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Home My WebLink About203887 11/21/2011 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: $163.09 CARMEL IN 46032 CHECK NUMBER: 203887 CHECK DATE: 11/21/2011 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1110 4351000 27887 55062 163.09 VEHICLE REPAIRS (2 L/ Date: 11/09/2011 Hubler Express Collision Carmel INVOICE 503 West Carmel Drive RO 55062 Carmel, IN 46032 (317) 569 -9884, (317) 569 -9885 (fax) Est: Aaron McGinn CITY OF CARMEL 07 CHEV IMPALA POLICE CITY OF CARMEL POLICE CITY OF CARMEL Color: WHITE DEPARTMENT 1 CIVIC SQUARE Type: PC 4D SED Adjustor: CARMEL, IN 46032 VIN: 2G1WS55R179342039 Phone: Home: Prod Date: 0207 Plate: IN 11910 Claim Deductible: 0 Work: Mileage: 0 Loss Type: Fax: Eng ine: 6- 3.9L -FI P= h Pa ys? (I Insurance, C Customer) Qty Type Description Part Amount Sup Labor Op Labor Paint P Units Units 1 Parts New REAR DOOR LT Body side mldg 19120768 109.89 Body Repl 0.2 0.4 1 REAR DOOR Add for Clear Coat 0.1 1 1 Supplies REAR DOOR Flex Additive 3.00 Body I 1 Haz REAR DOOR Hazardous waste removal 3.00 Body I Pnt/Mat MISC Paint Materials 15.00 0.5 1 SubTotal 163.09 Taxes 0.00 Grand Total 163.09 Due from Insurance 1 Due from Customer J Sub -Total 163.09 Sub -Total 0.00 Tax 0.00 Tax 0.00 Total 163.09 Total 0.00 Total Amount 163.09 INVOICE #22 11/09/2011 08:38:05 AM RO# 55062 Hubler Express Collision Carmel Page 1 INDIANA RETAIL TAX EXEMPT PAGE q fty o f C sane i CERTIFICATE NO. 003120155 002 0 PURCHASE ORDER NUMBER FEDERAL EXCISE TAX EXEMPT 27I7 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. 'URCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION MW 9 bublor Expfuos Collision Cormol Police Dopartmen4 VENDOR SHIP 3 Civic Sg S03 Mst C @rmol Ddys TO Cyr ol, IN Coral„ IN 4 (M) 671 CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT QUANTITY I UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION Account 43-690.03 9 Each repairs to vehicle $963.09 $963.09 Sub Toted: $903.09 O rr A, �e mr L3410 send Invoice To: Cotol P011co @opFAmont Attn: Torm Andomon 3 Citric liiguo Camol, IN 4i PLEASE INVOICE IN DUPLICATE DEPARTMENT ACCOUNT PROJECT I PROJECT ACCOUNT AMOUNT mol Police De pt. 4. PAYMENT 9963.09 A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O. NUMBER IS MADE APART OF THE VOUCHER AND EVERY INVOICE AND VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED. SHIPPING INSTRUCTIONS I HEREBY CERTIFY THAT HEPE IS AN UNOBLIGATED BALANCE IN SHIP REPAID. THIS APPROPRIATIO S F I(31ENT TO PAY FOR THE ABOVE ORDER. ,.O.D. SHIPMENTS CANNOT BE ACCEPTED. ORDERED BY 'URCHASE ORDER NUMBER MUST APPEAR ON ALL Chi O il 'HIPPING LABELS. Chi 01 Pollee HIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945 TITLE (r] NO PCSS AMENOASORV THEREOF AND SUPPLEMENT THERETO. p� n1T �`T CLERK- TREASURER J GU1Y \E CO \RO`NO• COPY -SIGN AND RETURN TO CLERK'S OFFICE VOUCHER NO. WARRANT NO. 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 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)) 11/09/11 55062 repairs to vehicle $163.09 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 $163.09 ON ACCOUNT OF APPROPRIATION FOR Carmel Police Department PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members 27887 I 55062 I 43- 510.00 $163.09 I 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 Wednesday, November 16, 2011 Chief of Police Title Cost distribution ledger classification if claim paid motor vehicle highway fund