192108 11/23/2010 CITY OF CARMEL, INDIANA VENDOR: 361690 Page 1 of 1
ONE CIVIC SQUARE HUBLER EXPRESS COLLISON CHECK AMOUNT: $1,655.00
CARMEL, INDIANA 46032 503 W CARMEL DR
CARMEL IN 46032 CHECK NUMBER: 192108
CHECK DATE: 11/2312010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4351000 27049 53430 1,655.00 VEHICLE SUPPLIES
Date: 11/05/2010
Hubler Express Collision Carmel INVOICE
503 West Carmel Drive RO 53430
Carmel, IN 46032
(317) 569 -9884, (317) 569 -9885 (fax) Est: Aaron McGinn
CITY OF CARMEL 07 CHEV IMPALA POLICE CITY OF CARMEL POLICE
CITY OF CARMEL Color: WHITE DEPARTMENT
1 CIVIC SQUARE Type: PC 4D SED Adjustor:
CARMEL, IN 46032 VIN: 2G1WS55R279342860 Phone:
Home: Prod Date: Plate: IN 11908 Claim VEHICLE #8
Work: Mileage: 70552 Deductible: 0
Fax: Engine: 6- 3.91_-FI I Loss Ty Other
P Who Pays? I Insurance, C Customer)
Oty Type Description Part Amount Sup Labor Op Labor Paint P
Units Units
FRONT BUMPER GRILLE RECOND
i. Parts AM Bumper cover w/o fog lamps "9025047 314.00- Body Repl 2.0 3.0 C
FRONT BUMPER GRILLE Add for 1.2 C
Clear Coat
Parts Other FRONT BUMPER GRILLE Upper Body R &I C
grille LS, LT, LTZ, POLICE
Parts Other FRONT BUMPER GRILLE Lower Body R &I C
grille center LS, LT, LTZ, POLICE
1 Body FRONT BUMPER GRILLE Flex 3.00 Body C
Supplies Additive
1 Haz FRONT BUMPER GRILLE 3.00 Body C
Hazardous waste removal
Parts Other RADIATOR SUPPORT Radiator support Body Rpr 5.0 1.5 C
RADIATOR SUPPORT Pull Radiator
Frame 2.0 C
support
1 Body RADIATOR SUPPORT Corrosion 10.00 Body 02 C
Supplies protection
RADIATOR SUPPORT Cover car 0.2 C
1 Parts AM AIR CONDITIONER HEATER Qual 89018841 190.00 Body Repl 2.6 C
Repl Parts Condenser 3.5, 3.9 liter
AIR CONDITIONER HEATER Mech 1.4 C
Evacuate recharge
AIR CONDITIONER HEATER Mech 0,4 C
Refrigerant recovery
Parts Other COOLING Radiator Body R &I C
2 Supplies COOLING Coolant 24.00 Body Repl C
Pnt/Mat MISC Paint Materials 165.20 5.9 C
SubTotal 1,655.00
Taxes 0.00
Grand Total 1,655.00
Due from Insurance Due from Customer
Sub -Total 0.00 Sub -Total 1,655.00
Tax 0.00 Tax 0.00
Total 0.00 Total 1,655.00
Total Amount 1,655.00
INVOICE #22 11/05/2010 09:09:50 AM RO# 53430 Hubler Express Collision Carmel
Pagel
INDIANA RETAIL TAX EXEMPT PAGE 1 Of 1
City of: C armel CERTIFICATE NO. 003120155 002 0 PURCHASE ORDER NUMBER
Police Department
FEDERAL EXCISE TAX EXEMPT
35- 60000972 27
3 'CIVIC SQUARE a' THIS NUMBER MUST APPEAR ON INVOICES, A/P
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
Dctober 11, 20 vehicle repairs
VENDOR Hubler Express Collision SHIP City of Carmel Police Department
503 W. Carmel Drive TO 3 Civic Square
Carmel, IN 46032 Carmelo IN 460032
OONRRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
repairs to vehicle 8 Hughes 1,655.00
Ail
h I (I? m
Send Invoice To:
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
1110 510 v auto repairs and main anc
j AYMENT
i k 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 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 BEACCEPTED- ORDERED BY h l i i l A6�
PURCHASE ORDER NUMBER MUST APPEAR ON ALL
SHIPPING LABELS.
THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945 TITLE phi pf Of Poll
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO,
CLERK TREASURER
DOCUMENT CONTROL No-27049 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 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 Express Collision Purchase Order No. 27049F
503 W est C Drive Terms
Car IN 46032 Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
11/5/10 53430 paymetn for vehicle repairs to car 8 Hughes S5
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 ubler Express Collision IN SUM OF
503 West Carmel Drive
Carmel, IN 46032
1,655.00
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
27049P 53430 510 1,655;o 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
November 16 20 1 pq
Signature
Chief of PoI ce
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund