178673 10/28/2009 CITY OF CARMEL, INDIANA VENDOR: 00350431 Page 1 of 1
ONE CIVIC SQUARE DICKINSON FLEET SERVICES, LLC
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CARMEL, INDIANA 46032 16389 COLLECTIONS CENTER DRIVE CHECK AMOUNT: $56.98
CHICAGO IL 60693 CHECK NUMBER: 178673
CHECK DATE: 10/28/2009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 1801238 56.98 OTHER EXPENSES
Dickinson Fleet Services, LLC Invoice #1801238
16389 COLLECTIONS CENTER DRIVE Date 10/12/09
CHICAGO, IL 60693 Page 1
Phone: 317.872.4542 Fax: 317.872.7624
Center 4
INDIANAPOLIS, IN 317 872 -4542 P.O.# :JEFF
Customer: CARMEL STREET DEPT
Address 3400 W 131 ST ST
City WESTFIELD, IN 46074
Phone 1 317 733 -2001 Ext
Phone 2 317) 733 -2005 Ext
Op Tech Description Labor Parts Subtotal
Quan Part Number Part Descripti n Reason for Replacement Price
MISCELLANEOUS PARTS 56.98 56 "98
9.00 12109 DRAIN VAL E 98.09
1.00 UPS sH1P�1NG 8.94
OK Bad Recommendation OK Bad Recommendation OK Bad Recommendation
RECD aCT 3 2D09
PAYMENT TERMS: NET30 REMIT: 16389 COLLECTIONS CENTER DRIVE, CHICAGO, IL 60693 Labor: $0.00
CUSTOMER ACKNOWLEDGES THAT HE HAS INSPECTED THE REPAIRS TO THE VEHICLE ON THIS Parts: $56.98
INVOICE AND THE REPAIRS MEET THE CUSTOMERS REQUIREMENTS AND EXPECTATIONS. Sublet: $0.00
CUSTOMER FURTHER AGREES TO PAY THE INVOICE IN FULL, AS SHOWN, WITHOUT Other Fees: $0.00
DEDUCTION OR SET OFF. ANY WARRANTIES ON THE PARTS AND ACCESSORIES SOLD HEREBY Mis /Fuel /EPA $0,00
ARE MADE BY THE MANUFACTURER. DICKINSON FLEET SERVICES, LLC MAKES NO Subtotal: $56.98
WARRANTIES OF ANY KIND, EXPRESS OR IMPLIED, AND DISCLAIMS ALL WARRANTIES OF Sales Tax: $0.00
MERCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE, WITH REGARDS TO THE
SERVICE, PARTS, LABOR, AND /OR ACCESSORIES PURCHASED AND THAT IN NO EVENT SHALL Paid By Total: $56.98
DICKINSON FLEET SERVICES, LLC 8E LIABLE FOR INCIDENTAL OR CONSEQUENTIAL On Account
Ref Paid $0.00
DAMAGES OR COMMERCIAL LOSS ARISING OUT OF SUCH PURCHASES. Pay Due: $56.98
x
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 of service rendered, by whom, rates per day, number of units,
price per unit, etc.
Payee (f
350431
DICKINSON FLEET SERVICE, LLC Purchase Order No.
4709 West 96th Street Terms
Indianapolis, IN 46268 Due Date 10/19/2009
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
10/19/200! 1801238 $56.98
hereby certify that the attached invoice(s), or bill(s) is (are) true and
:orrect and I have audited same in accordance with IC 5- 11- 10 -1.6
J L3
Date Officer
VOUCHER 096585 WARRANT ALLOWED
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350431 IN SUM OF
DICKINSON FLEET SERVICE, LLC
4709 West 96th Street
Indianapolis, IN 46268
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
1801238 01- 7502 -06 $56.98
I�
Voucher Total $56.98
Cost distribution ledger classification if
claim paid under vehicle highway fund