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161794 07/23/2008 CITY OF CARMEL, INDIANA VENDOR: 00350431 Page 1 of 1 ONE CIVIC SQUARE DICKINSON FLEET SERVICES, LLC CHECK AMOUNT: $25.00 CARMEL, INDIANA 46032 PO BOX 66724 INDIANAPOLIS IN 46266 CHECK NUMBER: 161794 CHECK DATE: 7/2312008 DEPART ACCOUNT PO NUMBER I NVOICE NUMBER AM DESCRIPTION 2201 4351000 573073 25.00 AUTO REPAIR &.MAINTEN I i Dickinson Fleet Services, LLC 14693 5 7 3 0 7 3 DICKINSON Indianapolis Service Center (Main Office) UNIT# MISC 4709 West 96th Street INVOICE Indianapolis, IN 46268 CARMEL STREET DEPT FLEET (317) 872-4542 3400 W 131ST ST SERVICES Fax (317) 872-7624 WESTFIELD IN 46074 PAGE 1 HOME:317-733-2001 BUS:317-733-2005 SERVICE ADVISOR: 115 SANDBLASTING UNIT� NO,.:�::x:� :�:�i��]:��ii:�:���MILEAGE.,IN/.:O.UT;* E/MO DEL_ YEAR. 08 MISCELLANEOUS MISCEL CITYOFCARMELMISC. MISCF 1 1 1 1. 11.1. 1. I :��i':':DATE �::PAYMENT INV� P �O NO IS I 23:00 02JUL08 CHG 11JUL08 R.O. OPENED. COMPLETED -1 COMMENTS: 06:54 02JUL08 12:26 11JUL08 LINE OPCODE TECH TYPE HOURS LIST NET TOTAL A SANDBLAST OIL PAN 68 DETAIL, CLEAN-UP 1999CSAND 25.00 25.00 PARTS: 0.00 LABOR: 25.00 OTHER: 0.00 TOTAL LINE A: 25.00 EST: 25.00 02JUL08 06:54 SA: 115 PLEIASE REMIT TO: DICKINSON FLEET SERVICES, LLC STA'rENIENT OF DISCLAINIER DESCRIPTION :TOTALS P.O. BOX 66724 ANY WARRANTIES ON THE, PARTS AND LABOR AMOUNT 25.00 ACCESSORIES SOLD HEREBY ARE MADE BY F PARTS AMOUNT INDIANAPOLIS, IN 46266-6724 THE MANU R. DICKINSON FLEET 0. 00 SERVICES, LLC MAKES NO WARRAN 01: ANY KIND, EXPRESS OR IMPLIED, AND GAS, OIL, LURE 0.00 DISCLAIMS ALL WARRANTIES of: SUBLET AMOUNT 0 00 CUSTOMER ACKNOWLEDGMENT MERCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE, 'A'11'11 REGARDS TO MISC. CHARGES 0.00 CUSTOMER ACKNOWLEDGES THAT HE HAS INSPECTED THE THE SERVICE. PARTS. LABOR. AND/OR REPAIRS TO THE VEHICLE ON THIS INVOICE AND THE REPAIRS ACCESSORIES PURCHASED AND THAT IN No TOTAL CHARGES 25 00 MEET 'IT CUS'T'OMERS TOMERS REQUIREMENTS AND EXPECTATIONS. S ERVICE S U iWENT SHALL FLEET SE 'I_C BE A FOR INCIDENTAL 6R CUSTOM LESS LR FURTHER AGREES To PAY THE INVOICE IN F L.L. 0.00 CONSEQUEN DA MAGE S OR COMME AS SHOWN. WITHOUT DEDUCTION OR SET OFF. LOSS A R IS[ N(; Our Of SUCH PURCHASE. SALES TAX 0. 00 PLEASE PAY CUSTOMER SIGNATURE THIS AMOUNT 2 5 QO CUSTOMER COPY 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)) 07/02/08 573073 $25.00 1 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 Dickinson Fleet Services IN SUM OF 4 6th Street India 46268 $25.00 ON ACCOUNT OF APPROPRIATION FOR Carmel Street Department PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members 2201 573073 43- 510.00 $25.00 1 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, July 17, 2008 Street &mm issioner Title Cost distribution ledger classification if claim paid motor vehicle highway fund