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Home My WebLink About204578 12/13/2011 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: $2,375.05 CARMEL IN 46032 CHECK NUMBER: 204578 CHECK DATE: 12/13/2011 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1110 4351000 25892 55119 2,375.05 VEHICLE REPAIRS -CAR 1 Date: 12/02/2011 Hubler Express Collision Carmel INVOICE 503 West Carmel Drive RO 55119 Carmel, IN 46032 (317) 569 -9884, (317) 569 -9885 (fax) Est: Aaron McGinn CITY OF CARMEL 07 DODG RAM 1500 4X4 MEGA CAB SLT CITY OF CARMEL POLICE CITY OF CARMEL Color: WHITE DEPARTMENT 1 CIVIC SQUARE Type: TK 4D P/U Adjustor: CARMEL, IN 46032 VIN: 3D7KS19D77G781142 Phone: Home: 317 571 -2500 Prod Date: Plate: IN 11780 Claim ESA7747001 Work: Mileage Deductible: 0 Fax: Engine: 8-5.7L-Fl Loss Ty Collision P Who Pays?(I= Insurance, C Customer) Qty Type Description Part Amount Sup Labor Op Labor Paint P Units Units Parts Other REAR DOOR RT Outer panel Body Rpr 4.5 2.4 1 REAR DOOR Add for Clear Coat 1.0 1 Parts Other REAR DOOR RT Run channel Body R &I 0.2 1 Parts Glass REAR DOOR RT Door glass Dodge Body R &I 0.5 1 Parts Other REAR DOOR RT R &I trim panel Body R &I 0.3 1 1 Parts New REAR DOOR RT Handle, outside 55275684AB 62.85 Body Repl 0.3 1 1 Parts New REAR DOOR RT Belt w'strip 55277030AD 40.00 1 Body Rep1 0.3 1 Parts Other CAB RT Aperture panel Body Rpr 5.5 2.0 1 CAB Overlap Major Adj. Panel -0.4 1 CAB Add for Clear Coat A 0.3 1 Parts Other CAB RT Upper seal Body R &I 0.1 1 1 Parts New CAB Nameplate MEGA CAB 55077837AA 41.20 Body Repl 0.2 Parts New PICK UP BOX RT Side panel 1 Body Rpr 15.0 3.1 1 PICK UP BOX Overlap Major Non -Adj. 1 -0.2 1 Panel PICK UP BOX Add for Clear Coat B 1 0.6 1 Parts Other PICK UP BOX R &I tailgate assy Body R &I 0.3 1 Parts Other PICK UP BOX R &I box assy Body R &I 2.5 1 Parts Other PICK UP BOX Front panel Blnd 1.2 1 Parts Other REAR LAMPS RT Tail lamp Body R &I 0.3 1 Parts Other REAR BUMPER R &I bumper assy Body R &I 0.8 1 1 Supplies REAR BUMPER Cover car 5.00 Body Repl 0.2 1 1 Supplies REAR BUMPER Corrosion protection 10.00 Body Repl 0.5 1 REAR BUMPER Remove police decals Body Rpr 1.5 1 REAR BUMPER Truck cap Body R &I 1.0 1 Pnt/Mat MISC Paint Materials 280.00 10.0 I SubTotal 1 2,375.05 Taxes 0.00 Grand Total 2,375.05 Due from Insurance Due from Customer Sub -Total 2,375.05 Sub -Total 0.00 Tax 0.00 Tax 0.00 Total 2,375.05 Total 0.00 Total Amount 2,375.05 INVOICE #22 12/02/2011 08:48:10 AM RO# 55119 Hubler Express Collision Carmel Pagel l f INDIANA RETAIL TAX EXEMPT PAGE City of r." 1el CERTIFICATE NO. 003120155 002 0 PURCHASE ORDER NUMBER x 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, SHIPPING LABELS AND ANY CORRESPONDENCE. FOAM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL 1997 'URCHASE ORDER DATE DA REQ UIRED REQUISITION NO. VENDOR NO. DESCRIPTION I MOW I ublGP Euprass Cailialon Caum of Police DGpai tP ont VENDOR SHIP 3 Civic Squm SM Wo&t CumGl Drive TO CumGl, IN 4I Camel„ IN 4 (317) 67 CONFIRMATION BLANK CONTRACT PAYMENTTERMS FREIGHT QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION Account 431 -610.09 4 Each repairs 1c vehide $3,195.25 $3,195.23 Sub Total: $3,195.25 pr� _4.... °j r x P 12� f C t��»fI c� Send invoice To: Attn: Tomsa Anderaen 3 Civic Squam C@fMGI, IN 4124 PLEASE INVOICE IN DUPLICATE DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT Carmel Police Dept. PAYMENT $3,195.25 1 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 THERE IS AN UNOBLIGATED BALANCE IN SHIP REPAID. THIS APPROPRIATIF I[ENT 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 P�II�G THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945 TITLE AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. DOCUMENT CONTROL NO. 2 5 892 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 VOUCHER NO. WARRANT NO. ALLOWED 20 Hubler Express Collision IN SUM OF 503 West Carmel Drive Carmel„ IN 46032 $2,375.05 ON ACCOUNT OF APPROPRIATION FOR Carmel Police Department PO# Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Members 25892 I 55119 I 43- 510.00 $2,375.05 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, December 08, 2011 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)) 12/02/11 55119 repairs to car 126 Graham $2,375.05 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