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204838 12/20/2011 CITY OF CARMEL, INDIANA VENDOR: 361690 Page 1 of 1 ONE CIVIC SQUARE HUBLER EXPRESS COLLISON CARMEL, INDIANA 46032 5o3 w CARMEL OR CHECK AMOUNT: $4,525.13 CARMEL IN 46032 CHECK NUMBER: 204838 CHECK DATE: 12/2012011 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1110 4351000 25905 55167 2,326.38 VEHICLE REPAIRS 1110 4351000 25901 55209 1,173.59 REPAIRS 1205 4347500 RO #55175 1,025.16 GENERAL INSURANCE Date: 12/13/2011 Hubler Express Collision Carmel INVOICE 503 West Carmel Drive Carmel, IN 46032 RO 55167 (317) 569 -9884, (317) 569 -9885 (fax) Est: Aaron McGinn CITY OF CARMEL 09 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: 2G1 WS57MX91306661 Phone: Home: 317 -571 -2500 Prod Date: 0509 Plate: IN 14237 Claim VEHICLE #26 Work: Mileage Deductible: 0 Fax: En ine: 6- 3.9L -FI Loss Typ P Who Pays? (I= Insurance, C= Customer Qty Type Description Part Amount Sup Labor Op Labor Paint P Units Units Body FRONT BUMPER GRILLE Flex 1 Supplies Additive 3.00 Body I FRONT BUMPER GRILLE O/H front Body 2.6 1 bumper 1 Parts New FRONT BUMPER GRILLE Bumper 89025047 392.33 Body Repl 3.0 1 cover w/o fog lamps FRONT BUMPER GRILLE Add for 1.2 1 Clear Coat 1 Parts New FRONT BUMPER GRILLE Energy 15886100 197.57 Body Repl I absorber 1 Parts New FRONT BUMPER GRILLE Impact bar 25957549 126.12 Body Repl 1.0 I FRONT BUMPER GRILLE Add for 0.2 1 Clear Coat A 1 Parts New FRONT BUMPER GRILLE Lower 22744452 85.81 Body Rep1 I deflector Parts Other FRONT BUMPER GRILLE Lower Body R &I I grille center w/o SS Parts Other FRONT BUMPER GRILLE Upper Body R &I I grille w/o SS Parts Other HOOD Hood Body Rpr 0.5 2.8 1 HOOD Add for Clear Coat B 1.3 1 1 Supplies HOOD Cover car 5.00 Body 0.2 1 1 Parts New FRONT LAMPS LT Headlamp assy 25958359 286.95 Body Repl 0.3 1 FRONT LAMPS Aim headlamps Body 0.5 1 Parts Other FENDER LT Fender Body Rpr 0.5 2.2 1 FENDER Overlap Major Adj. Panel -0.4 1 FENDER Add for Clear Coat C 0.4 1 1 Parts New FENDER LT Emblem GM 15223484 5.00 Body Repl 0.2 1 Parts Other PILLARS, ROCKER FLOOR LT Body R &I 0.8 1 Rocker molding PILLARS, ROCKER FLOOR Remove Body 0.5 1 decals 1 Body PILLARS, ROCKER FLOOR 5.00 Body 0.2 1 Supplies Corrosion protection Pnt/Mat MISC Paint Materials 327.60 11.7 I SubTotal 2,226.38 Taxes 0.00 Grand Total 2,226.38 Due from Insurance Due from Customer Sub -Total 2,226.38 Sub -Total 0.00 Tax 0.00 Tax 0.00 Total 2,226.38 Total 0.00 INVOICE #22 12/13/2011 01:45:46 PM RO# 55167 Hubler Express Collision Carmel Page 1 Date: 12/1312011 Total Amount 2,226.38 INVOICE #22 12/13/2011 01:45:46 PM RO# 55167 Hubler Express Collision Carmel Page 2 Date: 12115!2011 G Hubler Express Collision Carmel INVOICE 503 West Carmel Drive RO 55209 Carmel, IN 46032 (317) 569 -9884, (317) 569 -9885 (fax) Est: A Brumfield CITY OF CARMEL 07 CHEV IMPALA POLICE TRAVELERS CITY OF CARMEL Color: WHITE Adjustor: 1 CIVIC SQUARE Type: PC 4D SED CARMEL, IN 46032 VIN: 2G1 WS55RX79342900 Claim Home: 317- 571 -2500 Prod Date: Plate: IN 11911 Claim i Work: Mileage: 123456 Deducttiblle: e: 0 8001 0 Fax. En ine: 6- 3.9L-FI Loss Type: Collision P Who Pays. I W Insurance, C Customer W Type Description Part Amount Su p Labor Op Labor Paint P Units Units 1 Parts New FRONT BUMPER GRILLE RT 11517103 4.46 Body Repl I Bumper cover stud 1 Parts New FRONT BUMPER GRILLE Bumper 89025047 392.33 Body Repl 2.0 3.0 1 cover w/o fog lamps FRONT BUMPER GRILLE Add for 1.2 1 Clear Coat Parts Other FENDER RT Fender Body Rpr 1.5 2.2 1 FENDER Add for Clear Coat A 0.9 1 Parts Other FENDER RT Fender liner Body R &I 0.4 1 1 Parts New FENDER RT Emblem GM 15223484 5.00 Body Rep[ 0.2 1 Parts Other PILLARS, ROCKER FLOOR RT Body R &I 0.8 1 Rocker molding 1 Body PILLARS, ROCKER FLOOR Cover 5.00 Body 0.2 1 Supplies car 1 Body PILLARS, ROCKER FLOOR Flex 3 Body Supplies Additive y 1 Body PILLARS, ROCKER FLOOR 5.00 Body 0.2 1 Supplies Corrosion protection Pnt/Mat MISC Paint Materials 204.40 7.3 1 SubTotal 1,173.59 Taxes 0.00 Grand Total 1,173.59 Due from Insurance Due from Customer Sub -Total 1,173.59 Sub -Total 0.00 Tax 0.00 Tax 0.00 Total 1,173.59 Total 0.00 Total Amount 1,173.59 INVOICE #22 12/15/2011 03:01:45 PM RO# 55209 Hubler Express Collision Carmel Paae 1 City of Carmel CE INIANA RETAIL TAX EXEMPT RTIFICATE NO.3 2 0 0155 20 PAGE L PURCHASE ORDER NUMBER 003120155 FEDERAL EXCISE TAX EXEMPT 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 CPTY OF CARMEL 1997 SHIPPING LABELS AND ANY CORRESPONDENCE. PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION 12P1rA 99 Hublor Estpless Calllclan Cumol Police Dopartmo sk VENDOR SHIP 3 Civic @qu SW I tst Cumol Drive TO Carmel, IN 48M C al„ IN 4 (397) 671 CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT Account QUANTVTY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION Account 43-6 IQ,110 9 Each repairs $0 vehicle $2,326.38 $2,328.38 Stab Total: $2,326.38 p yy car 28 Looch C ?r i ,r Send Invoice To: C2mol Pollce DGpa>itmon Attn: game@ Andomon 3 Civic Squaw CarmoI, IN 462- PLEASE INVOICE IN DUPLICATE DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT CwTnel Police Dept. PAYMENT $2,M.33 A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE PO. NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED. SHIPPING INSTRUCTIONS I HEREBY CERTIF TH 7 THERE IS AN UNOBLIGATED BALANCE IN SHIP REPAID. THIS APPROP fR O UFFICIENT TO PAY FOR THE ABOVE ORDER. C.O.D. SHIPMENTS CANNOT BE ACCEPTED. PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY SHIPPING LABELS. ilf o /p r Palle@ THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945 TITLE AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. v CLERK TREASURER DOCUMENT CONTROL No.25905 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 2© Signature Title Cost distribution ledger classification if claim paid motor vehicle highway fund ity INDIANA RETAIL TAX EXEMPT PAGE ®,II 5 k arm CERTIFICATE NO. 003120155 002 0 PURCHASE ORDER NUMBER FEDERAL EXCISE TAX EXEMPT 2Mi 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 99 99 HubloF Exprws Collision C@r of Pollco Mp i' Gnt VENDOR SHIP 3 CIVIC aqum d 4yamal Dflyo TO Carmel, IN 4 Czool„ IN 4 (W) 671- CONFIRMATION BLANKET CO N TR ACT PAYMENT TERMS FREIGHT gg OUANTIITY UNITOF MEASURE DESCRIPTION UNIT PRICE EXTENSION Account 43-690.CD Each 9 Each repairs 8o vehicle $9 $1,973.59 Sub Total: $1.17 rr VA 3 Yy k °t PI cor 83 Dior Send Invoice To: I Cermol