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Home My WebLink About194012 01/20/2011 CITY OF CARMEL, INDIANA VENDOR: 00350559 Page 1 of 1 ONE CIVIC SQUARE GUARDIAN AUTO GLASS, LLC CHECK AMOUNT: $397.12 ra CARMEL, INDIANA 46032 24394 NETWORK PLACE CHICAGO IL 60673 -1243 CHECK NUMBER: 194012 CHECK DATE: 1120/2011 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1110 4351000 27225 5205061555 198.56 WINDSHIELD REPAIRS 1110 4351000 27226 5205061564 198.56 WINDSHIELD REPAIRS GUARDIAN AUTO CLASS, LLC GUARDIAN 940 N SHADELAND AVE A Company of Vision INDIANAPOLIS, IN 46219 REMIT TO: (317)353-6178 (800)882-2244 Guardian Auto Glass, LLC MVR# Y 24394 Network Place Chicago, IL 60673 -1243 INVOICE WORK PERFORMED FOR: PA'ft�fENT DF1Ez:DATE CARMEL POLICE DEPT 01/29/2011 3 CIVIC SQ ::::.IN1ttitCE N#SFiBER CARMEL POLICE DEPT CARMEL, IN 46032 5205061555 3 CIVIC SQ 1.2/30/2010 CARMEL, IN 46032 CLAIMANT EDEbtAT TAX .E!:NJA48E£t 27- 3440978 5200087243 ACCOUNT: 121805 HP: WP: 12/29/2010 'z�� pROp45ED ;CL?MP�ETZt1 ;DACE TWC 12/30/2010 08:00 05:0 X I I M HAMILTON '4.FTtlME::[ I OI�E WORI{ FSO1V8 EST.. bAT .::t3F L(}SS CAUSE. OF ;'.LC55. 1iEf3t#t20IfLE 317 -57i -2548 ROBERT "=P0# il>.O. 27226 rEGLs.'ID i3.QENSE;UiFT :I?S1SE�k ,:biI1rEPGE ;SD:?€�yz 3AKEN i31* 2G1 /74 JAMES C LIPTON JWILLIAM 2010 CHEVROLET IMPALA 4 DOOR SEDAN FORbf .Q?,':.QAYMEIIT OPEN CHARGE REPEAT CUSTOMER QTY PART,NUMBER/DESCRIPTION; LIST PRICE UNIT 'PRICE, TOTAL 1 DWO164OGBYN Windshield (W /Third Visor Frit) 022 198.56 2 RAHODOG04 Urethane, Dam, Primer 0.00 0.00 SUBTOTAL 198.56 *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 SURFACE RUS O R CO PRESENT AND TR EATED N W ARRANTY AGAINST LEAKA WHEN CHECKED: DATE CUSTOMER /WITNESS "Safest Installation Always„ TOTAL 198.56 GUARDIAN AUTO GLASS, LLC C I&FMIAN 940 N SHADELAND AVE ACompany of Vision INDIANAPOLIS, IN 4 6219 REMIT TO: (317)353 -6178 (800)882 -2244 Guardian Auto Glass, LLC MVR# Y 24394 Network Place Chicago, IL 60673 -1243 INVOICE WORK PERFORMED FOR: �A:YMEN`T DUE: CARMEL POLICE DEPT 02/04/2011 3 CIVIC SQ Ii�SJ:tCR `iIHER' CARMEL POLICE DEPT CARMEL, IN 46032 5205061564 3 CIVIC SQ ICR DATE CARMEL, IN 46032 CLAIMANT 01/05/2011 FEDERAL. TAX;: .RFt 27- 3440978 5200087283 ACCOUNT: 121805 HP: WP: 01/03/2011 IN5T,: Y.10ROP`CSED.:COMPLET>t3N:DFi E MO D..WE:::.12C.. FR Si SAT. b�..S:IT DMS 01/03/2011 08:00 -05:0 X I- MARION OE* .LC}S:S ,CAUSE OF,: LOS IrEgiIClSBT E 317- 571 -2548 ikUtF�d:$I2kD:'$Yri<. A[3EiIT: S NAMES'.';.'... ..,'i; AGENT: ROBERT :R::.0..:N 32ti$Ek ::UEHrCIE .I3] >'i4UrtBEEk.. ::s� LGkNSE: >VNIT >rIE7�I8kR MSLEACE 2GIWS583281354627 /24 JAMES C LIPTON BSCHRIER YSAF MAKE::; M(7i3:RL 80D`1 :STYLE 2008 CHEVROLET IMPALA 4 DOOR SEDAN L;FQRbT .O ;.PA7ttXENT REFISRR£Td.,zEY. OPEN CHARGE REPEAT CUSTOMER QTY PART:;INUMBER /DESCRIPTYON LIST "UNIT PRICE TOTAL. 1 DWO164OGBYN Windshield (W /Third Visor Frit) 177 198.56 2 HAH000004 Urethane, Dam, Primer 0.00 0.00 SUBTOTAL 19 8.. 5 6 *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 SURFACE RUST OR CORROSION P AND TR EATED NO WA RRANTY A G A INS T LEAKA WHEN CHECKED: DATE CUSTOMER /WITNESS Installation... Always” TOTAL 198.56 INDIANA RETAIL TAX EXEMPT PAGE C 1t of C arme l CERTIFICATE NO. 003120155 002 a PURCHASE ORDER NUMBER FEDERAL EXCISE TAX EXEMPT 35- 60000972 27M5 ONE 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. 'URCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION 999 Guardian Class Company Carmol Police Dopmrtmeht VENDOR SHIP 3 Civic Squam TO 24381 Notwofft Place Castel, IN 4 CI'tic @Sa, IL OMA243 (397) 67i GONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT QUANTITY OF MEASURE DESCRIPTION UNIT PRICE EXTENSION Account 43 9 Each repair windshield $988.66 $988.66 Sub Total: $198.66 All CJ :I P s• •a fc Send Invoice To. i Carmel Police Depmtmont Attn: Toms@ Anderson k 3 Civic Squam PLEASE INVOICE IN DUPLICATE DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT Carmel Police Cep PAYMENT LE S A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT` UNLESS THE HE P- 0. .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 THAL4, E�tE IS AN UNOBLIGATEO BALANCE IN SHIP REPAID. THIS APPROPRIAT U F CIENT 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 9 q x o p 4 AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. CLERK TREASURER DOCUMENT CONTROL No-27 A.P.V. COPY SIGN AND RETURN TO CLERK OFFICE VOUCHER NO. WARRANT NO. ALLOWED 20 IN THE SUM OF ON ACCOUNT OF APPROPRIATION FOR PO# Board Members EP or INVOICE NO. ACCT #MTLE 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 Cast distribution ledger classification if claim paid motor vehicle highway fund INDIANA RETAIL TAX EXEMPT PAGE City C arme l CERTIFICATE NO. 003120155 002 0 PURCHASE ORDER NUMBER FEDERAL EXCISE TAX EXEMPT 35- 60000972 27226 ONE 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 GARMEL 1997 SHIPPING LABELS AND ANY CORRESPONDENCE. DURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VE NDOR NO. DESCRIPTION IJ312011 Guardlan Glass Company Camel Police Department VENDOR SHIP 3 CIVIC Squam TO 24394 Noh;v®rk Place Camol, IN 46032 Chicano, IL 6M-1243 (397) 679 CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION Account 43.610.00 9 Each repair windshield $918.56 M8.30 Sub Total: $108.56 n f i y Send Invoice To:�° Carmol Police Department f Attu: Yerose Anderson 3.CIWc Square Ca IN 414 PLEASE INVOICE IN�DUPLICATE DEPARTMENT ACCOUNT PROJ T PROJECT ACCOUNT AMOUNT Camel Police Dept. PAYMENT $988.56 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 1 I HEREBY CERTIFY �TH9T THERE IS AN UNOBLIGATED BALANCE IN SHIP REPAID. �r THIS APPROPRIAATI c N 5Y1�FFICI ENT TO PAY FOR THE ABOVE ORDER. C.O.D. SHIPMENTS CANNOT BE ACCEPTED. ORDERED BY PURCHASE ORDER NUMBER MUST APPEAR ON ALL SHIPPING LABELS. THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945 TITLE AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. �tt5 2 CLERK TREASURER DOCUMENT CONTROL NO. A.P.V. COPY SIGN AND RETURN TO CLER OFFICE VOUCHER NO. WARRANT NO. ALLOWED 20 IN THE SUM OF r 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 w which charge is made were ordered and received except___ 20 Signature Title Cost distribution ledger classification if claim paid inotor vehicle highway fund VOUCHER NO. WARRANT NO. ALLOWED 20 Guardian Glass Company IN SUM OF 24394 Network Place Chicago, IL 60673 -1243 $39 7.12 ON ACCOUNT OF APPROPRIATION FOR Carmel Police Department PO# Dept. INVOICE NO. ACCT #!TITLE AMOUNT Board Members Prior Year I hereby certify that the attached invoice(s), or 27225 5205061555 43- 510.00 $198.56 bill(s) is (are) true and correct and that the 27226 5205061 564 43 -51 0.00 $198.56 materials or services itemized thereon for which charge is made were ordered and received except Thursday, January 13, 2011 Chief of Police 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)) 12/31110 5205061555 payment for repairs to windshield for car 74 new vehicle $198.56 01105/11 5205061564 payment for repairs to windshield for car 24 R. White $198.56 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