HomeMy WebLinkAbout156090 02/06/2008 CITY OF CARMEL, INDIANA VENDOR: 360772 Page 1 of 1
ONE CIVIC SQUARE AUTO GLASS OF INDIANA INC
CARMEL, INDIANA 46032 8481 BASH STREET CHECK AMOUNT: $204.22
STE 400
o CHECK NUMBER: 156090
INDIANAPOLIS IN 46250
CHECK DATE: 2/612008
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
601 5023990 032081 204.22 6500.05DPENSES
I
1 GL o
INDIANAPOLIS
8481 Bash Street, Ste. 400 Indianapolis, IN 46250 INV. 1 03 208 1. DATE 171 v I 2 71 y
317 577 -8900 1- 800 877 -0986
SOUTH WEST CUST. 7 1 6 3 93 9 SALE C= AGH` I P
317 888 -0882 317 271 -8900 TYPE
1- 800 877 -0986 1- 800 877 -0986
Federal Tax No. CUST. SOLD
35- 1823609 F L D# 20. -3r 62 65 P.O. BY
1 FED. INSTL.
TAX BY
CARMEL WATER L'iEPARTMF:"NT
34:_ 0 W 131 ST
f IN 4
J
3 i.'" —716 -3939
73 3 sue
YEAR c_002' MAKE DODGE `POLICY
MODEL CARAVAN BODY I VAN AUTHOR
STYLE ]ZED BY
LIC. CLAIM LOSS
V.I.N. CODE DATE
HOME 317) 71.6 3939 BUS DAMAGE/
PHONE PHONE CAUSE
QT. PART DESCRIPTION BLOCK SIZE LIST PRICE TOTAL
1 .GW61.'22418BNN W.i.nd th i e ld 43x66 21.0. Self 115. E,7 115. 67
I LABOR Labor 2. 90 hofar 70.. 00 7(6 00
1 HAH>zl�++Z►Q�04'. 0 Ur: thane, Tian,, P r I oo Ii2l. 00. 10.
1 WFC_:;b1c:c:8 Fi:l?Fr, (Black) (Strip) 8.55 8.55 8.55
i
s
SPECIAL INSTRUCTIONS
s_tbtuta1 '1:34.2-2
Auto Glass of Indiana, Inc. hereby warrants that all materials shall be of original equipment quality. Auto Glass of Indiana, Inc. I a b imi r 70. 0171
further warrants that the replacement glass and all seals, gaskets, and bonding, therefore, will not leak as long as the customer
owns said vehicle, and if a leak does occur and is deemed faulty installation, we will repair the leak at no
charge.
Auto Glass Of Indiana, Inc. installation methods shall be safe and in full compliance with auto glass installation meth-
ods recommended by the applicable manufacturer of each vehicle. We further warrant that we will promptly and
courteously respond to all customer complaints on a timely basis.
The glass listed has been replaced repaired with like kind and quality to my entire satisfaction, and I authorized my Insurance T 4 2:2
Company to pay Auto Glass of Indiana, Inc. directly for the glass and installation charges or repairs. If for any reason the insurance
company fails to pay for said installation, I agree to pay for the work myself.
TERMS: 1 per month (18% per annum) FINANCE CHARGE will be added to accounts not paid by the 20th of the month Ba 1 ancC 204. 22
following month of purchase.
Customer Signature Install Date
VOUCHER 074532 WARRANT ALLOWED
360772 IN SUM OF
AUTO GLASS OF INDIANA4 0
8481 BASH STREET
SUITE 400 A
INDIANAPOLIS, IN 46250 �ERgi`
Carmel Water Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
032081 01- 6500 -05 $204.22
Voucher Total $204.22
Cost distribution ledger classification if
claim paid under 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 of service rendered, by whom, rates per day, number of units,
price per unit, etc.
Payee
360772
AUTO GLASS OF INDIANA INC Purchase Order No.
8481 BASH STREET Terms
SUITE 400 Due Date 1/28/2008
INDIANAPOLIS, IN 46250
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
1/28/2008 032081 $204.22
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
Date Officer