169840 03/18/2009 CITY OF CARMEL, INDIANA VENDOR: 00350155 Page 1 of 1
i' ONE CIVIC SQUARE CARMEL AUTO REFINISHING
0 CHECK AMOUNT: $780.38
308 GRADLE DRIVE
1a CARMEL, INDIANA 46032
CARMEL IN 46032 CHECK NUMBER: 169840
CHECK DATE: 3118/2009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 R4351000 19012 780.38 REPAIRS TO CAR 47
CARMEL. AUTO REFINISHING
Federal Tax ID: 0
Estimate Carmel, GRADLE DRIVE. Customer No: 1536
Carmel, IN 46032 Report No: 1573
212612009 Phone (317) 815 -8379 Claim A5C4815001
Fax M (317) 844 -6659 Assign No:
Vehicle Information Owner Carmel Police Dept. Car 47 Accident Location
2007 Chevrolet Impala 3 civic square
Style: 4D SED POLICE 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 WS55R179342039
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: 2/26/2009 Date of Loss: 2/26/2009 Date of Inspection: 2/2612009
Options: Part Color
Description of Work Part Number Price Labor Paint Other
FRONT BUMPER GRILLE BUMPER COMPONENTS
Replace Front Bumper cover, w/o fog lamps 89025047 $392.33 1.7* body 3.0
+Clearcoat (0.7 0.7
FRONT BUMPER GRILLE GRILLE COMPONENTS
Replace Front Lower grille, center, LS, LT, LTZ, 10333711 $68.75
POLICE
Sub Totals
THANK YOU FOR LETTING US SERVE YOU
Hours Rate Total
Body Labor 1.7hrs $42.00 /hr $7T
Paint Labor 3.Ohrs $42.00 /hr $126.00
Clearcoat Labor 0.7hrs $42.00 /hr $29.40
OEM Parts $461.08
Paint Supplies 3.Ohrs $25.00 /hr $75.00
Clearcoat 0.7hrs $25.00 /hr $17.50
Tax Non -Taxed
Grand Total $780.38
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 (DR1CB06). 11/08
Indicates Estimator's Judament
T Indicates Taxed Item
CCC Comp -Est A product of CCC Information Services Inc.
Page 1 of 1
0 INDIANA RETAIL TAX EXEMPT PAGE
l o f C anal CERTIFICATE NO. 003120155 002 0 F
�i \�1// lS.�s. li PURCHASE ORDER NUMBER
Police Department FEDERAL EXCISE TAX EXEMPT
35- 60000972 1 o 1)
3 ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICE CARMEL, INDIANA 46032 -2584 VOUCHER, DELIVERY MEMO, PACKING SHIPPING LABELS AND ANY CORRESPON
FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL 1997
PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION
Decenber 18. 2 08 repairs to veh &le
VENDOR Carmel Auto Refinishing SHIP City of Carmel Police Department
308 Gradle Drive TO 3 Civic 0quafe
Carmel, IN $6032 Carmel, IN 46032
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
repairs to car 47 819.13
j
t
m mg
Send Invoice To:
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
1110 510 auto repairs and maintena ce 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
VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED.
SHIPPING INSTRUCTIONS 1 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. /f
PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDE RED B
'l'lf,E'�.l�.r.au"
SHIPPING LABELS.
THIS ORDER ISSUED IN COMPLIANCE WITH'CHAPTER 99 ACTS 1945 TITLE Chief of Police
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
CLE RK- TREASURER
DOCUMENT CONTROL NO A�Pg 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
receivedexcept
20
Signature
Title
i
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
Carmel Auto Refinishing Purchase Order No. 19012RF
308 Gradle Drive Terms
Carmel, IN 46032 Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
2/26/09 a ent for repairs to car 47 Lytle 780.38
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.
il ALLOWED 20
Carm Auto Refinishing IN SUM OF
308 Gradle Drive
Carmel, IN 46032
780.38
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
190129 510 780.38 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
March 12 2009
ignature
Assistant Chief of Polic
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund