HomeMy WebLinkAbout198565 06/22/2011 CITY OF CARMEL, INDIANA VENDOR: 361690 Page 1 of 1
ONE CIVIC SQUARE HUBLER EXPRESS COLLISION CHECK AMOUNT: $480.55
CARMEL, INDIANA 46032 503 W CARMEL DR
ti ;o o CARMEL IN 46032 CHECK NUMBER: 198565
CHECK DATE: 6/22/2011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4351000 27803 54335 480.55 REPAIRS
Date: 06/01/2011
Hubler Express Collision Carmel INVOICE
503 West Carmel Drive RO 54335
Carmel, IN 46032
(317) 569 -9884, (317) 569 -9885 (fax) Est: AARON MCGINN
CITY OF CARMEL Chevrolet Impala
C CITY OF CARMEL POLICE
1 CIVIC SQUARE Color: WHITE DEPARTMENT
Type: Police 4 DR Sedan
CARMEL, IN 46032 VIN: 2GiWS57M291308498 Adjustor:
Home: Phone:
Work: Prod Date: 0509 Plate: IN 14211 Claim Deductible: 0
Fax: Mileage: 0 Loss Type:
Engine- 6cyl_Gas 3.9 Li F
P Who P ays? Q =1 Insurance, C Customer)
Sup Labor Paint
Type Description Part Amount Labor O Units P
j
Mldg,Rocker Panel LT Body Rpr 3.0 l 1
Mldg, Rocker Panel LT A Refn I 2.4 1
Mldg Panel LT B Body R &I 0.4 1
1 Parts New Clip,Rocker Panel Mldg LT MULTI -PART 52.32 Body Repl I
1 Parts New Shield,Quarter Inner LT 15952291 38.29 Body Repl 0.5 1
1 Parts New Retainer clips {6} 10431761 28.14 Body Repl I I
f Pnt/Mat MISC Paint &Materials 12-011j 1_ -J
SubTotal 480.55
Taxes 0.00
Grand Total 480.55
D ue from Insurance j Du e from Customer
Sub -Total 480.55 I, Sub -Total 0.00
Tax 0 -00 Tax 0.00
i i
Total 480.55 Total 0.00
Total Amount 480.55
INVOICE #22 06/01/2011 05:20:57 PM RO# 54335 Hubler Express Collision Carmel
Page 1
INDIANA RETAIL TAX EXEMPT PAGE
c i ty O sane l CERTIFICATE NO. 003120155 002 0 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 2
35- 60000972
ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES, A/P
CARMEL, INDIANA 46032 2584 VOUCHER DELIVERY. MEMO, PACKING SLIPS,
FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL 1997 SHIPPING LABELS AND ANY CORRESPONDENCE.
PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION
99
Hublor ftrws Collision CumG Pollco Dopotmont
VENDOR SHIP 3 CIVIC aquae
Met Comol DrIvG TO Carmel, IN 4
Cumel„ IN 4 (317) 579
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Account 43.6iO.M
I Each repairs 4c Mehicia $4 0.53 W80.55
Sub T®tEl: MO.55
n`
VAN
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L
Send Invoice To:
Carmel Pollco Dopaftment
Attn: TGmsa Andarzon
3 Civic squm
Carmel, IN 4&M- PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT I PROJECTACCOUNT AMOUNT
Camel Police
PAYMENT
y
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.
SHIPPING INSTRUCTIONS I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN
T
SHIP REPAID. HIS APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER.
C.O.D. SHIPMENTS CANNOT BE ACCEPTED. 1
PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY
y� p ,,fig
SHIPPING LABELS. Chlo ®T olleo
THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945 TITLES .S
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
CLERK- TREASURER
DOCUMENT CONTROL No.27803 A.P.V. COPY SIGN AND RETURN TO CLERK OFFICE
VOUCHER NO. WARRANT NO.
ALLOWED 20
IN THE SUM OF
S
CSI
ON ACCOUNT OF APPROPRIATION FOR
i
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
Signature
Title
Cost distribution ledger classification it
claim paid motor vehicle highway fund
VOUCHER NO. WARRANT NO.
ALLOWED 20
Hubler Express Collision
IN SUM OF
503 West Carmel Drive
Carmel„ IN 46032
$480.55
ON ACCOUNT OF APPROPRIATION FOR
Carmel Police Department
PO# 1 Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Members
27803 54335 43- 510.00 $480.55 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
Friday, June 17, 2011
k Chief of Police
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
Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
06/01/11 54335 payment for vehicle repairs $480.55
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