160749 06/25/2008 CITY OF CARMEL, INDIANA VENDOR: 3607 72 Page 1 of 1
ONE CIVIC SQUARE AUTO GLASS OF INDIANA INC CHECK AMOUNT: $210.00
CARMEL, INDIANA 46032 8481 BASH STREET
STE 400 CHECK NUMBER: 160749
INDIANAPOLIS IN 46250
CHECK DATE: 6125/2008
DE PARTMENT ACCOUNT P O NUMB IN VOICE NUM AMO UNT DESCRIPTION
601 5023990 32713 210.00 OTHER EXPENSES
ENTERED M,4Y 2 3 ,2008
UT
G
7 A
LASS6
4r
l INDIANAPOLIS
+91 8481 Bash Street, Ste. 400 Indianapolis, IN 46250
r 317 577 -8900 1 -800- 877 -0986 I032713 DATE 1 05/21 /2008
SOUTH WEST CUST.
317 888 -0882 317 271 -8900 SALE
7163939 TYPE I CASHSHOF
1- 800 877 -0986 1- 800 877 -0986
Federal Tax No. CUST. 1 SOLD
35 -18 3609 PO. I BY
FED ID# 203962765
FED. I INSTIL. i
TAX BY
CARMEL WATER DEPARTMENT
3450 W 131 ST
�ESTFIELD, IN 46074
L' J
4
3'17 -716 -3939
YEAR 2006 MAKE'` FORD POLICY
t AI
MODS F SERIES F150 '.BODY DOOR STANDARD C UTHOR
r3 STYLE ►ZED IY
LIC CLAIM LOSS
i.l I VI:N CODE DATE 05/ 19/08
HOMES (31 7) 716- BUS DAMAGE/
P iJ i .PHONE I CAUSE
OT. 4'" PART DESCRIPTION -$LO SIZE LIST PRICE TOTAL
S�
i DW01548GTYN Windshield (slr contr) (W /Th 37.2><70.7 223. 60 116.27 116.27
1 L'''ABOR Labor 2.80 hours 78.73 78.73
1 HAH000004 2.0 Urethane, Dam, Primer 15.00 15.00 15.00
I
o f 1,1-_....na Inc. I
i
0481 E�oG' "t., �zo 400
�a IndianapoiiS, IN 46250
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1 SPECIAL INSTRUCTI Sf_tbt of al 131.27
Auto Glass of Indiana, Inc. hereby warrants that all materials shall be of original equipment quality. Auto Glass of Indiana, Inc. Labor 78. 73
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
Company to pay Auto Glass of Indiana, Inc. directly for the glass and installation charges or repaFs. If for any reason the insurance Total 21
company fails to pay for said installation, I agree to pay for the work myself.
TERMS: 1 per month (18% per annum) F" 'tNCE CHARGE will be added to accounts not. paid by tl 20th of the month 6 a 1 anc. e_____ 2 10. 00
following month of purchase.
Custo `,)er Signature Install Date
Prescribed by State Board of Accounts
Form'No.301 (Rev. 1995) ACCOUNTS PAYABLE VOUCHER
TO
ADDRESS
Invoice Date Invoice Number Item Amount
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
Mo. Day Yr. Signature Title
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- 1 1 -1.6.
Mo. Day Yr. Officer Title
Vouch No. Warrant N o.
ACCOUNTS PAYABLE DETAILED ACCOUNTS
MUNICIPAL WATER DEPT. ANO
NO.
CARMEL, INDIANA Q►��
avor Of
eR
Total Amount of Voucher
Deductions
lQ !!SCD. o r
Amount of Warrant 6
Month of Yr
VOUCHER RECORD Acct.
No.
Source of Suppl
Water Treatment
Transmission and Dist.
Customer Accounts
Administrative and General
Operation-Maintenance
Utility Plant in Service
Constr. Work in Progress
Materials and Supplies
Customers Deposits
Total
Allowed
Board of Control
Filed
Official Title
BOYCE FORMS SYSTEMS 1. 800 -382 -8702 325