Polito Dopaltrnont Attn: 'toms@ Andorson 3 Civic Squaro Cmarol, IN A PLEASE INVOICE IN DUPLICATE DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT CSI Police Dep1, PAYMENT SI 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 HERE IS AN UNOBLIGATED BALANCE IN SHIP REPAID. PPR THIS APPROPRI FICIENT TO PAY FOR THE ABOVE ORDER. ffffjj C.O.D. SHIPMENTS CANNOT BE ACCEPTED- PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED 8Y SHIPPING LABELS. L r l..ff �rS ®II�. THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945 TITLE IQ AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. CLERK- TREASURER DOCUMENT CONTROL NO-25 A.P.V. COPY SIGN AND RETURN TO CLERIC OFFICE VOUCHER NO. WARRANT NO. ALLOWED 20 IN THE SUM OF ON ACCOUNT OF APPROPRIATION FOR n 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 $3,399.97 ON ACCOUNT OF APPROPRIATION FOR Carmel Police Department PO# Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Members 25905 55167 43- 510.00 $2,226.38 I hereby certify that the attached invoice(s), or bill(s) is (are) true and correct and that the 25901 55209 43- 510.00 $1,173.59 materials or services itemized thereon for which charge is made were ordered and received except Friday, December 16, 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)) 12/13111 55167 vehicle repairs $2,226.38 12/15/11 55209 vehicle repairs $1,173.59 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 Document Page 1 of I Hubler Express Collision Carmel INVOICE 503 West Carmel Drive RO 55175 Carmel, IN 46032 (347) 569 -9884, (317) 569 -9885 (fax) Est: Aaron McGinn CITY OF CARMEL 07 CHEV TAHOE 4X4 LS CITY OF CARMEL Color: BEIGE CITY OF CARMEL 31 1 ST AVENUE NW Type: UV 4D UTV Adjustor: CARMEL, IN 46032 VIN: 1GNFK13057J335062 Phone: Home: 317 727 -8507 Prod Date: 0307 Plate: IN 63202 Claim Deductible: 0 Work: Mileage: 0 Loss Type: Fax: Engine: 8-5.3L-Fl P Who Pays? I Insurance, C Customer) Qty Type Description Part Amount SU P Labor Op Labor Paint P Units Units Parts New REAR BUMPER OIH bumper assy Body Ovrh 1.7 1 1 Parts New REAR BUMPER Bumper cover w/o reverse 20951794 553.16 Body Repl 3.4 1 sensing system REAR BUMPER Add for Clear Coat 1.4 1 Parts Other REAR BUMPER Impact bar -Rpr bracket Body Rpr 0.5 1 1 Supplies REAR BUMPER Flex Additive 3.00 Body I 1 Haz REAR BUMPER Hazardous waste removal 3.00 Body I PndMat MISC Paint Materials T: 144.001 1 4.8 I SubTotal 1,025.16 Due from Insurance Due from Customer Taxes 0.00 Sub -Total 1,025.16 Sub -Total 0.00 Tax 0.00 Tax 0,00 Grand Total 1 1,025.16 Total 1,025.16 Total 0.00 Total Amounti 1,025.16 file: /CADocuments and Settings \jpspelbringTocal Settings \Temporary Internet Files \Content.0... 12/12/2011 VOUCHER NO. WARRANT NO. ALLOWED 20 Hubler Express Collision Carmel IN SUM OF 503 West Carmel Drive Carmel, IN 46032 $1,025.16 ON ACCOUNT OF APPROPRIATION FOR Administration Department PO# Dept. INVOICE NO. ACCT #!TITLE AMOUNT Board Members 1205 RO 55175 43- 475.00 $1,025.16 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 Monday, December 19, 2011 Director, Admi istration 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)) 12/12/11 RO 55175 $1,025.16 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