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Home My WebLink About155739 01/23/2008 CITY OF CARMEL, INDIANA VENDOR: 00350559 Page 1 of 1 ONE CIVIC SQUARE GUARDIAN AUTO GLASS CARMEL, INDIANA 46032 12232 COLLECTIONS CENTER DRIVE CHECK AMOUNT: $381.93 CHICAGO IL 60693 CHECK NUMBER: 155739 CHECK DATE: 1/23/2008 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1110 4351000 17317 5205047948 381.93 WINDOW REPLACEMENT I i GUA RDIAN A UTO G GUARDIAN 940 N SHADELAND AVE A Company of Vision INDIANAPOLIS, IN 46219 (317)353 -6178 (800)882 -2244 REMIT TO: INVOICE Guardian Auto Glass WORK PERFORMED FOR 12232 Collections Center Dr. CARMEL POLICE DEPT Chicago, Illinois 60693 3 CIVIC S4 >::<i:> CARMEL, IN 46032 5205047948 CARMEL POLICE DEPT i'iii 3 CIVIC SQ 01/07/2008 CARMEL, IN 46032 CLAIMANT FKDERIiT�: TAX: ::NUMBER«:: 34- 0801385 5200068020 ACCOUNT: 121805 HP WP 01/03/2008 WE:.> R::: »rots... HY.;>;; ZN SS <;8: PIbOPOSEI3: COi�PE:Tat�N,:DA 2E: >.:.:?A:> MO.::: Tit 3I................ 3A.......5�7............... DMS 01/04/2007 08:00 12:0 X M HAMILTON LOSS:.: 317 571 -2548 ►rHarn .;air:. ROBERT >:�Orv3:C.... NUMEE PO# 17317 2G1WF55K449417562 IHOUSE 20 BSCHRIER o... S 2004 CHEVROLET IMPALA 4 DOOR SEDAN ?4••�3F •PI'KME REk OPEN CHARGE YELLOW PAGES QTY PART: :NUMBER /DESCRIPTION LIST PRICE UNIT PRICE TOTAL 1 DB09626GTYN Back Window (Heated)(W /Antenna)(Sol 331.93 1 LABOR 40.00 2 HAH000004 Urethane, Dam, Primer 5.00 10.00 SUBTOTAL 381.93 *STATEMENT OF AUTHORIZATION AND SATISFACTION SALES TAX 0.00 REPLACEMENT HAS BEEN MADE TO MY SATISFACTION AND I HEREBY AUTHORIZE THE ABOVE INSURANCE COMPANY TO PAY DIRECT IN FULL TO GUARDIAN AUTO GLASS FOR SAID INSTALLATION. IF FOR ANY REASON THE INSURANCE COMPANY DOES NOT PAY FOR THESE REPAIRS OR DEDUCTIBLE REPLACEMENTS THE BELOW SIGNED AGREES TO PAY FOR SAID REPAIRS OR REPLACEMENTS. DATE CUSTOMER /WITNESS TOTAL 381.93 Your Satisfaction is Our Guarantee INDIANA RETAIL TAX EXEMPT PAGE C o II Carmel PURCHASE OR CERTIFICATE NO. 003120155 002 0 D Jl DER NUMBER i Police Department FEDERAL EXCISE TAX EXEMPT 35- 60000972 1 317 3 e..., ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES, A/P CARMEL, INDIANA UARE25H4 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 January 4, 2009 window replacement VENDOR Guardian Auto GUss SHIP City of Carmel. Police Department 940 N. Shadeland Avenue TO 3 Civic Square Indianapolis, IN 46119 Carmel, IN 46032 CONFIRMATION BLANKET I CONTRACT PAYMENTTERMS FREIGHT QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION rear window replacement for car. 27 Sedbarry 361.93 f 4 0 3 eve N Send Invoice To:�'� 1 PLEASE INVOICE IN DUPLICATE DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT 1110 510 auto repairs and matntanance 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. SHIPPING INSTRUCTIONS I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN THIS APPROPRIATION SU TO THE ABOVE ORDER. SHIP REPAID. OPRIA C.O.D. SHIPMENTS CANNOT BE ACCEPTED. PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY SHIPPING LABELS. THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945 TITLE AssUtatt Chie -of POli.ce AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. CLERK- TREASURER DOCUMENT CONTROL NO .1 7 3 1 7A.P.V. COPY SIGN AND RETURN TO CLERK'S OFFICE VOUCHER NO. WARRANT NO.. ALLOWED 20 IN THE SUM OF J 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 20 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 Guardian Auto Glass Purchase Order No. 17317F 940 N. Shadeland Avenue Terms Indianapolis, IN 46219 Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) 1/7/08 5205047948 payment for rear windshield replacement 381. 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 Guardian Auto Glass IN SUM OF 940 N. Shadeland Avenue Indianapolis, IN 46219 381.93 ON ACCOUNT OF APPROPRIATION FOR police general fund Board Members PO# or INVOICE NO. ACCT #/TITLE AMOUNT DEPT. I hereby certify that the attached invoice(s), or 5 205047948 510 381.93 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 In nuar3V? 4 20 nR Signature Chief of Police Cost distribution ledger classification if Title claim paid motor vehicle highway fund