176161 08/19/2009 CITY OF CARMEL, INDIANA VENDOR: 363018 Page 1 of 1
ONE CIVIC SQUARE CAMPBELL SALES SERVICE
0 CHECK AMOUNT: $34.00
CARMEL, INDIANA 46032 1332 S 8TH STREET
NOBLESVILLE IN 46060 CHECK NUMBER: 176161
CHECK DATE: 8/19/2009
DEPARTMENT ACCOUNT PO NU INVOICE NUMBER AMOUNT DESCRIPTION
2201 4237000 5378590 34.00 REPAIR PARTS
CAMPBELLS SALES SERVICE SERVICE ORDER �Ln VO 1 0b
BR1 s sTt=r i 1332 S. 8TH ST.
NOBLESVILLE, IN 46060 NO 5
GENUINE DEALERS 317 773 -6727
USE GENUINE PARTS DATFrV DATE PROMISED
NAME ENGINE MODEL NO. EQUIP T MAN ACTURER
ADDRESS TYPE OR SPEC N0. TYP EQ
CITY /STATE /ZIP SERIAL/CODE NO. EQUIPM 0.
j DEALER TO PICKUP /DELIVER PHONE D PHONE EVENING EQUIP T I
CUST. NOTIFIED r_j DATE
EMAIL ADDRESS DATE/TIME DATE OV PURC ASE
SERVICE CHECKLIST
AIR FILTER: PRESENT? CONDITION: CLEAN O DIRTY O DAMAGED O RALL MACHINE CONDITION:
BLADE CONDITION: I OIL LEVEL CONDITION: FRESH O USED O DARK O BURNT O
FUEL CONDITION:. FRESH O STALED RANCID O AGE: I COOLING FINS CONDITION: CLEAN O DIRTY O CLOGGEDO
REPAIR AS NEEDED TUNE -UP: MINOR MAJOR CHECK COMPRESSION
DIAGNOSE CALL WITH ESTIMATE CHANGE ENGINE OIL CHECK CARBURETION
WARRANTY INSPECTION SHARPEN BLADE
REPAIR STARTER CHECK IGNITION N
VV -tT
PARTS
DESCRIPTiOU AMOUNT, LABOR
PICKUP /DELIVERY
SHOP SUPPLIES/
:�.'t''. ENVIRON. FEES
t
GAS OIL
FREIGHT
..tare -c. 7 i
r
SUBTOTAL
r
TAX
r
-e
TOTAL 3 Y'U�D
',',IM -�.PLEASE NOTE
While the manufacturer may warrant the goods sold to the
customer, we make no warranties, express or implied, includ-
ing any implied warranties of merchantability or fitness, with
i respect to such goods.
Not responsible for loss or damage in case of fire, theft or any other
cause beyond our control.
I hereby authorize the above repair work to be done along with the
TOTAL necessary material and hereby grant you and/or your employees
permission to operate the unit as necessary for the purpose of testing
I FULLY UNDERSTAND THE PURPOSES OF THE SAFETY DEVICES ON THIS EQUIPMENT AND SPECIFICALLY REQUEST THAT THEY and /or inspection. An express mechanic's lien is hereby acknowl-
NOT BE REPAIRE REPACED, AND I ASSUME RESPONSIBILITY FOR AND HOLD YOU HARMLESS FROM ANY INJURY TO edged on above unit to secure the amount of repairs thereto.
ANYONE THAT M R SULT TL M.
X X
AUTHORIZED SIGNATURE AUTHORIZED SIGNATURE,
PRINTED IN U.S.. COPYRIGHT 2003 BRIGGS STRATTON CORPORATION PART NO. 273188-9/03
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))
07/27/09 5378590 $34.00
1 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
V OUCHER NO. W ARRANT NO.
ALLOWED 20
Campbells Sales Service
IN SUM OF
1332 S. 8th Street
Noblesville, IN 46060
$34.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO# Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Members
2201 5378590 42- 370.00 $34.00 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
hursdayl
Auju 13, 2009
.1
Strg ?t Cr�missioner
rea IssIof u
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund