191140 10/27/2010 CITY OF CARMEL, INDIANA VENDOR: 363018 Page I of 1
6 ONE CIVIC SQUARE CAMPBELL SALES SERVICE CHECK AMOUNT: $18.00
CARMEL, INDIANA 46032 1332 S 8TH STREET
NOBLESVILLE IN 46060 CHECK NUMBER: 191140
CHECK DATE: 10/27/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2201 4237000 18.00 REPAIR PARTS
'v 6.1 I M a, %W r� v° R v 1 1
9nice &STRATTON
OAMPBELLS SALES SE:I�VI OE NO, A 718
GENUINE DEALERS im S. 8TH ST.
USE GENUINE PARTS NOBLE IN 46030 DATE IN D� DATE PROMISED
on F 317473 I NAME ENGINE MODEL NO_ EQUIPMENT MANUFACTURER
ADDRESS TYPE OR SPEC NO, TYPE OF EQUIPMENT
CITYISTATEIZIP SERIALJCODE NO. EQUIPMENT MODEL NO,
DEALER TO PICKUPIDELIVER PHONE- DAY PHONE EVENING EQUIPMENT SERIAL MD.
CUST. NOTIFIED DATE EMAILADDRESS DATEMME DATE OF PURCHASE
WMICE. CHECKLIST
AIR'FILTEER: PRESENT? CONDITION: CLEAN C] DIIITY O DAMAGED O OVERA MACHINE CONDITIO
BLADE: CONDITION: OIL. LEVEL C ONDITION: FRESH O USED Q DARK O BURNT Q
FUELCONDITION: FRESH C7 -STALE a RANCID CD AGE: COOLING FINS CONDITION CLEANCO DIRTY CLOGGEDC)
REPAIR AS NEEDED TUNE -UP: MINOR Mt_hJOR D CHECK COMPRESSION
DIAGNOSE CALL WITH ESTIMATE CHANGE ENGINE OIL CHECK CARBURETION.
WARRANTY INSPECTION SHARPEN BLADE
REPAIR STARTER CHE IGNIT
PARTS
LABOR
PICKUPIDEUVERY
r SHOP SUPPLIES/
ENVIFION_ FEES
GAS &OIL
FREIGHT
SUBTOTAL
TAX
r
TOTAL
While the manufacturer may warrant the goods sold to the
customer, we mate no Wnrrantles, express or Implied, includ-
Ing any Implied warranties of merchentahlllty or fitness, With
t respect to Ouch goods,
Not respnnglhle for lass or damage In CASs of firs, then or any other
cause bcynnd our rantrol.
I hereby OtAhOTIze the above repair WorK ID he done along with the
TOTAL necessary malydel and hereby grant you andlor your en
permisslon to operate the unit as necessary bf fhn Purpose of testing
I FULLY UNDERSTAND THE PURPOSES OF THE SAPF DEVICES ON TWfS FDUIPMI'NT AND SPECIFICALLY REQUEST THAT THEY andlor Inspncrlon. An express rriechAq Ilnrt N hereby acknowl-
NOT BE REPAIRED OR REPLACED, AND I ASSUME- RESPONSIBILITY FOR AND HOLD YOU HARMLESS FROM ANY INJURY TO odpoaon ntrove unit to secutothe amount of rapairg thereto.
ANYONE THAT MAY RESULT THEREFROM,
X K AUTHORIZED SIGNATURE
AUTHORIZED SIGNATURE
PART N0.273130.9103
PRINTED IN U.S.A. Q COPYRIGHT 2003 9RIGGS 8 STRATTON GORPORATIDN
VOUCHER NO. WARRANT NO.
ALLOWED 20
Campbells Sales Service
IN SUM OF
1332 S. 8th Street
Noblesville, IN 46060
$18.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO# 1 Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Members
2201 42 370.00 $18.00 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
Friday, October 22, 2010
L
S Me et Comm ii
Street C8Mmissioner
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))
10/11/10 $18.00
1 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