177624 09/29/2009 CITY OF CARMEL, INDIANA VENDOR: 362147 Page 1 of 1
ONE CIVIC SQUARE CUSTOM TRUCK AUTO INC
CARMEL, INDIANA 46032 17249 FOUNDATION PARKWAY CHECK AMOUNT: $1,380.72
WESTFIELD IN 46074
CHECK NUMBER: 177624
CHECK DATE: 9/2912009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMB A DESCRIPTION
1120 4351000 6893 1,380.72 AUTO REPAIR MAINTEN
f f
CUSTOM TRUCK AND AUTO, INC
17249 FOUNDATION PARKWAY
WESTFIELD IN 46074
317 896 -5956
9/16/2009 9:45 AM page 1
Invoice 6893
FIRE DEPARTMENT CARMEL
1 CIVIC SQUARE
CARMEL IN 46032
fold here
Vehicle 1996 KME FIRE ENGINE 44 FIRE TRUCK CUMMINS M11
VIN 1 K9AF4288TNO58336 Color Red -White
Fleet 44
Created :9/16/2009 9:41:01 AM Odometer In 0
Complete 9/16/2009 9:44:57 AM Odometer Out 0
Invoiced 9/16/2009 9:44:57 AM
Contact BOB (664 -0958)
Qty Code/Tech' Reference Description Condition Unit Price Price
1 DM' 50 GALLON FUEL TANK New $1,068.73 $1,068.73
REPAIR WORK COMPLETED ON PREVIOUS WORKORDER 6690
2 DM' TANK STRAPS New $103.77 S207.54
1 DM' FREIGHT CHARGE 84.45 5 84.45
Labor........................ $0.00
Parts $1,276.27
Sublet/Misc. $0.00
SHOP SUPPLIES $20.00
Charges I............... $84..45
Sales Tax Tax Exempt 0031201550020 $0.00
Total Due $1,380.72
Tech Certification
DM JS91R2PE9MOFFI
Any warranties on the item /items sold are j W
KE�E,P
and Auto, Inc., hereby expressly disclaims
implied. warranty of merchantability or fitne
Inc., neither assumes nor authorizes any o'_'
the same of this item /items.
A, U9
PAYMENT IS DUE AT TIME OF REPAIR wq U �k
WITH MANAGEMENT.
THANK YOU FOR YOUR BUSINESS!
a
IIIIII IIIIIIIIIIIII IIII
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))
6893 $1,380.72
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
ClAtomt Truck Auto, Inc.
IN SUM OF
17249 Foundation Parkway
Westfield, IN 46074
$1,380.72
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members
1120 6893 43- 510.00 $1,380.72 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
C E D 2 o c 90 9 9
Fire Chief
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund