174256 07/08/2009 F CITY OF CARMEL, INDIANA VENDOR: 00350155 Page 1 of 1
ONE CIVIC SQUARE CARMEL AUTO REFINISHING CHECK AMOUNT: $2,143.74
CARMEL, INDIANA 46032 308 GRADLE DRIVE
CARMEL IN 46032 CHECK NUMBER: 174256
CHECK DATE: 7/812009
DEPARTME ACC OUNT PO NUMBER INVOICE N UMBE R AMOUNT DESCRIPTION
,L110 4351000 20998 2,143.74 REPAIRS TO CARS 76
INVOICE Federal AUTO REFINISHING
Federal Tax ID: 0
308 GRADLE DRIVE. Customer No: 1660
Estimate Carmel, IN 46032 Report No: 1699
611812009 Phone (317) 815 -8379 Claim
Fax M (317) 844 -6659 Assign No:
VeAicle Information Owner Carmel Police Dept. Car 76 Accident Location
2003 Chevrolet Impala 3 civic square
Style: 4D SED Carmel, IN 46032
Color: Home Phone: (317) 571 -2500
Color Code: Work Phone: (317) Phone #1:
Production Date: 0 Fax (317) Phone #2:
License: State: IN Insured Claimant
VIN: 2G1 WF55K039313097
Miles In: 0
Miles Out: 0 Home Phone: (317) Home Phone: (317)
Condition: Work Phone: (317) Work Phone: (317)
Estimator: Fax (317) Fax (317)
Date Assigned: 5/22/2009 D ate o f Loss: 5 /22/2009 Date of Inspection: 5/22/2009
Description of Work Part Number Price Labor Paint Other
FRONT BUMPER BUMPER COMPONENTS. W/O IMPALA SS
Replace Front Bumper cover, Impala 12335505 $375.00 2.0* body 3.0*
+Clearcoat (1.2 1.2
FRONT BUMPER GRILLE COMPONENTS
Replace Front Grille 10289769 $126.02 Included
HOOD HOOD COMPONENTS
Replace Hood 19120224 $558.02 1.0 body 3.0
+Underside (1.5) +Clearcoat (1.2 2.7
FENDER FENDER COMPONENTS
Blend Right Fender 1.0
Blend Left Fender 1.0
'Other operations
R &I right bodyside mldg 0.4* body*
R &I left body side mldg 0.4* body*
Repair clean adhesive 1.0* body*
Sub Totals
THANK YOU FOR LETTING US SERVE YOU
Hours Rate Total
Body Labor 4.8hrs $45.00 /hr $2:1
Paint Labor 9.5hrs $45.00 /hr $427;WL
Clearcoat Labor 2.4hrs $45.00 /hr' $108.00
OEM Parts $9;059.04
Paint Supplies 9.5hrs $28.00 /hr $266:00
Clearcoat 2.4hrs $28.00 /hr $67.20
Tax Non -Taxed
Grand Total $2,143.74
Estimate based on MOTOR CRASH ESTIMATING GUIDE. Unless otherwise noted all items are derived from the Guide. NAGS Part Numbers and
Benchmark Prices are provided by National Auto Glass Specifications. Labor operation times listed on the line with the NAGS information are MOTOR
suggested labor operation times. NAGS labor operation times are not included. Guide used is (DR1CB00). 5/09
Indicates Estimator's Judament
T Indicates Taxed Item
CCC Comp -Est A product of CCC Information Services Inc.
Page 1 of 1
C 4 INDIANA RETAIL TAX EXEMPT PAGE
1� ®CERTIFICATE NO. 003120155 002 0 f llll�....� PURCHASE ORDER NUMBER
Police Department FEDERAL EXCISE TAX EXEMPT
35- 60000972 )nQG
39 -NI.R 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
May 28 2009 vehicle tepairs
VENDOR Carmel Auto Refinishing SHIP City of Carmel Police Department
308 Gradle Drive TO 3 Civic Square
Carmel, IN 46032 Carmel, IN 46032
CONFIRMATION BLANKET CONTRACT PAYMENTTERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
repairs to car 76 Williams 2,143.74
CA
Send Invoice To: Y10 H
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
1210 510 auto reppris and maintenance/-
J/ 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
J VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED.
SHIPPING INSTRUCTIONS I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN
SHIP REPAID. THIS APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER.
C.O.D. SHIPMENTS CANNOT BE ACCEPTED. J'
PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY A" .fl D I l /�il
SHIPPING LABELS.
THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945 TITLE Chief of Police
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
J 9 9 CLERK TREASURER
DOCUMENT CONTROL NO.
A.P. .COPY -SIGN AND RETURN TO CLERK'S OFFICE
VOUCHER NO. WARRANT NO.
c°
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
receivedexcept
20
Signature
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
PrescritrCd by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No. 207 (Rev. 7995)
i
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
Carmel Auto Refinishing Purchase Order No. 20998F
308 Gradle Drive Terms
Carmel, IN 46032 Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
p ayment for vehicle repairs to car 76 WIlliams 2,143.74
Total
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. WARRANT NO.
ALLOWED 20
J'
C armel Auto Refinishing IN SUM OF
308 Gradle Drive
Carmel, 1N 46032
2,143.74
ON ACCOUNT OF APPROPRIATION FOR
police general fund
Board Members
PO# or INVOICE NO. ACCT #/TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
20998F 510 2,143.74 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
June 30 20 09
Signature
Chief of Police
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund