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HomeMy WebLinkAbout197096 05/11/2011 CITY OF CARMEL, INDIANA VENDOR: 365268 Page 1 of 1 ONE CIVIC SQUARE BILL KITCHENS BODY SHOP CHECK AMOUNT: $1,081.60 CARMEL, INDIANA 46032 1297 S 10TH STREET NOBLESVILLE IN 46060 CHECK NUMBER: 197096 CHECK DATE: 5/11/2011 DEP ARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1110 4351000 27796 1,081.60 REPAIRS HILL KITCHENS BODY SHOP 1297 S. 10TH ST. NOBLESVILLE IN 46060 Phone: 317 773 -8981 Fax: 317 773 -959.4 License 05/02/2011 LUCKIE CAREY 523 WIND SKIP CR WESTFIELD IN 46074 Insurance Co: Claim Repair Order Re: 2006, CHEV IMPALA POLICE Dear LUCKIE CAREY Enclosed is the documentation for the repair work performed on your vehicle. The following is a breakdown of the billing and payments received. Repair Order Amount: 1103.41 Supplement Amount' (1): 0.00 Supplement Amount' (2): 0.00 Supplement Amount' (3): 0.00 Total Amount: 1103.41 Less Payment Received: Current Balance Owed: Please review your records and issue payment for the current balance due. Thank you for your prompt attention to this matter. Sincerel MICHELLE JE GS OFFICE MANAGER 'Refers to costs for repairs not identified in the original estimate. INDIANA RETAIL TAX EXEMPT PAGE City ®f t rme� CERTIFICATE NO. 003120155 002 0 PURCHASE ORDER NUMBER s �s 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. DURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION 4� Bill Kitchons Body fhop Cwmol Police DGpartmGnt VENDOR SHIP 3 Civic Squmm 9297 S. 4Oth St rwt T O C@rmol, IN 4&W Noblesville, IN 4MM 679 CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION Account 43.610.0 9 Each repairs to vehide $1,081.60 $9,089.80 Saab Total: $9,081.60 TE 77 7 J r, �y to IrAll k; 3 ro olm to csr 125 1 /11C Pit I Send Invoice To: Cmmol Polka DGPEOMOM Attn: Tiamsa Andemon 3 Civic ilqum Carmol, IN 2° PLEASE INVOICE IN DUPLICATE DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT Carmel Police Dept, PAYMENT A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O. .r NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED. SHIPPING INSTRUCTIONS I HEREBY CER I �Y THAT THERE IS AN UNOBLIGATED BALANCE IN SHIP REPAID. THIS APPR T N SUFFICIENT TO PAY FOR THE ABOVE ORDER. C.O.D. SHIPMENTS CANNOT BE ACCEPTED. PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY �a y SHIPPING LABELS. Chid of Polleg 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 7 9 6 A.P.V. COPY -SIGN AND RETURN TO CLERK'S OFFICE VOUCHER NO. WARRANT NO.—_ ALLOWEC? 20 IN THE SUM OF ON ACCOUNT OF APPROPRIATION FOR a 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 Title Cost distribution ledger classification it claim paid motor vehicle highway fund VOUCHER NO. WARRANT NO. ALLOWED 20 Bill Kitchens Body Shop IN SUM OF 1297 S. 10th Street Noblesville, IN 46060 $1,081.60 ON ACCOUNT OF APPROPRIATION FOR Carmel Police Department PO# I Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Members 27796 43- 510.00 $1,081.60 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 Thursday, May 05, 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)) 05/02/11 payment to repair vehicle 1251 Carey $1,081.60 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