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Home My WebLink About195473 03/16/2011 CITY OF CARMEL, INDIANA VENDOR: 361690 Page 1 of 1 ONE CIVIC SQUARE HUBLER EXPRESS COLLISION CHECK AMOUNT: $1,149.49 CARMEL, INDIANA 46032 503 W CARMEL OR CARMEL IN 46032 CHECK NUMBER: 195473 CHECK DATE: 3/1612011 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1110 4351000 27298 54011 1,149.49 REPAIRS TO CAR 135 Date: 03/08/2011 Hubler Express Collision Carmel INVOICE 503 West Carmel Drive Carmel, IN 46032 RO 54011 (317) 569 -9884, (317) 569 -9885 (fax) Est: Aaron McGinn CITY OF CARMEL 09 CHEV IMPALA POLICE CITY OF CARMEL CITY OF CARMEL Color: WHITE Adjustor: 1 CIVIC SQUARE Type: PC 4D SED CARMEL, IN 46032 VIN: 2G1WS57M891308487 Phone: Home: Prod Date: Plate. IN 14210 Claim A3Z6144001 Work: Mileage: 25383 Deductible: 0 Fax: Engine: 6-3.9L-Fl Loss Type: Collision P Who Pays, (I Insurance, C Customer) Qty Type Description Part Amount Sup Labor Op Labor Paint P Units Units Parts New REAR BUMPER O IH bumper assy B ody Ovrh 2.3 I 1 Parts New SS, POL ICE t POLI R Bumper covey L'T, LTZ 19120961 535.55 Body Repl 3.0 1 LTZ REAR BUMPER Add for Clear Coat 1.2 1 1 Supplies REAR BUMPER Flex Additive 5.00 Body I 1 Parts New REAR LAMPS RT Tail lamp assy 25971598 187.74 Body Repl 0.4 1 Pnt/Mat MISC Paint Materials 117.60 4.2 1 SubTota I 1,149.49 Taxes 0.00 Grand Total 1,149.49 Due from Insurance Due from Customer Sub -Total 1,149.49 Sub -Total 0.00 Tax 0.00 Tax 0.00 Total 1,149.49 Total 0.00 Total Amount 1,149.49 INVOICE #22 03/08/2011 11:46:07 AM RO# 54011 Hubler Express Collision Carmel Pagel INDIANA RETAIL TAX EXEMPT PAGE City o f C sane CERTIFICATE NO. 003120155 002 0 PURCHASE ORDER NUMBER ti FEDERAL EXCISE TAX EXEMPT 27 35- 60000972 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 224,99 Hublor Suproog Collision CmrmGg P®llco Dap l ono VENDOR SHIP 3 CIVIC squam SI3 wbat C2mol Dddo TO Carmal, IN 4 C ol„ IN 41 32 X 9 9 674 CONFIRMATION BLANKET CONTRACT PAYMENTTERMS FREIGHT QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION Account, 4 694.10 9' repairs to vehide $1,949.49 $9,9Q9.49 Sub Total: $1,149.49 `m. r �4 a r' °',w f l a cat 1351 Pads Sd Invoice To: r Cmfmgl Pallco Dop2itmont Attn: Tomem Andoman 3 Civic squam Carmol, IN 4M- PLEASE INVOICE IN DUPLICATE DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT C�rlxlol lAllc� r_.. i j PAYMENT 191949.49 A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O. NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED. SHIPPING INSTRUCTIONS I HEREBY CERTIFY THAT,fH RE IS AN UNOBLIGATED BALANCE IN SHIP REPAID. THIS APPROPRIATI OF CIENTTO PAY ,OR THE ABOVE ORDER. C.O.D. SHIPMENTS CANNOT BE ACCEPTED, ORDERED BY PURCHASE ORDER NUMBER MUSTAPPEAR ON ALL SHIPPING LABELS. rOy ll�(� of THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945 TITLE Ir AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. r) CLERK TREASURER DOCUMENT CONTROL NO C A.P.V. COPY SIGN AND RETURN TO CLERIC'S OFFICE VOUCHER NO. WARRANT NO. ALLOWED 20 IN THE SUM OE$ 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 r W_ Title Cost distribution ledger classification if claim paid motor vehicle highway fund VOUCHER NO. WARRANT NO. ALLOWED 20 Hubler Express Collision IN SUM OF 503 West Carmel Drive Carmei„ IN 46032 $1,149.49 ON ACCOUNT OF APPROPRIATION FOR Carmel Police Department PO# Dept. INVOICE NO. ACCT #(TITLE AMOUNT Board Members 27298 54011 43- 510.00 $1,149.49 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, March 11, 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 invoices) or bill(s)) 03/08/11 54011 payment for repairs to car 135 Paris $1,149.49 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