206699 02/28/2012 CITY OF CARMEL, INDIANA VENDOR: 361690 Page 1 of 1
s' s ONE CIVIC SQUARE HUBLER EXPRESS COLLISON CHECK AMOUNT: $1,700.75
CARMEL, INDIANA 46032 503 W CARMEL OR
CARMEL IN 46032 CHECK NUMBER: 206699
CHECK DATE: 2/28/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4351000 26049 55398 1,053.95 REPAIRS TO VEHICLE 9
1110 4351000 26056 55416 646.80 REPAIRS
Date: 02/07/2012
Hubler Express Collision Carmel INVOICE
503 West Carmel Drive RO 55416
Carmel, IN 46032
(317) 569 -9884, (317) 569 -9885 (fax) Est: A Brumfield
CITY OF CARMEL 08 CHEV IMPALA POLICE CITY OF CARMEL
CITY OF CARMEL Color: GREY Adjustor:
1 CIVIC SQUARE Type: PC 4D SED Phone:
CARMEL, IN 46032 VIN: 2G1WS583181352254 Claim UNIT 131 Deductible:
Home: 317 571 -2500 Prod Date: 0608 Plate: IN 13242
Work: 317 -571 -2559 Mileage: UNK O Loss Type:
Fax: Engine. 6-3.9L-Fl
P Who Pays? (I Insurance, C Customer)
Qty Type i Description Part Amount Sup Labor Op Labor Paint P
Units Units
Parts Other FRONT DOOR RT Outer panel Body Rpr 1.5 2.0 1
FRONT DOOR Add for Clear Coat 03 1
Parts Other FRONT DOOR RT Belt w strip Body R &I 03 1
Parts Other FRONT DOOR RT Body side mldg Body R &I 0.3 1
FRONT DOOR Clean &Retape side Body Rpr 0.3 1
molding
Parts Other FRONT DOOR RT Mirror assy w/o Body R &I 0.3 1
defogger smooth
Parts Other FRONT DOOR RT Handle, outside w/o Body R &I 0.3 1
chrome
Parts Other FRONT DOOR RT R &I trim panel Body R &i 0.4 I
Parts Other REAR DOOR RT Outer panel A j Body Rpr 1.0 2.0 1
REAR DOOR Overlap Major Adj. Panel -0-4 1
REAR DOOR Add for Clear Coat A 03 1
Parts Other REAR DOOR RT Belt w'strip A Body R &I 0.3 1
Parts Other REAR DOOR RT Body side mldg A Body R &I 0.2 1
REAR DOOR Clean &Retape side Body Rpr 03 I
molding A
Parts Other REAR DOOR RT Handle, outside w/o Body R &I 03 1
chrome A
Parts Other REAR DOOR RT R &I trim panel A Body R &I 0.4
1 Haz REAR DOOR Hazardous waste removal 3.00 i Body i
REAR DOOR Cover car 0.2 1
Pnt/Mat MISC Paint Materials 147.00 1 4.9 1
SubTotal 646.80
Taxes 0.00
Grand Total 646.80
Due from Insur Due from Customer
Sub -Total 646.80 Sub -Total 0.00
Tax 0.00 Tax 0.00
Total 646.80 Total 0.00
Total Amount 646.80
INVOICE #22 02/07/2012 11:16:39 AM RO# 55416 Hubler Express Collision Carmel
Page 1
L Date 02/10/2012
Hubler Express Collision Carmel INVOICE
503 West Carmel Drive RO 55398
Carmel, IN 46032
(317) 569 -9884, (317) 56_ 9 -9885 (fax) Est: A Brumfield
CITY OF CARMEL 11 CHEV IMPALA POLICE
CITY OF CARMEL Color: WHITE CITY OF CARMEL
1 CIVIC SQUARE Type: PC 4D SED Adjustor:
CARMEL, IN 46032 VIN: 2G1 WD5EM8B1288065 Phone:
Home: 317 571 -2500 Prod Date: 0411 Plate: IN 5425 Claim UNIT #9 Deductible: 0
Work: Mileage: 123546 Loss Type:
Fax: j Engine: 6-3.9L-Fl
P Who Pays? (I Insurance, C Customer)
Qty Type Description Part Amount Sup Labor 4p Labor Paint Units Units P
1 Parts New a h AR BUMPER Bumper cover w /dual 19120961 535.55 i Body Repl 1.9 3.0 1
REAR BUMPER Add for Clear Coat 1,2 1
1 Body upplies REAR BUMPER Flex Additive 3.00 Body
1 Hap REAR BUMPER Hazardous waste 3.00 Body
removal
Parts New REAR BUMPER O/H bumper assy Body Ovrh 2.3 1
1 Parts New REAR BUMPER Energy absorber 20759789 166.64 i Body Repl I
Pnt/Mat MISC Paint Materials 126.00 4.2 1
SubTotal 1,220.59
Taxes 0.00
Grand Total 1,220.59
Due from Insuranc Due_ from Customer
Sub -Total 1,220.59 Sub -Total 0.00
Tax 0.00 Tax 0.00
Total 1,220.59 Total 0.00
Total Amount 1,220.59
i
053, y5 C-Pb
t
INVOICE #22 02/10/2012 11:02:01 AM RO# 55398 Hubler Express Collision Carmel
Pagel
INDIANA RETAIL TAX EXEMPT PAGE
ul of C armel CERTIFICATE NO. 003120155 002 0
PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 28M
35- 60000972
ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES, A/P
CARMEL, INDIANA 46432 -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
10M12
Hublor Egmss Colligion Car mol Police Depadme ti
VENDOR SHIP 3 Civic 'Squ
M gt carmol Drive TO Ca8"ri ol, IN Sliw
carnal„ IN 4= (3117) 571
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Account 43 -610.03
1 Each repairs 8c while $1,053.95 $1,053.95
Saab Total: $1,053.95
p
Send Invoice To:
Cumel Policy Dopafmant
Attu: Tomes Andy son
3 Civic Baum
cufflral, IN m PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
Carmel Police Deist. PAYMENT $11,053.95
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 TH RErS AN UNOBLIGATED BALANCE IN
SHIP REPAID,
THIS APPROPRIATIO IaIIf TO PAY F E.1 -THE ABOVE ORDER.
C.O.D. SHIPMENTS CANNOT BE ACCEPTED. ORDERED BY
PURCHASE ORDER NUMBER MUST APPEAR ON ALL
SHIPPING LABELS.
THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945 TITLE (4 Q? PoileG
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
CLERK- TREASURER
DOCUMENT CONTROL NO. A .P.V. COPY SIGN AND RETURN TO CLERK OFFICE
VOUCHER NO. WARRANT NO.
ALLOWED 20
IN THE SUM OF
ON ACCOUNT OF APPROPRIATION FOR
Board Members
PO# EP or INVOICE NO. ACCT /TITL€ 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-
20
Signature
Title
Cost distribution ledger classification if
claim paid motor vehicle highway-fund
INDIANA RETAIL TAX EXEMPT PAGE
City of C armel CERTIFICATE NO. 003120155 002 0 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT
35- 60000972
ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES, A/P
CARMEL, INDIANA 46032 -2584 VOUCHER, DELIVERY MEMO, PACKING SLIPS,
FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL 1997 SHIPPING LABELS AND ANY CORRESPONDENCE.
DURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION
21192
Hubler Estpmoo Collision Carmel Polies Dapa (tent
VENDOR SHIP 3 CIVIC squaw
SM West Carrel Drivo TO Carmel, IN 46
Camel„ IN 46M (397) 6794M
coNFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Account 43.614.00
1 Each repairs to vehicle $848.80 $648.80
Sub Total: $846.80
7t F r
R
reivirs to car 131 L. Callins
Sen Invoice To:
Carmal Police Department
Attn: Tones Anderson
3 CIVIC ashe s
Carmol, IN 4&M- PLEASE INVOICE IN DUPLICATE
DEPARTMENT ,ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
Crrtel Police PAYMENT RD
i�r
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 T% PROPER SWORN AFFIDAVIT ATTACHED.
SHIPPING INSTRUCTIONS I HEREBY CER RY�HATTHERE IS AN UNOBLIGATED BALANCE IN
SHIP REPAID, >APPR, THIS IA r ON SUFFI ENT TO PAY FOR THE ABOVE ORDER.
C.O.D. SHIPMENTS CANNOT BE ACCEPTED. ORDERED BY
PURCHASE ORDER NUMBER MUST APPEAR ON ALL
SHIPPING LABELS. �eleP �1 1'aII�!
THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945 TITLE
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO,
CLERK TREASURER
DOCUMENT CONTROL NO. 260 56 A.P.V. COPY -SIGN AND RETURN TO CLERK'S OFFICE
VOUCHER NO. WARRANT NO.—e__
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_
20
,Signature
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
VOUCHER NO. WARRANT NO.
ALLOWED 20
Hubler Express Collision
IN SUM OF
503 West Carmel Drive
Carmel„ IN 46032
$1,700.75
ON ACCOUNT OF APPROPRIATION FOR
Carmel Police Department
PO# Dept. INVOICE NO. ACCT #!TITLE AMOUNT Board Members
26056 55416 43- 510.00 $646.80 I hereby certify that the attached invoice(s), or
bill(s) is (are) true and correct and that the
26049 55398 43- 510.00 $1,053.95
materials or services itemized thereon for
which charge is made were ordered and
received except
Thursday, February 23, 2012
Chief of Police
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
Prescribed by Slate 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))
02/07/12 55416 repairs to car 131 L. Collins $646.80
02/10/12 55398 car repairs car 9 Malloy $1,053.95
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