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Home My WebLink About207483 03/26/2012 CITY OF CARMEL, INDIANA VENDOR: 361690 Page 1 of 1 ONE CIVIC SQUARE HUBLER EXPRESS COLLISON CARMEL, INDIANA 46032 503 W CARMEL DR CHECK AMOUNT: $136.61 CARMEL IN 46032 CHECK NUMBER: 207483 CHECK DATE: 3/26/2012 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1110 4351000 26051 55561 136.61 REPAIRS TO VEHICLE 64 Document Page l of 1 Hubler Express Collision Carmel INVOICE 503 West Carmel Drive RO 55561 Carmel, IN 46032 (317) 569-9884,(317) 569 -9885 (fax) Est: ROBERT TRIMPL CITY OF CARMEL 09 CHEV IMPALA POLICE CITY OF CARMEL Color: WHITE CITY OF CARMEL 1 CIVIC SQUARE Type: PC 4D SED Adjustor: CARMEL, IN 46032 VIN: 2G1 WS57M391305111 Phone: Home: 317 571 -2500 Prod Date: Plate: IN 14232 Claim UNIT 64 Deductible: 0 Work: 317- 571 -2559 Mileage: 62523 Loss Type: Fax: Engine: 6-3.9L-Fl P Who Pa s? I Insurance, C Customer) Qty Type Description Part Amount Sup Labor Op Labor Paint P Units Units Parts Other FRONT DOOR LT R &I Vim panel JBody R &I 0.4 1 1 Parts New FRONT DOOR LT Handle, outside w!o 25963384 55.81 Body Repl 0.3 0.5 1 chrome FRONT DOOR Add for Clear Coat 0.1 I 1 Haz FRONT DOOR Hazardous waste removal 3.00 Body I PnVMat MISC Paint Materials 18.00 0.6 l SubTotal 136.61 Due from Insurance Due from Customer Taxes 0.00 Sub -Total 136.61 Sub -Total 0.00 Tax 0.00 Tax 0.00 Grand Total 136.61 Total 136.61 Total 0.00 Total Amounti 136.61 file: /C:\ Users \tanderson \AppData \Local\ Microsoft\Windows \Temporary Internet Files \Co... 3/20/2012 C 0 INDIANA RETAIL TAX EXEMPT PAGE t of Carmel CERTIFICATE NO. 003120155 002 0 PURCHASE ORDER NUMBER FEDERAL EXCISE TAX EXEMPT 2mi 35- 60000972 ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES, A/P CARMEL INDIANA 48032 -2584 VOUCHER, DELIVERY MEMO, PACKING SLIPS, SHIPPING LABELS AND ANY CORRESPONDENCE. FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL 1997 DURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION IMAM Hublor ExpInss CollIsIan Cannol PoIIco DopaAme t VENDOR SHIP 3 CIVIC agum S3 ft Camol I rl9l0 TO C�trr�tol, IN 48M Camol IN AM (317) 579 CONFIRMATION BLANKET CONTRACT PAYMENTTERMS FREIGHT OUANN �p� UNIT ppOF MEASURE DESCRIPTION UNIT PRICE EXTENSION gg 1 Esch repairs to vehicle $133.61 $130.01 Sub Total: $130.1 k vq i: �J" car 04 1 odic Send invoice To: Camol Pollco Cepvtmnt Aft Yom@ Andmon 3 CIVIC squm Col, IN PLEASE INVOICE IN DUPLICATE DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT Cumel Police Dept. PAYMENT 4136.17 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 T EREAS AN UNOBLIGATED BALANCE IN SHIP REPAID. THIS APPROPRIATIO F1 6NT TO PAY FOR THE ABOVE ORDER. C.O.D. SHIPMENTS CANNOT BE ACCEPTED. ORDERED BY yfcr� PURCHASE ORDER NUMBER MUST APPEAR ON ALL SHIPPING LABELS. 6 10 }p OF F POIICG THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945 TITLE AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. CLERK TREASURER DOCUMENT CONTROL NO. 26051 A.P.V. COPY SIGN AND RETURN TO CLERK'S OFFICE VOUCHER NO. WARRANT NO. ALLOWED 20 IN THE SUM OF ON ACCOUNT OF APPROPRIATION FOR Board Members PO# or IIU,VOICE NO, ACCT #ITITLE AMOUNT DEPT. I hereby certi 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 N ALLOWED 20 Hubler Express Collision IN SUM OF 503 West Carmel Drive Carmel„ IN 46032 $136.61 ON ACCOUNT OF APPROPRIATION FOR Carmel Police Department PO# I Dept. INVOICE NO. ACCT #!TITLE AMOUNT Board Members 26051 55561 I 43- 510.00 $136.61 1 hereby certify that the attached invoice(s), or bi11(s) is (are) true and correct and that the materials or services itemized thereon for which charge is made were ordered and received except Wednesday, March 21, 2012 Chief of Police Title Cost distribution ledger classification if claim paid motor vehicle highway fund 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)) 03/20112 55561 car 64 Batic $136.61 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