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Home My WebLink About190282 09/29/2010 CITY OF CARMEL, INDIANA VENDOR: 00350559 Page 1 of 1 ONE CIVIC SQUARE GUARDIAN AUTO GLASS CARMEL, INDIANA 46032 24394 NETWORK PLACE CHECK AMOUNT: $191.44 CHICAGO IL 60673 -1243 CHECK NUMBER: 190282 CHECK DATE: 9/29/2010 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1110 4351000 27025 5205060378 191.44 WINDSHIELD REPLACEMEN GUARDIAN AUTO GLASS GUARDIAN 940 N SHADELAND AVE ACompany of Vision INDIANAPOLIS, IN 46219 REMIT TO: (317)353-6178 (800)882-2244 Guardian Glass Company MVR$ Y 24394 Network Place Chicago, IL 60673 -1243 INVOICE WORK PERFORMED FOR: PA YMEN DUE DATFv.:: CARMEL POLICE DEPT 10 /14/2010 3 CIVIC SQ 1NV CARMEL, IN 46032 5205060378 CARMEL POLICE DEPT rI�QICE L1A'1E 3 CIVIC SQ 0 9/14 /2 010 CARMEL, IN 46032 CLAIMANT ;FED'ERA_�,; NUA iBET:- 34- 0801385 flRA�R` Nt7MS�R 5200085616 ORME DACE ACCOUNT: 121805 HP WP 09/09/2010 IN5T;; :BY .;:SNIT 83 PROPOSED' COMPLETt3N DAATE... PiZ, M0, fiU, k7E Tfl FR '.:SA: SST JOB I WAIT: DMS 09/10/2010 08:00 -05:0 X M- HAMILTON 317 571 -2548 ��_:':.:AGE ROBERT $bt,YCYiiNUM3Ex:<:.. :z rrnTM�CrjNR4T NANSAER PO# 27054 4 ::iIEHI E#7•.BET2:. ,Ti�G ENSE>'UNIT�':N UM.EER: MIS�EAGE.:: &AIiESPERS�ON ..�'AIEEN. $Y 2G1WD5EM4Al223812 JAMES C LIPTON BSCHRIER BODY sTYL 2010 CHEVROLET IMPALA 4 DOOR SEDAN OPEN CHARGE REPEAT CUSTOMER ;QTY PART;NUMBER /DESCRIPTION LIST PRICE UNIT PRICE TOTAL 1 DWO164OGBYN Windshield (W /Third Visor Frit) 022 191.44 2 HAH000004 Urethane, Dam, Primer 0.00 0.00 SUBTOTAL- 191144 *STATEMENT OF AUTHORIZATION AND SATISFACTION REPLACEMENT HAS BEEN MADE TO MY SATISFACTION AND I HEREBY AUTHORIZE THE ABOVE SALES TAX 0.00 INSURANCE COMPANY TO PAY DIRECT IN FULL TO GUARDIAN AUTO GLASS FOR SAID INSTALLATION. IF FOR ANY REASON THE INSURANCE COMPANY DOES NOT PAY FOR THESE REPAIRS OR REPLACEMENTS THE BELOW SIGNED AGREES TO PAY FOR SAID REPAIRS OR REPLACEMENTS. DEDUCTIBLE SURF RU ST OR CORROSION PRESENT AND TREATED NO WARRANTY AGAINST LEAKAGE WHEN CHECKED: DATE CUSTOMER /WITNESS "Safest Installation Always" TOTAL 191.44 City E RETAIL TAX EXEMPT PAGE Jl r CERTIFICATE NO. 003120155 d02 0 1 PURCHASE ORDER NUMBER Police Department FEDERAL EXCISE TAX EXEMPT 35- 60000972 391CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES, NP 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 'URCHASE ORDER DATE DATE REQUIRED REQUISITION NO, VENDOR NO. DESCRIPTION Se tembdrfB, 010 windshield replacement VEND Guardian Auto Glass SHIP Cit of Carmel Pdkiice Department 940 N. Shadeland Avenue TO 3 Civic Squame. Indianapolis, IN 46219 Carmel, IN 46032 CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION repairs to windshield for car 149 Dixon 191.44 t RN °r Send Invoice To: 0 I'f PLEASE INVOICE IN DUPLICATE DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT 1110 510 auto repaf�s and main V e YMENT P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O. UMBER 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 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 ,t t.(~' _.G•' SHIPPING LABELS. Chief of Police THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945 TITLE AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. CLERK- TREASURER DOCUMENT CONTROL No-27025 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 /TITt_E 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. 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 Guardian Auto Glass Purchase Order No. 27025F 940 N. Shadeland Avenue Terms Indianapolis, IN 46219 Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) 9Vr14.10 5205060378 a ent for windshield airs 191.44 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 G uardian Auto Glass IN SUM OF 940 N. Shadeland Avenue Indianapolis, IN 46219 191.44 ON ACCOUNT OF APPROPRIATION FOR police general f un d Board Members PO# or INVOICE NO. ACCT #!TITLE AMOUNT DEPT. I hereby certify that the attached invoice(s), or 27025F 5205060378 510 191.44 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 21 20 10 Signature Chief of Police Cost distribution ledger classification if Title claim paid motor vehicle highway fund