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,
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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