155849 01/23/2008 CITY OF CARMEL, INDIANA VENDOR: 00352025 Page 1 of 1
ONE CIVIC SQUARE P F M TRUCK CARE
CARMEL, INDIANA 46032 1402 WEST HANNA AVE CHECK AMOUNT: $272.35
INDIANAPOLIS IN 46217 CHECK NUMBER: 155849
CHECK DATE: 1123/2008
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1 20 4351000 2028278 272.35 AUTO REPAIR MAINTEN
SOUTH— 1402 W. Hanna Ave., Indianapolis, IN 46217
Truck Car Care Center 317 784 -7777 Fax 317 788 -5860
Car &Truck Care Center FISHERS 9501 Corporation Dr., Indianapolis, IN 46256
P O Mitsubishi Fuso 3 ZIONSVILLE 17- 577 -7777
4900 W. 106th St., Zionsville, IN 46077
Group OnSite Services 317- 733 -7777 Fax 317 733 -3979
Date 1114/08 Page: 1 PO Issued by:: Repair Order 2028278
Customer: CARMEL CLAY FIRE DEPARTMENT Vehicle 2002
Address: 2 CIVIC SQUARE Unit 42
City: CARMEL, IN 46032- VIN: 4Z3HAAA843RK92637 LicP 63478
Phone 1 571 -2600 Ext OFF Engine Trans
Phone 2 664 -0958 Ext CELL mileage: 36851 Loc
Op Description Part Description Labor Parts Subtotal
Price
Service Requests:
1. BRAKE CHAMBER LEAKING
HABO 222 CHECKED UNIT OUT FOUND LEFT REAR BRAKE CHAMBER BAD REPLACED CHAMBER AND CHECKED 123.56 130.97.,,254
FOR AIR LEAKS UNIT IS GOOD ADJUSTED ALL BRAKES ON UNIT Y
1.00 30/30 BRAKE CHAMBER 130.75
2.00 COTTER PIN 0.22
OK Bad Recommendation OK Bad Recommendation OK' Bad Recommendation
I hereby authorize the repair work to be done along with the necessary parts Labor: $123.56
and materials and hereby grant you and /or your employees permission to operate Parts: $130.97
the vehicle herein described on streets, highways or elsewhere, at your des- Sublet: $0.00
cretion, for the purpose of testing and /or inspection. An express mechanics Other Fees: $0.00
lien is hereby acknowledged on the above vehicle to secure the amount of re- Shop /EPA $17.82
pairs thereto. I understand that dealer /owner is not responsible for delay or Subtotal: $272.35
other consequence due to the unavailability of parts shipments beyond their Sales Tax: $0.00
control. Not responsible for damage or articles left in car in case of fire,
theft or any other cause beyond our control. Paid By Total: $272.35
WARRANTY IS 120 DAYS OR 6000 MILES WHICH EVER OCCURS FIRST, UNLESS SPECIFIED On Account Paid: $0.00
OTHERWISE! MAY QUALIFY FOR 12 MONTH 12,000 MILE NAPA AUTOCARE NATIONWIDE Pay Ref:
wARRANTx Due: $272.35 IL _j
Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No. 201 (Rev. 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))
Total
I hereby certify that the attached invoice(s), or bill(s), is (are) true and correct and I have audited same iri accordance
with IC 5- 11- 10 -1.6.
20
Clerk- Treasurer
VOUCHER NO. WARRANT NO.
ALLOWED 20
IN SUM OF
ON ACCOUNT OF APPROPRIATION FOR
Board Members
PO# or DEPT. INVOICE NO. ACCT #!TITLE AMOUNT 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
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund