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
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REPAIR ORDER s��
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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