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Home My WebLink About168007 01/21/2009 CITY OF CARMEL, INDIANA VENDOR: 00350559 Page 1 of 1 s ONE CIVIC SQUARE GUARDIAN AUTO GLASS CHECK AMOUNT: $181.32 CARMEL, INDIANA 46032 12232 COLLECTIONS CENTER DRIVE CHICAGO IL 60693 CHECK NUMBER: 168007 CHECK DATE: 1/21/2009 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1110 4351000 19017 5205052352 181.32 WINDSHIELD REPLACEMEN G 44 UA RDlA N AUTO GLASS GUARDIAN 9 4 0 N SHADELAND A VE A Compa- of Vision INDIANAPOLIS, IN 4 6219 (317)353-6178 (800)882-2244 REMIT TO: Guardian Class Company INVOICE WORK PERFORMED FOR: 24394 Network Place CARMEL POLICE DEPT Chicago, IL 60673-1243 3 CIVIC SQ I.. I I F Nvolcg; 440 CARMEL, IN 46032 5205052352 CARMEL POLICE DEPT 3 CIVIC SQ 01/06/2009 CARMEL, IN 46032 CLAIMANT: 34-0801385 5200074139 ..;::ORDER ACCOUNT: 121805 Hp- WP: 12/29/2008 tt! bg.:: DMS 112/31/2008 08:00 x j I CAU 317-571-25481 ROBERT JPO# 19017 v 2G1WF55K259370209 IHOUSE 20 IBSCHRIER 2005 CHEVROLET IMPALA 4 DOOR SEDAN OPEN CHARGE REPEAT CUSTOMER PART NUMBE "UNIT.PRIC TOTAL 1 DWO15SOGBYN windshield (W/Third Visor Frit) 022 181.32 2 HAH000004 Urethane, Dam, Primer 0.00 0.00 SUBTOTAL. ****STATEMENT OF AUTHORIZATION AND SATISFACTION SALES TAX 0.00 REPLACEMENT HAS BEEN MADE TO MY SATISFACTION AND I HEREBY AUTHORIZE THE ABOVE INSURANCE COMPANY TO PAY DIRECT IN FULL TO GUARDIAN AUTO GLASS FOR SAID INSTALLATION. IF FOR ANY REASON THE INSURANCE COMPANY DOES NOT PAY FOR THESE REPAIRS OR DEDUCTIBLE REPLACEMENTS THE BELOW SIGNED AGREES TO PAY FOR SAID REPAIRS OR REPLACEMENTS, DATE CUSTOMER /WITNESS TOTAL 181.32 Your Satisfaction is our Guarantee INDIANA RETAIL TAX EXEMPT PAGE O t ®_f C a rmel CERTIFICATE NO. 0031 201 55 002 0 I of 1 111 PURCHASE ORDER NUMBER Police Department FEDERAL EXCISE TAX EXEMPT 19017 35- 60000972 3 GRECIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES, A/P CARMEL INDIANA 46032 -2584 VOUCHER, DELIVERY MEMO, PACKING SLIPS, SHIPPING LABELS AND ANY CORRESPONDENCE. FORM APPROVED -BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL 1997 PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION Tanua v 8 2Q windshield replacement VENDOR Guardian Auto Glass SHIP City of Carmel Police Department 940 N. Shadeland Avenuye TO 3 Civic Square Indianapoiis, IN 46219 Carmel, IN 46032 CONFIRMATION BLANKET C ONTRACT PAYM TERMS FREI QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION replace windshield for car 45 K. White 181.32 a f -�6 r�°IX 3 4 4 �t Send Invoice To:� PLEASE INVOICE IN DUPLICATE DEPARTMENT ACCOUNT j PROJECT PROJECT ACCOUNT AMOUNT 1110 510 auto repairs and mainte n. a 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 I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN SHIP REPAID. THIS APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER. j1 'mil C.O.D. SHIPMENTS CANNOT BE ACCEPTED. ORDERED BY &1 r�'G'.,(' PURCHASE ORDER NUMBER MUST APPEAR ON ALL SHIPPING LABELS. THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945 TITLE Chief of Police AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. -L J u 7 CLERK TREASURER DOCUMENT CONTROL NO A. .V. COPY SIGN AND RETURN TO CLERIC'S OFFICE UCHER 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 received except. T 26 Signature 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 Guardian Auto Glass Purchase Order No. 19017F 940 N. Shadeland Avenue Terms Indianapoils, IN 46219 Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) 1/6/09 5205052352 pyament for windshield replacement 181.32 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. r• ALLOWED 20 G uardian Auto Glass IN SUM OF 940 Nf Shadeland Avenue I dianapolis, IN 46219 181.32 ON ACCOUNT OF APPROPRIATION FOR police g eneral fund Board Members PO# or INVOICE NO. ACCT #!TITLE AMOUNT DEPT. I hereby certify that the attached invoice(s), or 19017F 5205052352 510 181.32 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 January 15 20 09 Signature Chief of POlice Cost distribution ledger classification if Title claim paid motor vehicle highway fund