204257 12/06/2011 CITY OF CARMEL, INDIANA VENDOR: 361690 Page 1 of 1
0 ONE CIVIC SQUARE HUBLER EXPRESS COLLISON CHECK AMOUNT: $5,499.14
CARMEL, INDIANA 46032 503 W CARMEL DR
ti �o CARMEL IN 46032 CHECK NUMBER: 204257
CHECK DATE: 12/6/2011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4351000 27949 55074 2,617.35 REPAIRS
1110 4351000 25895 55100 591.25 REPAIRS TO CAR 122
1110 4351000 25893 55101 1,323.99 VEHICLE REPAIRS -CAR 8
1110 4351000 27941 55109 966.55 REPAIRS TO VEHICLE
Date: 11/22/2011
Hubler xpress Collision Carmel INVOICE
503 West Carmel Drive RO 55101
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: 2G1WS55R279342860 Phone:
Home: 317 571 -2500 Prod Date: Plate: IN 11908 Claim ESA7447001
Work: Mileage Deductible: 0
Fax: Eng ine: 6- 3.9L -FI Loss T Collision
P Who Pa ys? Ins C Customer)
Qty Type Description Part Amount Sup Labor Op I Units 1 Units Labor Paint P
Parts Other QUARTER PANEL LT Quarter panel Body Rpr 5.0 2.2 1
QUARTER PANEL Add for Clear Coat 0.9 1
Parts Other QUARTER PANEL Fuel door Body R &I 0.3 1
Parts Other QUARTER PANEL Fuel door Bind 0.2 1
1 Parts New QUARTER PANEL LT Emblem flying 10424491 39.59 Body Repl 0.2 1
impala
Parts Other QUARTER PANEL LT Wheelhouse liner Body R &I 0.3 1
1 Sublet QUARTER PANEL LT Qtr glass GM 19120720 66.00 1
QUARTER PANEL Set -up pull LT Qtr Body Rpr 1.5 1
Parts Other REAR DOOR LT Outer panel Bind 1.0 1
Parts Other REAR DOOR LT Belt w'strip Body R &I 0.3 1
Parts Other REAR DOOR LT Body side mldg` Body R &I 0.2 I
Parts Other REAR DOOR LT Handle, outside Body R &I 0.3 I
REAR DOOR Clean &Retape side Body Rpr 0.2 I
molding
Parts Other REAR DOOR LT R &I trim panel Body R &I 0.4 I
Parts Other REAR LAMPS LT Tail lamp assy Body R &I 0.4 1
Parts Other REAR LAMPS License lamp Body R &I 0.2 1
Parts Other REAR BUMPER Bumper cover w/o Body Rpr 1.5 2.6 1
dual exh
REAR BUMPER Add for Clear Coat A 1.2 1
Parts Other REAR BUMPER R &I bumper cover Body R &I 1.1 1
REAR BUMPER Remove police decals Body Rpr 1.5 1
1 Supplies REAR BUMPER A/M Car cover 5.00 Body Repl 0.2 1
1 Supplies REAR BUMPER Flex additive 3.00 Body Repl I
1 Supplies REAR BUMPER Corrosion protection 5.00 Body Repl 0.2 1
1 Parts Other REAR BUMPER Glass urethane kit 15.00 I 1
Pnt/Mat MISC Paint Materials 226.80 8.1 1
SubTotal 1,323.99
Taxes 0.00
Grand Total 1,323.99
Due fro Insura _D ue from Cu
Sub -Total 1,323.99 Sub -Total 0.00
Tax 0.00 Tax 0.00
Total 1,323.99 Total 0.00
Total Amount 1,3 23.99
INVOICE #22 11/22/2011 04:13:53 PM RO# 55101 Hubler Express Collision Carmel
Pagel
l lA➢ Date: 11/18/2011
Hubler Express Collision Carmel INVOICE
503 West Carmel Drive RO 55074
Carmel, IN 46032
(317) 569 -9884, (317) 569 -9885 (fax) Est: Aaron McGinn
CITY OF CARMEL 09 CHEV IMPALA POLICE TRAVELERS
CITY OF CARMEL Color: WHITE Adjustor:
1 CIVIC SQUARE Type: PC 4D SED Phone:
CARMEL, IN 46032 VIN: 2G1WS57M291307836 Claim ESA6253001
Home: 317 571 -2500 Prod Date: Plate: IN 14212 Deductible: 0
Work: Mileage. 58350 Loss Type: Collision
Fax: Engine: 6-3.9L-Fl
P Who Pays? I Insurance, C Customer)
Qty Type Description Part Amount S Labor Op a is Units P1
1 Parts New PILLARS, ROCKER FLOOR RT 19256957 187.98 Body Repl 0.8 2.1 1
Rocker molding
PILLARS, ROCKER FLOOR Add for 0.4 1
Clear Coat
Parts Other PILLARS, ROCKER FLOOR RT Body Rpr 4.0 1.3 1
Uniside assy
PILLARS, ROCKER FLOOR Add for 0.5 1
Clear Coat A
Parts Other PILLARS, ROCKER FLOOR RT Body R &I I
Weatherstrip
Parts Other PILLARS, ROCKER FLOOR RT Body R &I I
Carpet retainer rear ebony
Parts Other PILLARS, ROCKER FLOOR RT Body R &I I
Carpet retainer front ebony
1 Parts New FRONT DOOR RT Door shell 19178064 826.59 Body Repi 4.8 3.0 1
FRONT DOOR Overlap Major Non -Adj.
Panel 0.2 I
FRONT DOOR Add for Clear Coat B 0.6 1
FRONT DOOR Add for mirror Body 0.3 1
Parts Other FRONT DOOR RT Belt w'strip Body R &I I
1 Parts New FRONT DOOR RT Body side mldg 19120771 122.98 Body Repl 0.3 0.5 1
FRONT DOOR Overlap Minor Panel -0.2 1
FRONT DOOR Add for Clear Coat C 0.1 1
Parts Other FRONT DOOR RT Applique 2nd design Body R &I I
Parts Other FRONT DOOR RT Mirror assy w/o Body R &I I
defogger smooth
Parts Other FRONT DOOR RT R &I trim panel Body R &I I
Parts Glass FRONT DOOR RT Door glass GM Body R &I I
Parts Other FRONT DOOR RT Run channel Body R &I I
Parts Other FENDER RT Fender Bind 1.1 1
Parts Other FENDER RT Fender liner Body R &I 0.4 I
1 Parts New FENDER RT Emblem GM 15223484 5.00 Body Repl 0.2 1
Parts Other FRONT LAMPS RT Headlamp assy Body R &I 0.3 1
Parts Other FRONT BUMPER GRILLE R &I Body R &I 0.7 1
bumper cover Loosen
Parts Other REAR DOOR RT Outer panel Bind 1.0 1
Parts Other REAR DOOR RT Belt w'strip A Body R &I 0.3 1
Parts Other REAR DOOR RT Body side mldg A Body R &I 0.2 1
Parts Other REAR DOOR RT Handle, outside w/o Body R &I 0.3 1
chrome
REAR DOOR Clean &Retape Body Rpr 0.2 1
Parts Other REAR DOOR RT R &I trim panel A Body R &I 0.4 1
REAR DOOR Remove police decals Body 1.0 1
REAR DOOR anchor pull Body Rpr 2.0 1
1 Supplies REAR DOOR Cover car 5.00 Body Repl 0.2 1
1 Supplies REAR DOOR Corrosion protection 5.00 Body Repl 0.2 1
Pnt/Mat MISC Paint Mat erials 285.60 10.2 1
INVOICE #22 11/18/2011 08:03:19 AM RO# 55074 Hubler Express Collision Carmel
Page 1
y X.
Date 11/18/2011
sup Labor Paint
Qty Type Description Part Amount Labor Op Units Units P
SubTotal 2,61735
Taxes 000
Grand Total 2,61735
Due from Insurance Due from Customer
Sub -Total 2,617 35 Sub -Total 000
Tax 0 00 Tax 000
Total 2,617 35 Total 000
Total Amount 2,617 35
INVOICE #22 11/18/2011 08 03 19 AM RO# 55074 Hubler Express Collision Carmel
Page 2
Date: 11/17/2011
Hubler Express Collision Carmel INVOICE
503 West Carmel Drive RO 55100
Carmel, IN 46032
(317) 569 -9884, (317) 569 -9885 (fax) Est: Aaron McGinn
CITY OF CARMEL 06 FORD E250 4X2 CARGO CITY OF CARMEL POLICE
CITY OF CARMEL Color: GREY DEPARTMENT
1 CIVIC SQUARE Type: VN 3D VAN Adjustor:
CARMEL, IN 46032 VIN: 1FTNE24W36DA03882 Phone:
Home: 317 571 -2500 Prod Date: Plate: unk
Work: Mileage: 71000 Claim Deductible: 0
Fax: Engine: 8- 4.6L -FI Loss Type:
P Who Pa ys? Ins urance, C Customer)
Qty Type Description Part Amount S Labor Op Labor Paint
Uni Units �P
REAR BUMPER O/H rear bumper Body 1.0 1
1 Parts New REAR BUMPER Step bumper primed CP2Z17906E 351.85 Body Repl 1.6 1
REAR BUMPER Add for Clear Coat 0.7 1
REAR BUMPER add for step pad Body 0.3 I
1 Supplies REAR BUMPER Corrosion protection 10.00 Body Rep[ I
Haz REAR BUMPER Hazardous Waste 3.00 Body Subl I
Removal
Pnt/Mat MISC Paint Materials 64.40 2.3 1
SubTotal 591.25
Taxes 0.00
Grand Total 591.25
Due from Insur ance Due from Customer
Sub -Total 591.25 Sub -Total 0.00
Tax 0.00 Tax 0.00
Total 591.25 Total 0.00
Total Amount7 591.25
INVOICE #22 11/17/2011 11:01:05 AM RO# 55100 Hubler Express Collision Carmel
Pagel
P
Date: 11/18/2011
Hubler Express Collision Carmel INVOICE
503 West Carmel Drive RO 55109
Carmel, IN 46032
(317) 569 -9884, (317) 569 -9885 (fax) Est: Aaron McGinn
CITY OF CARMEL 10 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: 2G1WD5EM4Al224846 Phone:
Home: 317 571 -2500 Prod Date: 0310 Plate: IN 15083 Claim Deductible: 0
Work: Mileage: 16412 Loss Type:
Fax: Engine: 6-3.9L-Fl
P Who Pa ys? (I Insurance, C Custom
Qty Type Description Part Amount Sup Labor Op Labor Paint P
Parts New REAR BUMPER OM bumper assy Body Ovrh 2.3 I
1 Parts New REAR BUMPER Bumper cover LT, 19120961 535.55 Body Repl 3.0 1
LTZ, SS, POLICE
REAR BUMPER Add for Clear Coat 1.2 1
1 Supplies REAR BUMPER Flex Additive 3.00 Body I
1 Haz REAR BUMPER Hazardous waste 3.00 Body I
removal
Pnt/Mat MISC Paint Materials 126.00 4.2 1
SubTotal 966.55
Taxes 0.00
Grand Total 966.55
Due from Insurance Due from Customer
Sub -Total 966.55 Sub -Total 0.00
Tax 0.00 Tax 0.00
Total 966.55 Total 0.00
Total Amount 966.55
INVOICE #22 11/18/2011 03:19:25 PM RO# 55109 Hubler Express Collision Carmel
Pagel
C 4 INDIANA RETAIL TAX EXEMPT PAGE
ny cArmel CERTIFICATE NO. 003120155 002 0 li PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 26
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
'URCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION
99f oWl
Hubler Exproa9 Collision Cumel Police Department
VENDOR SHIP 3 CIVIC squm
SM wit Cool Ddvo Te Cotei, IN 40M
Comol„ IN 4 (397) 671
CONFIRMATION BLANKET CONTRACT PAYMENTTERMS FREIGHT
A ccount g8 UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Account 43.6iO.M
1 Each repairs 90 vehicle $1,323.99 $1 ,323.99
Sub Total: $1,323.99
v
Send Invoice 0 Hughes {0 Cv
Camel Police Dopartmontt
Attn: Teresa Anderson
3 Chic squam
Carries, IN 412= PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
Cwmel Police Dept. Z T PAYMENT $113M.99
I 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 THE E IS AN UNOBLIGATED BALANCE IN
SHIP REPAID.
THIS APPROPRIATION S F IENT TO PAY FOR THE ABOVE ORDER.
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 wi
of Poll cc)
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
CLERK- TREASURER
DOCUMENT CONTROL NO. 2 5 8 9 3 A.P.V. COPY SIGN AND RETURN TO CLERK'S OFFICE
VOUCHER NO. WARRANT NO.
ALLOWED 20
IN THE SUM OF
C1
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 t y o Carmel CERTIFICATE N0.003120155 002 0 1i PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 27940
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.
PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. tVENDOR NO DESCRIPTION
99f2t2419
HublerExprass ColRsl ®n Cwffl0l Pollco DepadmGnt
VENDOR
SHIP 3 Civic squam
SM Mot C2tel DdvG TO Carmel, IN
Cumal, IN 48M �397j5o9
CONFIRMATION BLANKET CONTRACT PAYMENTTERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
fi,ccount 43 -610.00
9 Each repairs 8® vohicle $2,617.35 $2,617.35
Sub Total: $2,617.35
rT
Tie
Send Invoice To 2 l �GOVI4
Cwmol Police DepmdmGn4
Attn: Tarosa AndGrmon
3 Citric Squam
41:
CwmGI, IN 2= PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT P EJECT PROJECT ACCOUNT AMOUNT
Carmel Police Dept. PAYMENT $2,617'35
J 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 CERT FY THAT THERE IS AN UNOBLIGATED BALANCE IN
SHIP REPAID.
THIS APPROP ATI N SUFFICIENT TO, PAY FOR THE ABOVE ORDER.
C.O.D. SHIPMENTS CANNOT BE ACCEPTED.
PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY hid SHIPPING LABELS. hiGtl 0?
Pollee
THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945 TITLE
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
CLERK TREASURER
DOCUMENT CONTROL No-27949 A.P.V. 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
INDIANA RETAIL TAX EXEMPT PAGE
City 'o f C armel CERTIFICATE NO. 003120155 002 0 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 29
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
PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION
IOA=i I
Hubl Express Collision Carmel Police Depa@rrment
VENDOR
SHIP 3 Civic Squara
S3 West Carmel Drive TO Cumol, IN
Carol„ IN 4M (317) 589 2
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Account 43 -690.0
9 Each repairs to dehids $855.55 $955.55
Sub Total: $968.55
G..`...
ZIQ
IQ
r 0
car 9S 1 Dawson tl 0
Send Invoice To:
Camel Police DopitmG t
Attn: Toms@ A nderson
3 CIVIC squm
Carol, IN PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT I PROJECT ACCOUNT AMOUNT
Carmel Police Dept. PAYMENT •55
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 PRO ER SWORN AFFIDAVIT ATTACHED.
I HEREBY CERTIFY f f THERE IS AN UNOBLIGATED BALANCE IN
SHIPPING INSTRUCTIONS THIS APPROPR T
SHIP REPAID. FFICIENT TO Y FOR THE ABOVE ORDER.
C.O.D. SHIPMENTS CANNOT BE ACCEPTED. ORDERED BY
PURCHASE ORDER NUMBER MUST APPEAR ON ALL ,p
SHIPPING LABELS. Qr 87
Polica
THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945 TITLE I
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
a CLERK TREASURER
�d
DOCUMENT CONTROL NO. A.P.V. COPY SIGN AND RETURN TO CLERK'S OFFICE
VOUCHER NO. WARRANT NO._
ALLOWED 20
IN THE SUM OF
Cori
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
df C INDIANA RETAIL TAX EXEMPT PAGE
0 sane l CERTIFICATE NO. 003120155 002 0
1i PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 2
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.
PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION
990�9i2099
HISblerExpress Collision Carmel Police Department
VENDOR
SHIP 3 CIVIC Square
5M West CwmGI Drive TO Cm rmGi, IN 4
Camel, IN 46 (W) 6791
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Account 43. 610.00
9 Each repairs to vehicle $621.09 $621.09
Stab Total: $621.09
a
car 122 Elliott
Send Invoice To:
�,f I
Carmel Police Department
Attn: Torusa Anderson
3 CIVIC Square
Carmel, IN 4 PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
Carmel Police Dept. C c PAYMENT M1•09
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 T�ERE IS AN UNOBLIGATED BALANCE IN
SHIP REPAID.
THIS APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER.
C.O.D. SHIPMENTS CANNOT BE ACCEPTED. ORDERED BY
PURCHASE ORDER NUMBER MUST APPEAR ON ALL
SHIPPING LABELS.
THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945 TITLE
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
CLERK TREASURER
DOCUMENT CONTROL No.25895 A.P.V. COPY SIGN AND RETURN TO CLERIC'S OFFICE
VOUCHER NO. WARRANT NO.
ALLOWED 20
IN THE SUM OF
S
ON ACCOUNT OF APPROPRIATION FOR
Board Members
PO# or INVOICE NO. ACCT #ITITLE 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 e
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))
11/17/11 55100 car repairs 122 Elliott $591.25
11/18/11 55074 car repairs car 2 Gerdt $2,617.35
11/18/11 55109 car repairs car 15 Dawson $966.55
11/22/11 55101 car repairs car 8 Hughes $1,323.99
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. WARRA NO.
ALLOWED 20
Hubler Express Collision
IN SUM OF
503 West Carmel Drive
Carmel„ IN 46032
$5,499.14
ON ACCOUNT OF APPROPRIATION FOR
Carmel Police Department
PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members
25895 55100 43- 510.00 $591.25 I hereby certify that the attached invoice(s), or
bill(s) is (are) true and correct and that the
27949 55074 43- 510.00 $2,617.35
materials or services itemized thereon for
27941 55109 43- 510.00 $966.55 which charge is made were ordered and
25893 55101 43- 510.00 $1,323.99 received except
Thursday, December 01, 2011
Chief of Police
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund