HomeMy WebLinkAbout177432 09/15/2009 CITY OF CARMEL, INDIANA VENDOR: 363221 Page 1 of 1
f b ONE CIVIC SQUARE UNITED GOLF CARS CHECK AMOUNT: $27.10
CARMEL, INDIANA 46032 Po BOX 256
PATRICKSBURG IN 47455 CHECK NUMBER: 177432
CHECK DATE: 9/1512009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4237000 27.10 REPAIR PARTS
S L 5
REPAIR ORDER r 0 ✓��X�S�
MATERIAL USED
DSS JISJ
NAME DATE Lubrication
4 C e L F /J e/°
4 1 Change Oil
030 R e v ea_,s r O ADDRESS Change Oil
G Filter Cart. El
MAKE TYPE OR MODEL YEAR RECEIVED Change Trans.
A.M.
P. M. Change Diff.
SERIAL NO. ENGINE NO. PROMISED
A.M. Pack Front
P.M. Wheel Brgs.
ODOMETER LICENSE NO- TERMS PHONE WHEN READY El Adjust Brakes
S ❑NO
ORDER WRITTEN BY PHONE Rotate Tires
Wash Polish
OP NO. INSTRUCTIONS State Inspection
yry o A T riz A Prz r�
vL �6' cp 1z ,rb o t�- �y•� 2st vz�
1
OUTSIDE REPAIRS
You are entitled to a price estimate for the repairs you have authorized. The repair price may be less than the estimate, but will not exceed the estimate without
your permission. Your signature will indicate your estimate selection.
Teardown estimate I understand that my car will be reassembled within days of the date shown if I choose not to authorize the services recommended.
1. 1 request an estimate in wriling before you begin repairs.
BROUGHT FORWARD 2. Please proceed with repairs, but call me before continuing if the price will exceed
TOTAL PARTS 3. 1 do not want an estimate.
e e hereby eudarine the above repair work to be dome along whh the necessery rotas tal, and hereby hem METHOD OF PAYMENT: TOTAL LABOR
and I or your employees pemilsabn to operate the car or hick hershi descrmed on streets, highways l
elsewhere for the purpose of testing and! or tnspedlon. An egress mechaVs Ben Is hereby sdmawl []CASH
TOTAL PARTS
edged on above car or trudt to BMW the amamt of ra*rs thereto I
X CHECK ACCESSORIES
NOT RESPONSIBLE GAS, OIL, GREASE PRICE ❑CHARGE GAS, OIL GREASE
FOR LOSS OR DAM
AGE TO CARS OR GALS. GAS LABOR: OUTSIDE REPAIRS
ARTICLES LEFT IN
i CARS IN CASE OF OTS.OIL i ❑FLAT RATE 7
FIRE, THEFT OR ANY
OTHER CAUSE LBS. GREASE ❑HOURLY TAX
TOTAL ACCESSORIES BEYOND OUR coN- BOTH
TROL. TOTAL_ GAS, OIL, GREASE TOTAL AMOUNT Q
��.&darns GT3810/GT3811
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))
$27.10
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 NO. WARRANT N
ALLOWED 20
United Golf Cars
IN SUM OF
P.O. Box "256
Patricksburg, IN 47455
$27.10
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO# l Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Members
1120 42- 370.00 $27.10 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
cop 14 ?nna
Fire Chief
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund