187402 07/07/2010 CITY OF CARMEL, INDIANA VENDOR: 00351300 Page 1 of 1
0 ONE CIVIC SQUARE PADDACK WRECKER SERVICE, INC
CARMEL, INDIANA 46032 18702 US 31 NORTH CHECK AMOUNT: $76.00
WESTFIELD IN 46074
o CHECK NUMBER: 187402
CHECK DATE: 7/712010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 122289 76.00 TRANSPORTATION EXPENS
e
U" PADDACK;
WRECKER SERVICE, INC.
18702 US 31 North
n WESTFIELD, INDIANA 46074
G� Y� (317) 896 -3206 .Q
(317) 846 -3206
Service
DATE r If J^y TITO S 00 11 REOUESTEE Br P.O. NO.
NAME `GGff� 1 (V 1 J� VLJ J I4 PHONE
ADDRESS
CITY STATE ZIP
LOCATION OF VEHICLE
YEAR, MAKE, MO tyyt L /G7 J r 1 CO I(�� R MILEAGE
�`IV I��
T I N [PSAL�FT 1 0 5al. V fH& 7OW SLIPN
MILEAGE SERVICE TIME ACCIDENT
'START START IMPOUND;
0 BREAKDOWN
FINISH FINISH
SERVICE CALL
TOTAL r TOTAL
DESCRIPTION OF SERVICES SPECIAL EQUIPMENT
SINGLE LINE WINCHING
DUAL LINE WINCHING
SNATCH BLOCKS
DOLLY
El
TYPE OF TOW TOWED PER ORDER OF VEHICLE TOWED TO
❑�SLiNWHOIST TOW [71 STATE POLICE FIRST TOW
Rl
FLAT BED /RAMP LOCAL POLICE f t R U P
WHEEL LIFT SHERIFF DEPT. SECOND YOW
El DEALER 1e WNER
STORAGE TOWING CHARGE !rr^? Q
To, DAYS MILEAGE CHARGE
PAID LABOR CHARGE
DRIVER'S
CASH 71 CHECK UC.NO.
WINCH CHARGE'
EXP.
MC VISA AMEX DISCOVER DATE SPILL
CONTAINMENT
SPECIAL
cc No. EQUIPMENT
OPERATOR'S SIGNATU 1 Z DAT CLEAN UP
2 7.1 UNIT NO.
STORAGE
AU RIZED SIG DATE
SUB -LET
VEHICLE RELEASED TO DATE
TOTAL (a,
/y ry /'1
Not responsible for loss or damage to vehicle Thank You
C 2 8 dM i n case of fire, theft or any other cause beyond our control. 1�
t;aati, r'�a.;i HER CD57f fl1 }lfltitillf� SerVict. n c n_ A 6a<? Nlrb,' ,l oaoh, Nli 03458 ..v. .:,:.co e. t; -�t EJi� (z t5�•�04575
MP• ti
t
Customer RMeaze far
Ciability Release F,dra
I have requested towing, transport recovery roadside services that.
are'not recommended by the company below, If damage or theft cif.
my vehicle(s) occurs because of this request,'I .release the company
below'of responsibility, both civil and Grim' inal,:in'acourt of law.
Date
`,Driver's License
Vehicle. ID
Authoriii64 Signature
Operator Signature
�`dOUCHER 105729 WARRANT ALLOWED
00351300 IN SUM OF
PADDACK WRECKER SERVICE
18702 US 31 NORTH
WESTFIELD, IN 46074
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
122289 01- 7502 -06 $76.00
Voucher Total $76.00
Cost distribution ledger classification if
claim paid under vehicle highway fund
Prescribed by State Board of Accounts Citv.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 of service rendered, by whom, rates per day, number of units,
price per unit, etc.
Payee
00351300
PADDACK WRECKER SERVICE Purchase Order No.
18702 US 31 NORTH Terms
WESTFIELD, IN 46074 Due Date 6130/2010
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
6/30/2010 122289 $76.00
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
Date Officer