic Square
308 Gradl,e Drive Carmel., IN 46032
Carmel, IN 46432
CONFIRMATION BLANKET CONTRACT PAYMENTTERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
reppirs to car 19 Bar &aw 10,837.54
A
tom
61
Send Invoice To:
PLEASE INVOICE IN DUPLICATE
7
DEPARTMENT ACCOUNT PROJECT PROJECTACCOUNT AMOUNT
1110 510 auto repairs and mai na� 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 AFFIDAVITATTACHED.
SHIPPING INSTRUCTIONS I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN
THIS APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER.
SHIP REPAID. d 7
G.O.D. SHIPMENTS CANNOT BE ACCEPTED.
PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY
SHIPPING LABELS. r
THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945 TITLE Chief of Police
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
r• .P
CLERK- TREASURER
y
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
Prescribed by State Board of Accounts City Form No. 261 (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
Dan Young Chevrolet Purchase Order No. 21243RF 21831F
P.O. Box 348
875 E. Jefferson Street Terms
Tipton, IN 46072
ATTN: Jim Goodson Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
5/10/10 a ent for vehicle 24 836.00
Total
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
Dan Young Chevrolet IN SUM OF
875 E. Jefferson Street
P.O. Box 398
Tipton, IN 46072
ATTN: Jim Goodson
24,836.00
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
21243RF 51.0 10,837.54 bill(s) is (are) true and correct and that the
21831E 650 -01 13,998.46 materials or services itemized thereon for
which charge is made were ordered and
received except
May 13 20 10
Signature
Chief of POlice
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund