HomeMy WebLinkAbout196055 03/29/2011 CITY OF CARMEL, INDIANA VENDOR. 354974 Page 1 of 1
ONE CIVIC SQUARE PENSKE COLLISION REPAIR CENTER CHECK AMOUNT: $461.58
CARMEL, INDIANA 46032 PO BOX 40319
INDIANAPOLIS IN 46240 CHECK NUMBER: 196055
CHECK DATE: 3/29/2011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOU DESCRIP
1110 4351000 27294 461.58 REPAIRS TO CAR 143
RO: 0001538.00 Detailed Customer Invoice Page: 1
816,943 3/15/11 2:39PM 77,449
Penske Collision
4100 E. 96th Street
Indianapolis, IN 46240
Phone: (317)817 -0125 Fax: (317)817 -0164
CARMEL POLICE Date of Loss: CITY OF CARMEL
3 CIVIC SQUARE Year: 09
CARMEL, IN 46032 Make: CHEV
Model: IMPALA POLICE
Home: 317 -733 -4600 Type: PC Phone:
Work: Style: 4D SED Fax:
Est.: JOHN Engine: 6- 3.9L -FI Adjuster:
Received: 3/14/11 Color: WHITE Claim PO- -27294
Del. Date: License: Policy:
Date Paid: Mileage: 1 Betterment:
VIN: 2G1 WS57M891306965 Deductible:
Ln. Description Parts Labor Units Refin Units Other
1 FRONT DOOR
2 LT Mirror assy w/o defogger gr 147.35 0.30 0.60
3 Add for Clear Coat 0.10
4 LT R &I trim panel 0.40
5 HAZARDOUS WASTE DISPOSAL 3.00
6 LT Outer panel (Stay Below Mid 3.00 1.40
7 Overlap Minor Panel -0.20
8 Add for Clear Coat 0.50
901 Parts Discount/Markup -7.37
913 Paint Materials 46.80
919 Clear Coat Paint Materials 15.60
Totals 147.35 3.70 2.40 58.03
Total Category Rate Units Est. Suppl. Total
BODY LABOR 42.00 3.70 155.40 155.40
PAINT LABOR 42.00 2.40 100.80 100.80
OEM PARTS 139.98 139.98
PM 62.40 62.40
SUBLET NT 3.00 3.00
Subtotals 6.10 461.58 461.58
Grand Total: 6.10 461.58 461.58
Notes
PO SCANNED CITY OF CARMEL
THE SELLER, PENSKE PAINT BODY HEREBY DISCLAIMS ALL WARRANTIES, EITHER EXPRESS OR IMPLIED
INCLUDING ANY IMPLIED WARRANTY OF MERCHANT ABILITY OR FITNESS FOR A PARTICULAR PURPOSE AND
PENSKE BODY PAINT NEITHER ASSUMES NOR AUTHORIZES ANY OTHER PERSON TO ASSUME FOR IT ANY
LIABILITY IN CONNECTION WITH THE SALE OF THE PRODUCTS.
RO: MOMS 00 Detailed Customer Invoice Page: 2
816,943 3/15/11 2:39PM 77,449
Penske Collision
4100 E. 96th Street
Indianapolis, IN 46240
Phone: (317)817-0125 Fax: (317)817-0164 Signature Date
:r
INDIANA RETAIL TAX EXEMPT PAGE
Cny f C lS.rs. rme l CERTIFICATE NO. 003120155 002 0 PURCHASE ORDER NUMBER
`S.J�
FEDERAL EXCISE TAX EXEMPT 2M
35- 60000972
ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES, AIP
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
21`14MI i
Pensho Collision RepmlrCanter Camel Police Department
VENDOR SHIP 3 Civic Square
P.O. Bolt Me TO Carmel, IN
Indlempolia, IN 4WOM19 (W 59
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
Accou QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Account 43.610 Li!
I Each repairs to vehicle $461.58 $481.58
Sub Total: $481.58
a�
a
e 4
S ter, ..a.m• ,,��c
repairs to cier 943 t Semester Z/ I j 6 e
Send Invoice To: m m
Camel Police Department
Attn: Teas@ Andors ®n
3 Civic squm
Carmel, IN PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT I PROJECT ACCOUNT AMOUNT
Camel Police Dept. �•j PAYMENT 9.
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 SWO4RN AFFIDAVIT ATTACHED.
SHIPPING INSTRUCTIONS I HEREBY CERTIFYTHATTF{ REj AN UNOBLIGATED BALANCE IN
SHIP REPAID.
THIS APPROPRIATIOp U I OVE ORDER.
C.O.D. SHIPMENTS CANNOT BE ACCEPTED.
PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY s'
SHIPPING LABELS. CI�I ®1 1�"�ll�l`y�
THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945 TITLE
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
CLERK TREASURER
DOCUMENT CONTROL NO. 2 7 2 9 4 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
j
Board Members
PO# or INVOICE NO. ACCT #(TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
bili(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
VOUCHER NO. WARRANT NO.
ALLOWED 20
Penske Collision Repair Center
IN SUM OF
P.O. Box 40319
Indianapolis, IN 46240 -0319
$461.58
ON ACCOUNT OF APPROPRIATION FOR
Carmel Police Department
PO Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Members
27294 43- 510.00 $461.58 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
Wednesday, March 23, 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))
03/15/11 payment for repairs to car 143 Semester $461.58
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