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163514 09/04/2008 CITY OF CARMEL, INDIANA VENDOR: 00350155 Page 1 of 1 ONE CIVIC SQUARE CARMEL AUTO REFINISHING CHECK AMOUNT: $854.00 CARMEL, INDIANA 46032 308 GRADLE DRIVE CARMEL IN 46032 CHECK NUMBER: 163514 CHECK DATE: 9/4/2008 ;7E PARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOU DESCR IPTION 1110 4351000 18915 854.00 CAR REPAIRS CARREL AUTO REFINISHING Federal Tax ID: 0 308 GRADLE DRIVE. Customer No: 1312 Estimate Carmel, IN 46032 Report No: 1342 812612008 Phone (317) 815 -8379 Claim M. Fax (317) 844 -6659 Assign No: Vehicle Information Owner Carmel police dept Accident Location 2008 Nissan Titan Pickup 3 Civic sq Style: 4D SHOR Carmel, IN 46032 Color: Home Phone: (317) 571 -2500 Color Code: Work Phone: (317) Phone #1: Production Date: 0 Fax (317) Phone #2: License: State: IN Insured Claimant VIN: lN6AA07C78N336094 Miles In: 0 Miles Out: 0 Home Phone: (317) Home Phone: (317) Condition: Work Phone: (317) Work Phone: (317) Esttmator: Fax (317) Fax (317) Date Assigned: 7117/2008 Date of Loss: 7/17/2008 Date of Inspection: 7117/2008 Options: 3.3 Liter, Maxima Description of Work Part Number Price Labor Paint Other CAB. CREW CAB. W/O SUNROOF ROOF 8 COMPONENTS Repair Roof panel 12.0* body 3.6 +Clearcoat (1.4) 1.4 Sub Totals 12. THANK YOU FOR LETTING US SERVE YOU Hours Rate Total Body Labor 12.0hrs $42 .001hr $504.00 Paint Labor 3.6hrs $42.00 /hr $151.20 Clearcoat Labor 1.4hrs $42.00 /hr $58.80 Paint Supplies 3.6hrs $28.00 1hr $100.80 Clearcoat 1.4hrs $28.00 /hr $39.20 Tax Non -Taxed Grand Total $854.00 Estimate based on MOTOR CRASH ESTIMATING GUIDE. Unless otherwise noted all items are derived from the Guide. NAGS Part Numbers and Benchmark Prices are provided by National Auto Glass Specifications. Labor operation times listed on the line with the NAGS information are MOTOR suggested labor operation times. NAGS labor operation times are not included. Guide used is (ARF3625). 5/08 Indicates Estimator's Judament T Indicates Taxed Item CCC Comp -Est A product of CCC Information Services Inc. Page 1 of 1 C O INDIANA RETAIL TAX EXEMPT PAGE ily o I' s rmel CERTIFICATE NO. 003120155 002 0. PURCHASE ORDER NUMBER Police Department FEDERAL EXCISE TAX EXEMPT r 35- 60000972 1891 3 WhIE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES, A/P CARMEL, INDIANA 46032 -2584 VOUCHER, DELIVERY MEMO, PACKING SLIPS, SHIPPING LABELS AND ANY CORRESPONDENCE, FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL. 1997 PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION July 18, 2008 repairs to vehicle VENDOR Carmel Auto Refinishing SHIP City of Carmi,l Police Department 308._Gradle Drive TO 3 Civic Square Carmel, IN 46032 Carmel, IN 46032 CONFIRMATION BLANKET CONTRACT PAYMENTTERMS FREIGHT QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION repairs to leased vehicle Dietz 854.00 f v 4 6� is t Send Invoice To: PLEASE INVOICE IN DUPLICATE DEPARTMENT ACCOUNT PROJECT t PROJECT ACCOUNT AMOUNT 1110 510 auto repairs and main ance PAYMENT 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 SWORN AFFIDAVIT ATTACHED. 0 SHIPPING INSTRUCTIONS HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN THIS APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER. SHIP REPAID. C.O.D. SHIPMENTS CANNOT BE ACCEPTED. OR ERED BY PURCHASE ORDER NUMBER MUST APPEAR ON ALL SHIPPING LABELS. THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 5945 TITLE Chief ©f Police AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. CLERK- TREASURER DOCUMENT CONTROL NO. A COPY SiGN AND RETURN TO CLERK'S OFFICE VOUCHER NO. WARRANT NO. ALLOWED 20 IN THE SUM OF ON ACCOUNT OF APPROPRIATION FOR 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 i Signature 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 Carmel Auto Refinishing Purchase Order No 18915F 308 Gradle Drive Terms Carmel, IN 46032 Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) r 8/26/08 a ent for repairs to leased vehicle 854.00 Total 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 VOUCHER NO. WARRANT NO. ALLOWED 20 C armel Auto Refinishing IN SUM OF 308 Gradle Drive Carmel, IN 46032 r 854.00 ON ACCOUNT OF APPROPRIATION FOR p olice genres luf Board Members PO# or INVOICE NO. ACCT #/TITLE AMOUNT DEPT. I hereby certify that the attached invoice(s), or 18915F 510 854.00 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 August 26 2008 Signature Chief of Police Cost distribution ledger classification if Title claim paid motor vehicle highway fund