189572 08/31/2010 r
CITY OF CARMEL, INDIANA VENDOR: 353827 Page 1 of 1
0 ONE CIVIC SQUARE ZIEBART OF INDIANAPOLIS CHECK AMOUNT: $319.30
CARMEL, INDIANA 46032 6155 E 86TH ST
INDIANAPOLIS IN 46250
CHECK NUMBER: 189572
CHECK DATE: 8/31/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4351000 349985 319.30 AUTO REPAIR MAINTEN
s'
CUSTOMER COPY INVOICE
Date Order
08/25/10 349985
Auto- x -10'd, Inc. /iN37
6155 E 86th St. Suite C
Sales ID: CW
Indianapolis, IN 46250
Phone #:317- 577 -9192 Fax #:317- 841 -0426
Email: IN37@Ziebartl.com
CUSTOMER OF:
C Carmel Fire Dept None
u 10701 N. College Ave
s
r Carmel, IN 46032 Phone None
o Customer Phone 3178183400
M
E
R
CUSTOMER T cla e BRANCH/ CUST. AR## CARMEL
P.O. FLEET MASTER BILLING NO. BATCH
DELIVER TO. i
VEHICLE I,D, /SERIAL NO. AFC18037 UNIT! STOCK NO MFGR DATE :READI ER YEAR 2010 MAKE, MODEL COLOR Ford F -150 White 04110
Qty. Description Part Warranty Amount
SG SPLASH GUARDS *SPLASH GDS 90.00
SD UNDERBODY SOUND BARRIER UNDERBODY SND 150.00
ZF VENT VISORS *VENT VISORS 70.00
Z1 Environmental Impact Surcharge *EPA COMP 9.30
319.30
Diamond Gloss is now on sale ask about our RHINO
LININGS sale call 317- 577 -9192
TOta A 319.30'
CASH ON ACCOUNT CHECK BANKCARD REM CARD
I HEREBY AUTHORIZE THE WORK SHOWN TO BE DONE ALONG WITH THE NECESSARY MATERIALS AND AGREE THAT YOU ARE NOT RESPONSIBLE
FOR LOSS OR OAMAGE TO VEHICLE OR ARTICLES LEFT IN CASE OF FIRE, THEFT OR ANY OTHER CAUSE BEYOND YOUR CONTROL, AN EXPRESS
i
MECHANIC'S LIEN IS HEREBY ACKNOWLEDGED ON THE ABOVE VEHICLE TO SECURE THE AMOUNT OF SERVICE HERETO.
VOUCHER NO. WARRANT NO.
ALLOWED 20
Ziebart
IN SUM OF
6155 E. 86th Street #C
Indianapolis, IN 46250
$319.30
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO# Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Members
1120 349985 43- 510.00 $319.30 1 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
AUG 302010
Fire Chief
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))
349985 C4550 Ford $319.30
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