HomeMy WebLinkAbout205197 01/05/2012 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: $1,145.80
CARMEL IN 46032 CHECK NUMBER: 205197
CHECK DATE: 1/5/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 R4351000 27950 55232 1,145.80 REPAIRS
f 71
Date: 12122/2011
Hubler Express Collision Carmel INVOICE
503 West Carmel Drive RO 55232
Carmel, IN 46032
(317) 569 -9884, (317) 569 -9885 (fax) Est: Aaron McGinn
CITY OF CARMEL 09 CHEV IMPALA POLICE
CITY OF CARMEL Color: WHITE TRAVELERS
1 CIVIC SQUARE Type: PC 4D SED Adjustor:
CARMEL, IN 46032 VIN: 2G1WS57M191307388 Phone:
Claim EMC3460001
Home: 317 -571 -2500 Prod Date: Plate: IN 14251
Work: Mileage: Deductible: 0 Loss Type: Collision
Fax: Engine: 6- 3.9L -FI
P Who Pays? (I insurance, C Customer)
Qty Type Description Part Amount Sup Labor Op Units Units P1
FRONT BUMPER GRILLE 0IH front 1 Body 2.6 1
bumper
1 Parts New FRONT- BUMPER GRILLE Bumper 89025047 392.33 Body Repi 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 Upper 10333709 84.95 Body Repl I
grille w/o SS
1 Parts New FRONT BUMPER GRILLE Lower 10333711 68.75 Body Rep] I
grille center wlo SS
1 Supplies FRONT BUMPER GRILLE Flex agent 3.00 Body Repl I
1 Parts New FRONT BUMPER GRILLE impact bar 25957549 126.12 1 Body Repl 1.0 1
FRONT BUMPER GRILLE Add for 1 0.2 1
Clear Coat A
1 Parts New FRONT BUMPER GRILLE Lower 22744452 68.53 1 Body Repl I
deflector
Pnt/Mat MISC Paint Materials 151.20 5.4 I
SubTotal 1,444.45
Taxes 0.00
Grand Total 1,444.45
Due from Insurance Due from Cust
Sub -Total 1,444.45 Sub -Total 0.00
Tax 0.00 Tax 0.00
Total 1,444.45 Total 0.00
Total Amount 1,444.45
t" YCA
INVOICE #22 12/22/2011 07:51:38 AM RO# 55232 Hubler Express Collision Carmel
Page 1
INDIANA RETAIL TAX EXEMPT PAGE
Cn ®f CERTIFICATE NO. 003120155 002 0 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 270
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.
DURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION
999
HublorEnpro s.Doliision CarmolPolleoDap@rtmow4
VENDOR :w. w SHIP 3 Civic Squam
SM Mgt Camel Wye TO Cartel, IN 41
Carmel, IN 4M (397) 6711
CONFIRMATION BLANKET CONTRACT PAYMENTTERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION y UNIT PRICE EXTENSION
Account 43.6%0
9 Each repairs vehide $945.$0 94
Sub Total: 1'45.80
r !�1 _4 J
5 ev
kpt
wr 940 Layoa
Send Invoice To:
Attn: Tomsa Anderoon a
3 Civic Squara
Czrmel, IN 4 PLEASE INVOICE IN DUPLICATE
I I
DEPARTMENT ACCOUNT 1 PROJECT PROJECT ACCOUNT AMOUNT
Caramel Police Dept. a PAYMENT
WP VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O.
NUMBER 1S MADE A PART OF THE VOUCHER AND EVERY INVOICE AND
VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED.
SHIPPING INSTRUCTIONS I HEREBY CE TIFY THAT THERE IS AN UNOBLIGATED BALANCE IN
SHIP REPAID.
THIS APP R11 ION SUF CIENfTO PAY FOR THE ABOVE ORDER.
C.O.D, SHIPMENTS CANNOT BE ACCEPTED.
PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY,
s°
SHIPPING LABELS.
THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945 TITLE.
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
CLERK TREASURER
DOCUMENT CONTROL NO. 27 9 50 A.P.V. COPY SIGN AND RETURN70 CLERK'S OFFICE
VOUCHER NO. WARRANT NO.
ALLOWED 20
IN THE SUM OF$
ON ACCOUNT OF APPROPRIATION FOR
Y .F
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.
Hubler Express Collision ALLOWED 20
IN SUM OF
503 West Carmel Drive
Carmel„ IN 46032
$1,145.80
ON ACCOUNT OF APPROPRIATION FOR
Carmel Police Department
PO# Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Members
Prior Year Encumbered I hereby certify that the attached invoice(s), or
27950 55232 43- 510.00 $1,145.80
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
Tuesday, January 03, 2012
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))
12/22/11 55232 repairs to car 140 Loveall $1,145.80
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