169870 03/18/2009 CITY OF CARMEL, INDIANA VENDOR: 362147 Page 1 of 1
ONE CIVIC SQUARE CUSTOM TRUCK AUTO INC
I' CHECK AMOUNT: $76.00
CARMEL, INDIANA 46032 17249 FOUNDATION PARKWAY
WESTFIELD IN 46074 CHECK NUMBER: 169870
CHECK DATE: 3/1812009
DEPARTMENT ACCOUNT P O NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4351000 5335 76.00 AUTO REPAIR MAINTEN
-J
CUSTOM TRUCK AND AUTO, INC
17249 FOUNDATION PARKWAY
WESTFIELD IN 46074
317- 896 -5956
2/24/2009 3:51 PM page 1
Invoice 5335
FIRE DEPARTMENT CARMEL
1 CIVIC SQUARE
CARMEL IN 46032
-fold here
Vehicle :2003 INTERNATIONAL 4300 DT 466
VIN 3HTMNAAL83N585815 Color Red
Fleet Driver 1674
Created :2/5/2009 9:19:41 AM Odometer In 88949
Complete 2/23/2009 10:09:27 AM Odometer Out: 88949
Invoiced :2/23/2009 10:09:27 AM
Contact BOB (664 -0958)
Qty Code/Tech* Reference Description Condition Unit Price Price
1 PM* HD RADIATOR FLUSH New $13.08 $13.08
PM* GENERAL USE LABOR $60.00
RECIRCULATED COO FLUS T HEA CORES
L $60.00
Parts........................ $13.08
Sublet /Misc. $0.00
SHOP SUPPLIES I...... $2.92
Cha $0.00
Sales Tax Tax Exempt 0031201550020 $0.00
Total Due $76.00
Tech Certification
PM IPOJX9QK5MOODY
Any warranties on the item /items sold are those made by the manufacturer. The seller, Custom Truck
and Auto, Inc., hereby expressly disclaims all warranties, either express or implied, including any
implied warranty of merchantability or fitness for a particular purpose, and Custom Truck and Auto,
Inc., neither assumes nor authorizes any other person to assume for it any liability in connection with
the same of this item /items.
PAYMENT IS DUE AT TIME OF REPAIRS UNLESS OTHER ARRANGEMENTS HAVE BEEN MADE
WITH MANAGEMENT.
0
THANK YOU FOR YOUR BUSINESS!
a
III I VIII I II II I I I III
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))
5335 Repair A42 $76.00
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
Custom Truck Auto, Inc.
IN SUM OF
17249 Foundation Parkway
Westfield, IN 46074
$76.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members
1120 5335 43- 510.00 $76.00 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
MAR 2009
Fire Chief
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund