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Home My WebLink About189830 09/14/2010 CITY OF CARMEL, INDIANA VENDOR: 361690 Page 1 of 1 ONE CIVIC SQUARE HUBLER EXPRESS COLLISON +a CARMEL, INDIANA 46032 503 W CARMEL DR CHECK AMOUNT: $894.66 CARMEL IN 46032 CHECK NUMBER: 189830 CHECK DATE: 9/14/2010 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1110 4351000 27018 53227 499.06 VEHICLE REPAIRS 1110 4351000 27009 53253 395.60 VEHICLE REPAIRS Date: 0910912010 Hubler Express Collision Carmel INVOICE 503 West Carmel Drive RO 53253 Carmel, IN 46032 317 569 -9 317 56 -98 85 (f Aa ron McG inn CITY OF CARMEL 10 NISS PATHFINDER 4X4 LE CITY OF CARMEL Color: BURGUNDY 1 CIVIC SQUARE Type: UV 4D UTV Adjustor: CARMEL, IN 46032 VIN: 5N1AR1NB9AC617077 Phone: Home: 571 -253 -1 Prod Date: 0312 Plate: IN 674LBI i Claim Deductible: 0 Work: Mileage: 72858 Loss Type: Other F ax: En Ine:6- 4.0L -Fl P Who P (I In C Customer) Uni f Units I Type Description Part Amount Sup Labor op Q ty P Parts Other REAR BUMPER R &I bumper assy Body R &I 1.0 C I I Parts Other REAR BUMPER Bumper cover Body Rpr 1.51 3.0' C REAR BUMPER Add for Clear Coat 1.2 C REAR BUMPER Partial Refinish Refn -0.5 C Parts Other REAR BUMPER Ste p cover Body R &I 0.3 C Body 1 Supplies REAR BUMPER Flex Additive 3.00 Body C REAR BUMPER Hazardous waste 1 Haz removal 3.00 Body j C Pnt/Mat MISC Paint Materials 103.60 3.7 C SubTotal 395 60 Taxes 0.00 Grand Total 395.60 i T D ue from Insur ance Du e from Customer Sub -Total 0.00 Sub -Total 395.60 Tax 0.00 Tax 0.00 Total 0,00 Total 395.60 j To tal Amount 395.60 D DO INVOICE #22 09/09/2010 10:46:00 AM RO# 53253 Hubler Express Collision Carmel Page 1 08/10/2010 at 04:19 PM Job Number: 24979 HUBLER EXPRESS COLLISION CARMEL www.expresscollision.org 503 W. Carmel Dr Carmel, IN 46032 (317)569 -9884 Fax: (317)569 -9885 PRELIMINARY ESTIMATE Written By: Alex Brumfield Adjuster: Insured: CITY OF CARMEL Claim Owner: CITY OF CARMEL Policy Address: 1 CIVIC SQUARE Deductible: CARMEL, IN 46032 Date of Loss: Other: (571)253 -1 Type of Loss: Point of Impact: Inspect Location: Insurance Company: Days to Repair 2010 NISS PATHFINDER 4X4 LE 6- 4.OL -FI 4D UTV Int: VIN: 5N1AR1NB9AC617077 Lic: Prod Date: Odometer: Air Conditioning Rear Defogger Tilt Wheel. Cruise Control Intermittent Wipers Climate Control Keyless Entry Alarm Dual Air Condition Rear Window Wiper Steering Wheel Controls Parking Sensors w /Equip Power Adjustable Pedals Message Center Body Side Moldings Dual Mirrors Console /Storage Overhead Console Wood Interior Trim Luggage /Roof Rack Electric Glass Sunroof Fog Lamps Clear Coat Paint Power Steering Power Brakes Power Windows Power Locks Power Driver Seat Power Passenger Seat Power Mirrors Heated Mirrors Memory Package AM Radio FM Radio Stereo Search /Seek CD Changer /Stacker Premium Radio Auxiliary Audio Connectio Satellite Radio Anti- -Lock Brakes (4) Driver Air Bag Passenger Air Bag Head /Curtain Air Bags Front Side Impact Air Bag 4 Wheel Disc Brakes Positraction Traction Control Stability Control Leather Seats Bucket Seats Heated Seats 3rd Row Seat Rear Step Bumper Running Boards /Side Steps Trailering Package Power Trunk /Gate Release Automatic Transmission 4 Wheel Drive Overdrive Aluminum /Alloy Wheels NO. OP. DESCRIPTION QTY EXT. PRICE LABOR PAINT 1 REAR BUMPER 2 R &I R &I bumper assy 1.0 3* Rpr Bumper cover 1.5 3.0 1 08/10/2010 at 04:19 PM Job Number: 24979 PRELIMINARY ESTIMATE 2010 NISS PATHFINDER 4X4 LE 6- 4.0L -FI 4D UTV Int: NO. OP. DESCRIPTION QTY EXT. PRICE LABOR PAINT 4 Add for Clear Coat 1.2 50 Refn Partial Refinish -0.5 6 R &I Step cover 0.3 7# Flex Additive 1 3.00 8# Hazardous waste removal 1 3.00 X Subtotals 6.00 2.8 3.7 Parts 3.00 Body Labor 2.8 hrs 44.00 /hr 123.20 Paint Labor 3.7 hrs 44.00 /hr 162.80 Paint Supplies 3.7 hrs 28.00 /hr 103.60 Sublet /Misc. 3.00 SUBTOTAL 395 -50 Sales Tax 106.60 7.00000 GRAND TOTAL 3.06 ADJUSTMENTS: Deductible 0.00 CUSTOMER PAY 0.00 INSURANCE PAY 403.06 *THIS IS A VISUAL DAMAGE EVALUATION ONLY. HIDDEN DAMAGE OR OMITTED DAMAGE BY THE ESTIMATOR IS NOT CALCULATED IN THIS REPORT. PART PRICES AND LABOR CHARGES MAY CHANGE AFTER A COMPLETE DISASSEMBLY AND REINSPECTION IS PERFORMED BY THE ESTIMATOR, TECHNICIAN, PARTS VENDORS, OR INSURANCE PERSONNEL. AN ITEMIZED INVOICE WILL BE PROVIDED AFTER REPAIRS ARE COMPLETED. A PERSON WHO KNOWINGLY AND WITH INTENT TO DEFRAUD AN INSURER FILES A STATEMENT OF CLAIM CONTAINING ANY FALSE, INCOMPLETE, OR MISLEADING INFORMATION COMMITS A FELONY. 2 08/10/2010 at 04:19 PM Job Number: 24979 PRELIMINARY ESTIMATE 2010 HISS PATHFINDER 4X4 LE 6 4.OL FI 4D UTV Int: Estimate based on MOTOR CRASH ESTIMATING GUIDE. Unless otherwise noted all items are derived from the Guide ARF3636, CCC Data Date 07/01/2010, and the parts selected are OEM -parts manufactured by the vehicles Original Equipment Manufacturer. OEM parts are available at OE /Vehicle dealerships. OPT OEM (Optional OEM) or ALT OEM (Alternative OEM) parts are OEM parts that may be provided by or through alternate sources other than the OEM vehicle dealerships. OPT OEM or ALT OEM parts may reflect some specific, special, or unique pricing or discount. OPT OEM or ALT OEM parts may include "Blemished" parts provided by OEM's through OEM vehicle dealerships. Asterisk or Double Asterisk indicates that the parts and /or labor information provided by MOTOR may have been modified or may have come from an alternate data source. Tilde sign items indicate MOTOR Not- Included Labor operations. Non- Original Equipment Manufacturer aftermarket parts are described as AM, Qual Repl Parts or Comp Repl Parts which stands for Competitive Replacement Parts. Used parts are described as LKQ, Qual Recy Parts, RCY, or USED. Reconditioned parts are described as Recond. Recored parts are described as Recore. NAGS Part Numbers and Benchmark Prices are provided by National Auto Glass Specifications. Labor operation times listed on the line with the NAGS information are MOTOR suggested labor operation times. NAGS labor operation times are not included. Pound sign items indicate manual entries. Some 2010 vehicles contain minor changes from the previous year. For those vehicles, prior to receiving updated data from the vehicle manufacturer, labor and parts data from the previous year may be used. The Pathways estimator has a complete list of applicable vehicles. Parts numbers and prices should be confirmed with the local dealership. CCC Pathways A product of CCC Information Services Inc. 3 I USAA NR: 00223 38 58 CHECK NR: 34 55129255 POL HOLDER: KAY M RADDATZ PAYEE: Carmel Police Department LOB /CLAIM NR: AUTO 000012 USAA DATE: 08/17/10 LOSS DATE: 08/05/10 USAA REP: 00028 UNIT: 0 6 811 USAA CASUALTY INSURANCE COMPANY PO BOX 33490 SAN ANTONIO, TX 76265 EXPLANATION OF PAYMENT AMOUNT PAYMENT UNDER PROPERTY DAMAGE COVERAGE A /S /O 2010 NISSAN PATHFIND ER TOTAL PAYMENT AMOUNT $395.60 ieaaa -o�Ds DATE OF ISSUE: 08/17/10 55129255 �'!;IY rd��P�a�i'4i�� "Ih" r "USAA�CAIJALTY,''INSURAWCE COMPANYP YOID DAYS FRDM r4 m' a ySwdo'. ,%N, Z IBD I I PO BpX� 33496 d r; Essu> fDaTE u �r r�uw r�INd o 1 t` F- 7k 9t !�C'1C 11 ^SA NIINTON[IO TXd78 65� 3 95 60 1 r77 r Yoh NI�W ��r u kR4ra' I N� Y R Rp.Y1 M`� Id +l�f'rr a` C V k C fiM N 6� f m �rn LOB CL'Af a Po u$ U$A NR Pi +NidnD;. p 'RPOLICYHOLDER M NR., "LOSS DATE 0022331 KAY M RADDATZ At 68/05/10 @Nhu, rN'h";'kr, +Ili�� O 12 d PAY TO THE ORDER OF' 4 k'r "�'��0, y 4ukl� iY��11��d� ilb��'��!�d �p�i "w t h�' NATURE. OF PAYMENT Wda M �h'� qM a�1! '1� +�M� k��` Ilh "oti �d h �H rS d� "1a 91 Carmel p,O11Ce DePartk G MN '�wi��n ��r „1 N hdlsh`�V ��p ,,iI��nPAYMENT UNDER r -IV I C .`SQUARE t l l,a� �Hyro I I;� .,,:I PROPERTY `DAMAGE CARMEG LN •46032 COVERAGE �C rhr�Y�yd 7 I�i� rt1 "f �NI�I fh rrPlUr. >d1 l r rp B,�rry w A //0 N� w� vl 9 s X2010 NISSAN r a" DA I��hlli�Nl f:��9M ll I��n� 8 ��I�n� f l d "k�y 3vx ot AMfRFCA v DER �'[dudlI�II� ��P!N S) CT HARTFOR 1 �d�plJ r�+ dw "OSS b 292SS0 IM 11900449: 6780911' City of Carmel One Civic Square Carmel, Indiana 46032 h�t_ 317.571.2400 c JIIil Price Quote Data Form Date: $12412010 P.O. 27009 Vendor Item Price Quotation (Name, Address B Telephone Number) Hubler Express repairs to vehicle $395.60 Collision 503 W. Carmel Drive Carmel, IN 46032 Buyer: Hubler Express Collision Reason Order Was Placed With Successful Vendor: Preferred Vendor, Order placed by: Jason Ogle INDIANA RETAIL TAX EXEMPT PAGE C ity of sane CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER Police Department FEDERAL EXCISE TAX EXEMPT 35- 60000972 3MCIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES, A/P CARMEL, INDIANA 46032 -2584 VOUCHER, DELIVERY MEMO PACKING SLIPS, FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL 1997 1 SHIPPING LABELS AND ANY CORRESPONDENCE. PURCHASE ORDER DATE DATE REQUI REQUISITION-NO. VENDOR NO. DESCRIPTION v ehicle August 24, 2010 e rs VENDOR Hubler Express Collision SHIP City of Carmel Police Department 503 W. C Drive TO 3 Civic Square Cartel, IN 46032 Carmel, IN 46032 OONFIRMAT[ON BLANKET CONTRACT PAYMENTTERMS FREIGHT QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION repairs to uakicle J Dietz 395 U. J 1 f Send Invoice To: PLEASE INVOICE IN DUPLICATE DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT 1110 510 auto repairs and k an 9PAYMENT 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 HA S THE PROPER SWORN AFFIDAVIT ATTACHED. SHIPPING INSTRUCTIONS I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN THIS APB PRIATfON SUFFICIENT TO PAY FOR T E ABOVE ORDER. SHIP REPAID. p�1 C.O.D. SHIPMENTS CANNOT BE ACCEPTED. ORDERED BY PURCHASE ORDER NUMBER MUST APPEAR ON ALL SHIPPING LABELS. L 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. A .P.V. 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 ACCOUNTS PAYABLE VOUCHER City Form 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 Hubler E Collisio Purchase Order No. 270 503 W Carmel Drive Terms Carmel, IN 46032 Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) 9/9/10 53253 payment for vehicle repairs 395.60 Dietz 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. 2Q Clerk- Treasurer VOUCHER NO_ WARRANT NO. ALLOWED 20 H ubler Express Collision IN SUM OF 503 W Carmel Dr C armel, IN 46032 395'.60 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 27009F 53253 510 395.60 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 S 10, 20 10 Signature Chief of Police Cost distribution ledger classification if Title claim paid motor vehicle highway fund Date: 09/07/2010 Hubler Express Collision Carmel INVOICE 503 West Carmel Drive RO 53227 Carmel, IN 46032 (317 569 -98 (317) 569 -_9 885 fax) Est: Aaron Mc Ginn CITY OF CARMEL 107 CHEV IMPALA POLICE CITY OF CARMEL Color: WHITE 1 CIVIC SQUARE Type: PC 4D SED Adjustor: CARMEL, IN 46032 VIN: 2GIWS55RX79401914 Phone: Home: Prod Date: 0407 Plate: IN 12623 Claim Deductible: 0 Work: Mileage: 44098 Loss Type: Other Fax: En 6-3.9L-Fl P W Pa ys? (I Insurance, C Customer I Sup Labor Paint I Qty i Type Description Part Amount Labor Op Units Units P Parts Other FRONT BUMPER GRILLE R &I Body R &I 0.5 1 C bumaer_cover Parts Other FRONT LAMPS LT Headlamp assy Body R &I 0.3 C Parts Other FENDER LT Fender Body Rpr 2.5 2.2 C FENDER Add for Clear Coat 0.9 C Parts Other FENDER LT Fender liner 1 Body R &I 0.4 C 1 Parts New PILLARS, ROCKER FLOOR LT 19120760 257.46 1 Body Repl 0.8 2.1 C Rocker molding PILLARS, ROCKER FLOOR Add for 1 0.4 1 C Clear Coat A Parts Other FRONT DOOR LT Outer panel Body Rpr 1.0 2.0 C FRONT DOOR Overlap Major Adj. -0.4 C Panel I FRONT DOOR Add for Clear Coat B i 0.3 C Parts Other FRONT DOOR LT Belt w'strip Body R &I 0.31 C Parts Other FRONT DOOR LT Body side mldg Body R &I 0.3 C j FRONT DOOR Hazardous waste Haz 3.00 Body Subl C removal FRONT DOOR REMOVE DECALS Body Rpr 1.0 C Body 1 Supplies FRONT DOOR Corrosion protection 10.00 Body 0.2 C FRONT DOOR Cover car 0.2 C Parts Other FRONT DOOR LT R &I trim panel 1 Body R &I 0.4 C Parts Other FRONT DOOR LT Mirror assy w/o 1 Body R &I 0.3 C defogger Parts Other FRONT DOOR LT Handle, outside 1 Body R &I 0.3 C Pnt/Mat MISC Paint Materials 215.60 7.7 SubTotal 1,190.06 Taxes 0.00 Grand Total I 1,190.06 Due from I nsurance Due f rom Customer Sub -Total 0.00 Sub -Total 1,190.06 Tax 0.00 Tax 0.00 Total 0.00 Total 1,190.06 A mount 190.061 INVOICE #22 09/07/2010 09.45:51 AM RO# 53227 Hubler Express Collision Carmel Page 1 City Carmel INDIANA RETAIL TAX EXEMPT PAGE CERTIFICATE NO. 003124155 002 d PURCHASE ORDER NUMBER Police Department FEDERAL EXCISE TAX EXEMPT 35- 60000972 2701 3 =CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES, A/P CARMEL,.,INDIANA 46032 -2584 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 e tember 2. 2010 vehicle repairs VENDOR Hubler Express Collision SHIP City of Carmel Police Department 503 W. Carmel Drive TO 3 Civic Squarew Carmel, IN 46032 Carmel, IN 46032 CONFIRMATION BLANKET CONTRACT PAYMENTTERMS FREIGHT QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION additional repairs to car 130 Byrne 499.06 ti Send Invoice To: PLEASE INVOICE IN DUPLICATE DEPARTMENT ACCOUNT F PR( PROJECT ACCOUNT AMOUNT 1110 510 auto repairs and mu&nZienanc PAYMENT A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O. i NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND I l VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED. SHIPPING INSTRUCTIONS I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN SHIP REPAID THIS APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER. C.O.D. SHIPMENTS CANNOT BE ACCEPTED PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY SHIPPING LABELS. THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945 TITLE Chief of Po ice AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO, CLERK- TREASURER DOCUMENT CONTROL NO. 27018 A.P.V. 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 #trITLE 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 _._._.m---- Signature Title Cost distribution ledger classification if claim paid motor vehicle highway fund Prescribed by State Board of Accounts Dry 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 Hubler Express Collision Purchase Order No. 27018F 503 WestCarmel Drive Terms Carmel, IN 46032 Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) 9` 53227 payment for additional repairs to car 130 Byrne 499.06 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 H urler Express Collision IN SUM OF 503 West Carmel Drive Carmel, IN 46032 499.06 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 27018F 53227 510 499.06 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 September 13 2 0 10 Signature Chief of POlice Cost distribution ledger classification if Title claim paid motor vehicle highway fund