170784 04/16/2009 r'
±a, CITY OF CARMEL, INDIANA VENDOR: 057000 Page 1 Of 1
ONE CIVIC SQUARE CHARLIES RADIATOR SERVICE INC
CARMEL, INDIANA 46032 740 EAST 106TH ST. CHECK AMOUNT: $280.00
INDIANAPOLIS IN 4628D
CHECK NUMBER: 170784
CHECK DATE: 4116/2009
DEPARTMENT A P O NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
,;,2201 4351000 280.00 AUTO REPAIR MAINTEN
r
740 East 106th Street
Indianapolis, Indiana 46280
844.9452
7 6 /y
PATE SPY. I y 1 t'OUR ORDER NO.
SNIP VIA f TERM NET 30 D A Y S
t r'
MAK MODEL GUARAN E E
THIS RADIATOR
JOB N0. WAS PLUGGED -A
OESCR- A- u,,
CLE AN AND REPAIR RADIATOR Q
RECORE RADIATOR j
T
ROC OUT RADIATOR i
_LEAN AND REPAIR G°ASmTA_NK P� I 6
REMOVE AND REPLACE WATER PUMP
R ECORE HE l i
C OMPLETE NEW HEATER 1 i
REMOVE AND REPLACE RADIATOR
r
DISCOUNT
THERMOST AND GASKET
PARTS AND MATERIALS
COMPLETE NEW RADIATOR
REMOVE 8 REPLACE GAS TANK
ANTIFREEZE
REMOVE AND REPAIR THERMOSTAT
FEDERAL TAX
STATE TAX
MATERIAL TOTAL
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))
04/07/09 $280.00
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
VOUCHER NO. WARRANT NO.
ALLOWED 20
Charlie's Radiator Service
IN SUM OF
740 E. 106th St.
Indianapolis, IN 46280
$280.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO# Dept. INVOICE NO. ACCT #(TITLE AMOUNT Board Members
2201 43- 510.00 $280.00 l 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
f hursdaylApr,th04, 2009
Street Commissioner/
Ca e n
Quo
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund