HomeMy WebLinkAbout163662 09/17/2008 CITY OF CARMEL, INDIANA VENDOR: 357315 Page 1 of 1
tit ONE CIVIC SQUARE CARMEL AUTO DIESEL
;a CARMEL, INDIANA 46032 421 INDUSTRIAL DRIVE CHECK AMOUNT: $81.24
"rrs s� CARMEL IN 46032 CHECK NUMBER: 163662
CHECK DATE: 9/17/2008
DEPARTMENT ACCOUNT PO NUMBER INVO NUMBER T AMOUNT DES CRIPTION
1192 4351000 41028 81.24 AUTO REPAIR MAINTEN
j
Carmel Au Diesel Repair w' I' voice
421 Industrial Drive REC EIVED
Carmel, 11V 46032
GL" -'r �.0N 114VOICE
317- 846 -0661 ROCS V 41028
City of Carmel
BILL TO O INVOICE P.O. "W TER s DATE
CITY OF CARMEL l.Jepl. OT `OIT11T unit Services 8/14/2008
ATT:SUE COY DOCS
1 CIVIC SQUARE
CARMEL, IN 46032 VIN MAKE MODEL
1 FMCU96H36KA26085 FORD ESCAPE HY-
CONTACT YEAR ENGINE SIZE MILEAGE LICENSE
FLEET 94 2006 L4 2.3L 13845 27784
QTY DESCRIPTION TYPE AMOUNT
LUBED CHASSIS, CHANGED ENGINE OIL OIL FILTER, LABOR 15.00
CORRECTED ALL FLUID LEVELS TIRE PRESSURE
REPLACED AIR FILTER
1 7203 OIL FILTER PARTS 8.77
5W20 ENGINE OIL PARTS- OIL 14.30
1 9187 AIR FILTER PARTS 39.77
SHOP SUPPLIES 3.40
I hereby authorize the repair work to be done as described above. I agree to pay for said repair, parts,
and labor upon completion. Any unpaid balance shall constitute a lien on the vehicle listed hereon. A SUBTOTAL $81.24
service charge of 2% per month will apply after 30 days from the date of invoice (annual percentage
rate 24 If collection be required for the payment of this invoice, customer shall be responsible for
the payment of all collection costs, including legal fees and expenses, incurred by Carmel Auto SALES TAX (7.0 $0.00
Diesel Repair, Inc. Any unpaid balance shall constitute a lien on the vehicle mentioned herein. I
further agree that Carmel Auto Diesel Repair, Inc. will not be held responsible for loss or damage to
said machinery from fire, theft, or other causes beyond it's "control." TOTAL $8124
THANK YOU!
PAYMENTSICREDITS $0.00
SIGNATURE
DATE BALANCE DUE $81.24
C)
Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No. 201 (Rea 1995)
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)) I
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.
5 r ALLOWED 20
IN SUM OF
qc) -1
q
ON ACCOUNT OF APPROPRIATION FOR
Board Members
PO# or INVOICE NO. ACCT #/TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
�C 4/o 51 0 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
�S_i rya
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund