175244 07/23/2009 CITY OF CARMEL, INDIANA VENDOR: 363101 Page 1 of 1
ONE CIVIC SQUARE GLASS AMERICA CHECK AMOUNT: $174.25
CARMEL, INDIANA 46032 6155 E. 86TH ST., STE E
INDIANAPOLIS IN 46250 CHECK NUMBER: 175244
CHECK DATE: 7/23/2009
ACCOUNT PO NUM INVOICE NUM BER AMOU D
601 5023990 001544170 174.25 TRANS EXPENSES -OUST A
3
OFFICE COPY
GLASS AMERICA #15
6155 EAST 36TH STREET, SUITE E
INDI.ANAPOILI IN 46250
(31 7)570 -0009 Fax: (31 -998
Tax# 30- 0270064
Order: 0015 -44170
Date: 07/13/2.009
Sold To: ScheMed.07 /1Q009
CAn Lrr -ITIES A.TTIT: SCOTT
760 3RD AVE SW
t IN 46032
H (317)571 -2442 Far.(317)571 -2462
Csr Tech: PO T ennsC.O.D
R.et,:blC)USE
VehicleI998 FORD RANG PICKUP 2 DOOR STANDARD CAB
Put/ Des ca�a Iasi; Price material Labor Item Total
1.00 DD1031 PGTN DD49287 )Door Green. Tint- (Fmnt)... 177.50 124.25 50.40 174.25
Notes:TDEY ARE Fff 0 OUT CEMIT rlPP FOR AN-ACCOUNT.—.1
P.0.:21485 07 Expect /13/20 }9 Status:Sent
Job Location Mobile
760 3RD AVE SW
CARNML IN 46032
SEE SCOTT
Was the vehicles condition sufficient for proper application of retention system? Yes No (H No, complete and
attach Vehicle Diagaostic Forma)
D'OTO r Place 3 lot A stickers on store "file copy 1) Goss Akfivator 2)Pinchweld Pier 3)Ureffime
SAFE DRIVE AWAY TIC IS:� Customer It itials:
For nsliet ns o&y, the sealant manufactaiw ncoa =eands you w 4 1 hors attes insWhitsaaa to drive your vehicle.
Sipature: Q Vjk L I zm satisfied with the above work
and ad ize SfaS�agaCc com6ft to dkeetiy pad' Csax ss .rwFae tic
Material Labor T wr Total Deahactable Pets D2Lnce
124.25 50.00 8.70 182.95 0.00 0.00 182.95
GLASS A1V1ERJ.C,A,,
Gl.�,s,-,.Anrierica (dt'.-t "'Corrtpany"� Warrants ma its iristalhoon (I aWnWile, glaSS to be of
worknowsbip aw rnaterial f(-)I' a long as yrvu owvn the �wwwxlde hi which theg, is insitz"'Had,
I'lle ("""�mpany*'S QgatiorD. undl :'s' alias 'warranvy is oxprcssly linnited c), at ihie solo
tior, 0j' ffic the reinstall'iticni, repik ca replaccrnont of the grass, by the )inpany. whoW
in 1,fiw Company opinion. vva defleAvely installed; costs of the reinuAlation repWv or
replac("rnnent of thi g shall, be coveredl, in f[oll by the, (-'on).pany under this Unid ed. warramy,
except tat the (Ampany shall noi, be in Ix for any sales, use, c"wj�se or o�,h�;r tax inckki
to t'ne ""eins!"allation. repair or topjacerne lit ol" 1he glass, which taxes shadl be soh-Ay youir re'sponsi-
bility, lfthe Cornpany is Unable t10 make Lho, or replacQrneuo"_t c Corrip'uny
'Xill refund the originall vhas�,� Inke of s' ghlss. In the cvent. of the, C'orn p�Ul
put
the deibuive glass sh-all become A Propert' of the Company. If You befieve yieu ltzive a prolAo.rn
that is by dbis linnited wavranty,
plo,,�,se contact y(* nearest CJassArnotica tore, hiovicr
to exercise 3murrigigs under t3a iiis youtnust provide ao) invoice aa time ol'your
c.laini '-"'Jdencincs tht installati(ro of the gday by the (.,E'a iTany.
ni,is iiimiic.d s,varran'Ly doe' notapply to (a) any Maass tha', is not instai.!edby the (:,on-,pany. (b',
glass th'aa is modilfic,,J or repaired by anyor, is thalt the (Anpany (c) any dmwgu vwinjng (mt
of any leakage ar the glinq dmt is not awsed Cllr cculy by the cojrlpany�". 'ns"'aflation of the
gla, (d) any damage ariAng unit of of the automobile around the plan tat W wl
caused directly by !he Comlvin,'s installarku of the glam, Further th Cornpany ;s noL ""'or
any incidental, consequeraial €3E special claulage. or expc-;iisc'S' Solne do.n'o( "'Po%v tile' cxu"hu-
sion or limitwitmi ofinciderntal consequential darn.a,"'.�" 's and KIM= the fbivinhig exlusion.
or lin" ni'ay apply to you.
THE 1"OREG WARRADATTE'�S APPL.` ONLA TO THE ORK)U��'AL PUP�'-.HAS.ER A�,ND
ARE! M IJIEIj OF AET MHER TARRAMHES INIP[JED 010
INCLAAMNS WITI-10 OF
ANL') s A']' MRA INUMCUT-AR PTU ITARET ARE, M) YVAIRIVAMERE WHICH
"PI rchawr agrees tht Andd it nCC.ess,-ry to ernpl.oywi. attornk-y to
on.forcc� tart' terms of this contract on the purck= purchaver agrees u)
i rnburso soller all coms oi attorneys 1"ecs, coun, costs.
1 and odwr appli.cable expenses, in, ilig appc'ad"- "-?urchaser ',qr.rces Lo pa.y-
1 .6-1'anco cli""mges £9 per 113onth oD all ovcr"'Juc accounts'"
Prescribed by State Board of Accounts City Form No. 201 (Rev 1995) Z
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice or bill to be properly itemized must show, kind of service, where
performed, dates of service rendered, by whom, rates per day, number of units,
price per unit, etc.
Payee
T0702
GLASS AMERICA Purchase Order No.
6155 EAST 86TH ST STE E Terms
INDIANAPOLIS, IN 46250 Due Date 7/14/2009
Invoice Invoice Description
-Date Number (or note attached invoice(s) or bill(s)) Amount
7/14/2009 001544170 $174.25
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
Date Officer
VOUCHER 092381 WARRANT ALLOWED
T0702 IN SUM OF
GLASS AMERICA
6155 EAST 86TH ST STE E
INDIANAPOLIS, IN 46250
Carmel Water Utility
ON ACCOUNT OF APPROPRIATION FOR
:i Board members
PO INV ACCT AMOUNT Audit Trail Code
001544170 01- 6500 -07 $174.25
,V
'V
Voucher Total $174.25
Cost distribution ledger classification if
claim paid under vehicle highway fund