203478 11/09/2011 *f CITY OF CARMEL, INDIANA VENDOR: 361690 Page 1 of 1
ONE CIVIC SQUARE HUBLER EXPRESS COLLISON
CARMEL, INDIANA 46032 503 W CARMEL DR CHECK AMOUNT: $1,910.99
CARMEL IN 46032 CHECK NUMBER: 203478
CHECK DATE: 11/9/2011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4351000 54986 1,220.79 AUTO REPAIR MAINTEN
1110 4351000 27805 55029 690.20 REPAIRS
.Date: 11/02/2011
Hubler'Express Collision Carmel INVOICE
503 West-Carmel -Drive RO 55029
Carmel, IN 46032
(317) 569 -9884, (317) 569 -9885 (fax) Est: A Brumfield
CITY =OF =CARMEL !09 7CffEV qlMPALA -POLICE
CITY OF CARMEL Color. WHITE POLICE CITY OF CARMEL POLICE
1 CIVIC SQUARE Type: PC 4D SED DEPARTMENT
Adjustor.
_CARMEL, :IN 46032 VIN:_2G1 WS57MX91.306661
Home: 317 -571 -2500 Prod Date: Plate: IN unk Phone:
Work: Mileage: unk Claim Deductible: 0
Fax: En ine: 6-3.9L-Fl Loss Type:
P= ho Pays? I Insurance, C Customer
Qty Type Description Part Amount Sa p Labor Op Labor Paint P
Units 'Units
Parts Other FRONT BUMPER GRILLE R &I Body R &I 1.4 1
bumper cover-
Parts Other FRONT BUMPER GRILLE Bumper Body Rpr 6.0 3.0 1
cover w/o fog lamps
FRONT BUMPER GRILLE Add for 1.2 1
Clear Coat
Parts Other FRONT BUMPER GRILLE License Body R &I 0.2 1
bracket
Parts Other FRONT BUMPER GRILLE Upper Body R &I 0.2 1
grille w/o SS
Parts Other FRONT BUMPER GRILLE Lower Body R &1 0.2 1
,grille center .w /o -SS
1 Haz FRONT BUMPER GRILLE 3.00 Body I
Hazardous waste removal
Pnt/Mat MISC Paint Materials 126.00 4.2 1
SubTotal 690.20
Taxes 0.00
Grand Total 690.20
Due from Insurance Due from Customer
Sub -Total 690.20 -Sub -Total 0.00
Tax 0.00 Tax 0.00
Total 690.20 Total 0.00
Total Amount 690.20
INVOICE 4122 -1,1/021201,103:20 PM -RO# 55029 :Hubler•Express Collision Carmel
Paae 1
Date: 11/02/2011
Carmel INVOICE
Collision
Hubler Express
503 West Carmel Drive RO 54986
Carmel, IN 46032
(317) 569 -9884, (317) 569 -9885 (fax) Est: Aaron McG
CITY OF CARMEL 08 Chevrolet Impala ESURANCE
CITY OF CARMEL Color: WHITE Adjustor:
3 CIVIC SQUARE Type: Police 4 DR Sedan Phone:
Carmel, IN 46032- VIN: 2G1 WS583981359128 Claim FXP42061 -02
Home: 317 571 -2523 Prod Date: Plate: IN 13254 Deductible: 0
Work: Mileage-.43508 Loss Type:
Fax: Eng 6c yl Gas 3.9 Liter F
P= ho Pa ys? I Ins C Custom er)
Sup Labor Paint
Qty Type Description Part Amount Labor Op Units Units I P
Sd Rail,Rear Frame RT I Body RprP 1.0 1 I
Sd Rail, Rear Frame RT A Refn 0.6 1
MIdg,Rocker Panel LT 1 Body R &I 0.4 1
1 Parts New Clip,Rocker Panel Mldg LT MULTI -PART 80.46 1 Body Repl I
MIdg,Rocker Panel RT 1 Body R &I 0.4 1
1 Parts New Clip,Rocker Panel Mldg RT MULTI -PART 80.46 1 Body Repl I
Panel, Rear Body 1 Body Rpr 4.0 1
Panel, Rear Body A 1 Refn 1.0 1
Parts Other RR Bumper Cvr Overhaul 1 Body Addl 0.6 1
Cover,Rear Bumper Refn 4.2 1
1 Parts Used Reinf,Rear Bumper SALVAGE 625.00 1 Body Rep] I
PART
1 Parts New Reinf,Rear Bumper RT 20962236 40.34 1 Body Repl I
Reinf,Rear Bumper RT A 1 Refn 0.2 1
1 Parts New Brkt,Rear Bumper Mtg RT 10391196 65.24 1 Body Repl 3.4
Brkt, Rear Bumper Mtg RT A 1 Refn 0.2 1
1 Supplies Flex Additive REFINISH 8.00 Paint Refn I
Set -Up And Measure 1 Frame Rpr 1.0 1
1 Haz Hazardous Waste Removal SUBLET 3.00 Body Subl I
REPAIR
Pull rear body panel 1 Frame Rpr 2.0 1
Pnt/Mat MISC Paint Materials 186.00 1
SubTotal 2,004.50
Taxes 0.00
Grand Total 2,004.50
Due from Insurance Due from Custo
Sub -Total 2,004.50 Sub -Total 0.00
Tax 0.00 Tax 0_00
Total 2,004.50 Total 0.00 f�
Total Amount 2,004.50
n�� r
t
INVOICE #22 11/02/2011 03:24:44 PM RO# 54986 Hubler Express Collision Carmel
Pagel
r 0 INDIANA RETAIL TAX EXEMPT PAGE
S -oEH� Carmel CERTIFICATE NO. 003120155 002 0 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 25767
35- 60000972
ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES, A/P
CARMEL, INDIANA 46032 -2584 VOUCHER, DELIVERY MEMO, PACKING SLIPS,
SHIPPING LABELS AND ANY CORRESPONDENCE.
FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL 1997
DURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION
5P099
Hublor Suprano Collision Caffid P®Uco Dopa>tty m
VENDOR SHIP 3 Civic O#II;Am
SW Mot C @rmGl Drivo TO Carmel, IN 4M
Cumoi„ IN 46 M 671
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
Accou UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Account 43.610.09
I Each repairs 4® vehicle $9,220.79 $9,220.79
Sub Total:
mpalra to car 79 fnit
Send Invoice To:
Cumol P®ilco Department
Attn: Toms& Andorson
3 Citric Squam
Carmol, IN 46=- PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
Carmel Police IDopt. 257,220.
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 THA THERE IS AN UNOBLIGATED BALANCE IN
SHIP REPAID.
THIS APPROPRIATIO SUFFICIENT TO PAYABOVE ORDER.
C.O.D. SHIPMENTS CANNOT BE ACCEPTED. ORDERED BY
PURCHASE ORDER NUMBER MUST APPEAR ON ALL �y
SHIPPING LABELS. IGt ®q Pollen
THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945 TITLE V
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
CLERK- TREASURER
DOCUMENT CONTROL NO-2 576 7 A.P.V. COPY SIGN AND RETURN TO CLERK'S OFFICE
VOUCHER NO.- WARRANT
ALLOWED 20
IN THE SUM OF
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 except
20
Signature
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
INDIANA RETAIL TAX EXEMPT PAGE
C i ty o sane l CERTIFICATE NO.003120155 002 0 li li PURCHASE ORDER NUMBER
:Z
FEDERAL EXCISE TAX EXEMPT 27M5
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.
DURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION
5,f2�49
bubler Expross Collision Comol PollcG Depadmont
VENDOR
SHIP 3 Civic Squm
Sb3 W ost CwmGl Ddvo T O CarmG1, IN 46M
Carmol, IN 4 (W) 53792
CONFIFMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY I UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Account 43.61049
9 Each repairs to vehide $000.20 $000.20
Sub Total: $690.20
0c
lu A\
r 'Q n) �q
ropeirs t r 2 kkLQ dw C0
Send Invoice To: r
Comet Pollce Do p2dmont
Attn: `Pom@ Andorson
3 Civic 0gUam
Carmol, IN 40032- PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
Camel Pol Dept 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 P PER SWORN AFFIDAVIT ATTACHED.
SHIPPING INSTRUCTIONS I HEREBY CERTIFY �FFICIENTTO �-yHERE IS AN UNOBLIGATED BALANCE IN
•SHIP REPAID. THIS APPROPRI OJ3.THE ABOVE ORDER.
C.O.D. SHIPMENTS CANNOT BE ACCEPTED.
PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY
SHIPPING LABELS. IdY� pollco
THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945 r TITLE
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
CLERK- TREASURER
DOCUMENT CONTROL NO. 2 7 8 ®5 A.P.V :v.COPY -SIGN AND RETURN TO CLERK'S OFFICE
VOUCHER NO._ WARRANT NO.
ALLOWED 20
IN THE SUM OF
(f`d
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 except
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
Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
11/02/11 54986 vehicle repairs $1,220.79
11/02/11 55029 vehicle repairs $680.20
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
Hubler Express Collision
IN SUM OF
503 West Carmel Drive
Carmel„ IN 46032
lq�O �9C7'
ON ACCOUNT OF APPROPRIATION FOR
Carmel Police Department
PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members
25767 54986 43 510.00 $1,220.79 I hereby certify that the attached invoice(s), or
bill(s) is (are) true and correct and that the
27805 55029 43 510.00 _$649.2
1 materials or services itemized thereon for
which charge is made were ordered and
received except
Friday, November 04, 2011
Chief of Police
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund