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Home My WebLink About177599 09/29/2009 CITY OF CARMEL, INDIANA VENDOR: 00351564 Page 1 of I ONE CIVIC SQUARE GARY CARTER CHECK AMOUNT: $30.00 CARMEL, INDIANA 46032 4748 BISHOPSGATE DR CARMEL IN 46032 CHECK NUMBER: 177599 CHECK DATE: 912912009 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1120 4237000 15.00 REPAIR PARTS 1120 4358300 15.00 OTHER FEES LICENSES Sales Order C H Central Indiana Hardware Safes Order 5011077 9190 Corporation Drive Since, 1951 Indianapolis, Indiana 46256 Order Date Sep 24 2009 Tel: 317- 558 -5700 Fax: 317- 558 -5712 Customer: Ship To: CASH SALE INDIANAPOLIS CARMEL FIRE DEPARTMENT #2 9190 Corporation Drive CIVIC SQUARE INDIANAPOLIS„ Indiana 46256 CARMEL, Indiana 46032 Account Code 2969 Date Requested Sep 2412009 Terms Cash Purchase Order# VERBAL Customer Job Quote Salesperson Jim Stumpf Contact Jim Stumpf Order Name Unit Extended City Product Description Price Price 100 Door Silencer SR64 Gray 0.15 15.00 Freight Delivery Amount 0.00 Pre -Tax Total 15.00 IN INDIANA 0.00 Order Total 15.00 Printed Sep 24, 2009 12:52 PM Page 1 of 1 1 I� Bureau of Motor Vehicles II VIII III I I ICI I II��IIII I II Detailed Transaction Receipt BNiV>` State Form 51714 (4 -04) Branch: VEHICLE SERVICES REGISTRATIONS Date: 09/18/2009 Time: 15:51 EDT Visit ID: iH687761 CSR: AS Visit Customer: CITY OF CARMEL FIRE DEPT Transactions Trans IDTrans Type Trans Subtype Amount 170432289 Title Initial Title Issuance New Title Fee Vehicle $15.00 Vehicle: 4C9AU 1 419AE020777 2010 GRI UNK TR Lien Holder: None Customer: CITY OF CARMEL FIRE DEPT Purchase Date: 09/14/2009 $15.00 Charges to your credit card will appear as a line item charge not as a total transaction charge. Page 1 of 1 CREDIT CARD AUTHORIZATION (Revised 6 -1 -45) CARDHOLDER NAME: C'}er EXPIRATION DATE: CREDIT CARD AMT CHARGED: MASTER CART? VISA CUSTOMER NAME IF DIFFERENT FROM CARDHOLDEk: I hereby aut4orize the Indiana Bureau of Motor Ve_ldr._Ce_s.to_ _charge the above amount to the charge card number indicated above, DATE: SIGNAT TIM AUTHORIZATION AZIIST BE R.IrT[JIIiVTE<D_VYxTIT THE I<iNCLOSEP LL�T`Wi R TO THE ADDRrSS NOTE F ON THE LETTER i D 1 t• Bureau of Motor Vehicles Registration Fees Detailed Receipt I. »BMV State Form 51718 (4 -04) 3 Branch: VEHICLE SERVICES REGISTRATIONS Date: 09/18/2009 Time: 15.45 EDT Visit ID: �IH87761 Tran ID: 170432559 Visit Customer: CITY OF CARMEL FIRE DEPT STARS Trans 09180980300062 Transaction Type: New Motor Vehicle Registration Registration License Type: MUNICIPAL OWNED PlatelPermitlRegistration Number: 80821 Vehicle Identification Number: 4C9AU1419AE020777 Registration Year Fee Type Subtotal Total 2008 NONE (NONE) 2008 $0.00 CITY OF CARMEL FIRE DEPT Total NONE (NONE) 2008: $0.00 $0.00 Total for 2008: 0,00 Transaction Total: 0.00 Charges to your credit card will appear, as a line item charge not as a total transaction charge. Page 1 of 1 APPLICATION FOR CERTIFICATE OF TITLE STATE OF INDIANA BUREAU OF MOTOR VEHICLES State Form 205(R71 "4) Approved by Slate Board of Account 1997 TCTBE COMPLETED BY A POLICE OFFICER, BMV OFFICIAL OR BMV CERTIFIED DEALER SIGNEE INVE THE UNDERSIGNED SWEAR OR AFFIRM THAT THE INFORMA- FOR OUT OF STATE TI LES. t HEREBY CERTIFY THAT I PERSONALLY EXAMINED THE FOLLOWING TION ENTERED ON THIS FORM IS CORRECT, IAIVE UNDERSTAND VEHICLE AND RIND THE IDENTIFICATION NUMBER TO BE AS FOLLOWS, THAT MAKING A FALSE STATEMENT ON THIS FORM MAY CONSTI- VEHICLE IDENTIFICIAT ON NUMBER TUTE THE CRIME OF PERJURY. FUTHERMORE, IIWE AGREE TO I I I INDEMNIFY AND HOLD HARMLESS THE INDIANA BMV FROM ANY LIABILITY ARISING FROM THIS TRANSACTION, R MAKE MODEL TYPE DATE X X INSPECTOR'S PRINTED NAME TITLE CITY DATE: INSPECTOR'S SIGNATURE BADGE, BRANCH OR The law requires that you apply for Gertifioateof Title within thirty-one days from the date of purchase ofa motor vehicle. There is a delinquent fee of $21.00 for failure to ne so. Attach Certificate of Title assigned by seller. On en DEALER PLATE NOr dorsed Titles, liens must be released. supporting documents surrendered with this application cannot he returned to the appli cant. State fee for applying for Title is S15A0,'in accordance with Federal Code 383, TITLE NUMBER BRANCH NO INVOICE NO BMV USE ONLY 1. 09180980300057 803 MV- GOVERNMENT CERTIFICATE OF ORIGIN 'SOC. SEC.1FEDERAL I.D. NO APPLICANT'S NAME BMV USE ONLY D 2- CITY OF CARMEL FIRE DEPT 1 0 STREET ADDRESS CITY STATE ZIP CODE N 3. 2 CIVIC SQ CARMEL I 46032 D VEHICLE I.D. NUMBER VEH. YEAR VEH, MAKE VEH. MODEL NO. VEH. TYPE O EXEMPT 4• 4C9AU1419AE020777 2010 GRI UNK TR 0 M T FORMER TITLE NUMBER PURCHASE DATE LIEN SPEED PICK UP MAIL DEALER NO. BMV USE ONLY Y P 5. C OF O 09/14/2009 0 No No Yes E FIRST LIEN'S NAME OR SPECIAL MAILING ADDRESS STREET ADDRESS 6. I N CITY STATE ZIP CODE BMV USE ONLY 7 T H SECOND LIEN'S NAME STREET ADDRESS S CITY STATE ZIP CODE LICENSE NUMBER LICENSE FORMS BMV USE ONLY A 9, USED AS R E GROSS RETAIL USE TAX AFFIDAVIT I/WE HEREBY CERTIFY THAT SALES OR USE TAX ON THIS VEHICLE WAS PAID AS INDICATE BELOW A SELLING PRICE LESS TRADE -IN 1 DISCOUNT AMOUNT SUBJECTTO TA AMOUNT OF TAX DEALER BRANCH E PLACE PARA.# 10 1,295.00 0.00 0.00 1,295.00 X 1 'Your Social Security number/ Federal I.D. number is being requested by this agency under IC 4- 1 -6 -1. Disclosure is mandatory and this document cannot be processed without it APPLICANT RESPONSIBLE FOR ACCURACY OF INFORMATION APPLICATION FOR CERTIFICATE OF TITLE STATE OF INDIANA BUREAU OF MOTOR VEHICLES 2 0 5 1 7 0 4 3 2 2 8 9 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)) $15.00 Plates for New Trailer $15.00 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 N WA NO. Gary Carter ALLOWED 20 IN SUM OF $30.00 ON ACCOUNT OF APPROPRIATION FOR Carmel Fire Department PO# Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Members 1120 42 -37&00 $15.00 1 hereby certify that the attached invoice(s), or 1120 43- 583.00 $15.00 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 SEP 2 9 2009 Fire Chief Title Cost distribution ledger classification if claim paid motor vehicle highway fund