HomeMy WebLinkAbout202133 09/27/2011 CITY OF CARMEL, INDIANA VENDOR: 00350559 Page 1 of 1
ONE CIVIC SQUARE GUARDIAN AUTO GLASS, LLC
CHECK AMOUNT: $199.64
CARMEL, INDIANA 46032 24394 NETWORK PLACE
w o CHICAGO IL 60673 -1243 CHECK NUMBER: 202133
CHECK DATE: 9127/2011
DEPARTMENT ACCOUNT PO NUMBE INVOICE NUMBER AMOUNT DESCRIPTION
1110 4351000 5205064602 199.64 AUTO REPAIR MAINTEN
GU�ARDIAN AUTO GLASS, LLC
C;UAFLDIAN 940 N SHADELAND AVE
A Company o f vision INDIANAPOLIS, IN 46219
REMIT T0:
(317)353 -6178 (800)882 -2244 Guardian Auto Class, LLC
MVR## Y 24394 Network Place
Chicago, IL 60673 -1243
INVOICE WORK PERFORMED FOR:
PAYfEM2 DATE
CARMEL POLICE DEPT 10/12/2011
3 CIVIC SQ ICE;ER
CARMEL, IN 46032 5205064602
CARMEL POLICE DEPT
Ii+1tkOICE I1A�� ':j
3 CIVIC SQ 09/12/2011
CARMEL, IN 46032 CLAIMANT
F��BRAL T1+iX NUMSSR
27- 3440978
—J 5200091195
CtRt1k�2. 21ATE
ACCOUNT: 121805 HP WP 09/08/2011
:Ax ST OMPLETION::D 4 I?F
MH 09/09/2011 08:00 -05:0 X M- HAMILTON
N8
317 -571 -2548
JASON
pf5LICS� >NtftT$E#tl: a N[ 8E#� _d 7R.fl
:ttEHICLE ID:<: ll�is ?EiZ z; c >vNx .::NUMB MIIaEA +CE sus tzsaN A
2G1WS55R979347120 JAMES C LIPTON B9CH RIER
BODi� .S YL
2007 CHEVROLET IMPALA 4 DOOR SEDAN
3 ;F£3RM .0 Rp XMENT
OPEN CHARGE REPEAT CUSTOMER
QTY PART.NUMBER /DESCRIPTION LISVI PRICE UNIT PRICE TOTAL
1 DW01640GBYN Windshield (W /Third Visor Frit) 177 199.64
2 HAH000004 Urethane, Dam, Primer 0.00 0.00
i
i
i
SUBTOTAL —199.64,
*STATEMENT OF AUTHORIZATION AND SATISFACTION i
REPLACEMENT HAS BEEN MADE TO MY SATISFACTION AND I HEREBY AUTHORIZE THE ABOVE SALES TAX 0
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
REPLACEMENTS THE BELOW SIGNED AGREES TO PAY FOR SAID REPAIRS OR REPLACEMENTS. DEDUCTIBLE
I
SURFACE RUST OR CORR0970N PRESENT AND TREATED NO WARRANTY AG AINS T LEAKAGE W HE N C HE C KED: El
DATE CUSTOMER /WITNESS
"Safest Installation Always" TOTAL
149.64
VOUCHER NO. WARRANT NO.
ALLOWED 20
Guardian Glass Company
IN SUM OF
24394 Network Place
Chicago, IL 60673 -1243
$199.64
ON ACCOUNT OF APPROPRIATION FOR
Carmel Police Department
PO# Dept. INVOICE NO. ACCT #!TITLE AMOUNT Board Members
1110 I 5205064602 I 43- 510.00 I $199.64 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, September 22, 2011
2
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))
09/08/11 5205064602 payment for windshield repairs to car 68 Henry $199.64
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