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HomeMy WebLinkAbout175937 08/06/2009 CITY OF CARMEL, INDIANA VENDOR: 363221 Page 1 of 1 0 ONE CIVIC SQUARE UNITED GOLF CARS CHECK AMOUNT: $121.50 PO Box 256 CARMEL, INDIANA 46032 PATRICKSBURGIN 47455 CHECK NUMBER: 175937 CHECK DATE: 8/6 /2009 DEPARTMENT ACCOUNT PO NUMBE INVOICE NUMBER AMOUNT DESCRIPTION T 1120 4237000 121.50 REPAIR PARTS �i REPAIR ORDER s�� �o MATERIAL USED DSS ISJ �`o iz P tS f�� l t�irzS ASS NAME DATE Lubrication Change Oil ADDRESS Change Oil 2 C�`� C� vA Filter Cart. MAKE TYPE Of MODEL YEAR R CEIVED 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 ❑YES ❑NO ORDER WRITTEN BY PHONEY r Rotate Tires 3 °O LWah h ection INSTRUCTIONS a d2 1 BIZ- oL'1 {G zrG� C 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 1 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 writing 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. hereby wthorbe fire above work to be dare ebng whh the necessary material, end hereby gam METHOD OF PAYMENT: TOTAL LABOR you and 1 or your empnreee pemtsslan to operate the car or truck hereb described on One% highxays or elsewhere for the purpose of test V and! or Inspectlm. An e*resa meftno s Ilan Is hereby admowl- ❑CASH TOTAL PARTS edgid on above car or Mick to severe the amamt of MMM thereto. 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 CARS IN CASE OF QTS. OIL (a? ❑FLAT RATE S FIRE, THEFT OR ANY HOURLY U OTHER CAUSE LBS. GREASE T BEYOND OUR CON TOTAL ACCESSORIES TROL. TOTAL GAS, OIL, GREASE ❑BOTH TOTAL AMOUNT 2 SO a,,adama 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)) $121.50 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 NO. ALLOWED 20 United Golf Cars IN SUM OF P.O. Box 256 Patricksburg, IN 47455 $121.50 ON ACCOUNT OF APPROPRIATION FOR Carmel Fire Department PO# Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Members 1120 42- 370.00 $121.50 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 s 2009 a Fire Chief Title Cost distribution ledger classification if claim paid motor vehicle highway fund