177870 09/29/2009 CITY OF CARMEL, INDIANA VENDOR: 305700 Page 1 of 1
ONE CIVIC SQUARE TOM WOOD FORD INC CHECK AMOUNT: $599.13
CARMEL, INDIANA 46032 3130 E 96TH ST
INDPLS IN 46240 CHECK NUMBER: 177870
CHECK DATE: 9/29/2009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUN DESCRIPTION
601 5023990 W08956 239368 599.13 REPAIR TRUCK
a PFFZ__::7 PA GENUINE
RTS SERVICE
3130 E. 96th Street Indianapolis, Ind. 46240
(800) 423 -4646 o (317) 846 -4241
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CUST NUMBER ADVISOR TAG NO. INVOICE DATE INVOICE NO.
108036 PHIL 997203 1013 09/17/09 FONS239368
LICENSE NO. ODOMETER COLOR STOCK NO.
CITY OF CARMEL SEWER DEPT. 26 797 WHITE/
1 CIVIC SQ YEAR) MAKE l MODEL DELIVERY DATE DELIVERY ODOMETER
CARMEL IN 46032 -2584 06 FORD TRUCK ESCAPE 4DR FWD HYBRID
VIN SELLING DEALER NO, MANUFACTURED DATE
1 F M Y U 9 5 H 8 6 K D 3 6 9 6 6
NO. P.O. No. R.O. DATE
0031201550 -020 09/14/09
HOME PHONE BUSINESS PHONE INSTRUCTIONS
317- 571 -2645 MO: 26797
JOB# I CHARGES-- 'Disclaimer of Warranties Any warranties on
the products sold hereby are those made by
LABOR the manufacturer. The Seller, TOM WOOD
J# I IOFOZ DRIVE'ABILITY TECH(S) 997920 479x:80 FORD, Inc. hereby expressly disclaims all
CUST STATES THE "STOP SAFELY •NOW' LIGHT.CAME ON AND IT warranties, either express or implied, including
STALLED PULLING AWAY FROM STOP, NOW WONT START any implied warranty of merchantability or
DIAGNOSIS, ACCESS AND REPLACE AIR FLOW' MODE DOOR ACTUATOR fitness for particular purpose,, TOM WOOD
AND REPROGRAM PCM FORD, Inc., neither assumes nor authorizes
any other person to assume for it any liability
PARTS QTY FP- NUMBER DESCRIPTION- LIST PRICE -UNIT PRICE- in connection with the sale of said products.
1 8L8Z•19E616 -E MOTOR ASY 29.33 29.33 29 -33 1 hereby agree to pay Tom Wood Ford
TOTAL PARTS 29.33 attorney's fees if collection hereof becomes
necessary.
SUBLET- PO#------ :-VEND I NV I NV. DATE DESCRIPTION- Not responsible for car or contents in case of
4420 37457 09/14/09 TOW IN 60.00 fire or theft or freezing or any other cause.
TOTAL SUBLET 60.00 Storage will be charged 48 hours after repairs
are completed.
JOB# 1 TOTALS
LABOR 479.80
PARTS 29.33
SUBLET 60.00
JOB# 1 JOURNAL PREFIX FONS JOB# 1 TOTAL 569.13 X
JOB# 2 CHARGES
LABOR
J# 2 +02FOZRTIRE;
RED TIRE= TECH(5)�80,s :1100
Added Operation (8PHILC 09/17/2009 07:45)
TIRES REQUIRE IMMEDIATE ATTENTION
MEASUREMENT 3/32 OR LESS.
NEEDS TIRES WEAR ISSUE
NEEDS TIRES RED ZONE
JOB# 2' TOTALS
JOB# 2 JOURNAL PREFIX FONS JOB# 2 TOTAL 0.00
JOB# 3 CHARGES
o
m LABOR
J# 3 +02FOZGBK" GREEN 'BRAKES., TEGH(S) ";80 000
.z.
Added b ti"
on (8PHILC 09/17/2009 07:45)
BRAKES CHECK -OK (DISC OVER 5MM,DRUM OVER2MM)
ATW BRAKE CHECK -OK
BRAKES OK
Z
JOB# 3 TOTALS---
JOB# 3.JOURNAL PREFIX TONS JOB# 3 TOTAL 0.00
JOB# 4 CHARGES
9 LABOR
0 J#- 4 +02FOZGBATT;` GREEN- .BATT ERY ..,a••.- J w- 0,:00
Added Operation (8PHILC 09/17/2009 07:46)
BATTERY TEST OK -COLD CRANKING AMPS.TERMINALS CLEAN -OK
a TEST BATTERY
Q PAGE 1 OF 2 CUSTOMER COPY [CONTINUED ON NEXT PAGE] 10:03am
TWF -4020
DDD
GENURNE
3130 E. 96th Street o Indianapolis, Ind. 46240
(800) 423 -4646 (317) 846 -4241
�0 0 1 0 0 o a a
GUST NUMBER' ADVISOR TAG N0. INVOICE DATE INVOICE NO.
108036 PHIL ()q72Q3 10 13 09/1Z/_0q FONS219368
LICENSE. NO ODOMETER COLOR STOCK NO.
.CITY OF CARM E L SEWER DEPT YEAR !MAKE /MODEL DELIVERY DATE DELIVERY ODOMETER 26,797 WHITE/
1 SQ FORD TRUCK /APF /4D /AD
FSC FW
CA RMEL MEL IN 46032 -2584 VIN SELLING DEALER NO. MANUFACTURED DATE
F. T. E. NO PO N0. R.O. DATE
0031201550 -020 09/14/0
HOME PHONE BUSINESS PHONE INSTRUCTIONS
317 -571 -2645 M0: 26797
GOOD BATTERY Disclaimer of Warranties Any warranties on
T the products sold hereby are those made by
the .manufacturer. The Seller, TOM WOOD
JOB# 4 TOTALS FORD Inc. .hereby expressly disclaims all
warranties, either express or implied, including
JOB# 4 JOURNAL PREFIX FONS JOB# 4 TOTAL 0.00 any implied warranty of merchantability or
fitness for a particular purpose. TOM WOOD
MISC CODE DESCRIPTION CONTROLNO- FORD, Inc.,, neither assumes nor authorizes
JOB A Al SHOP SUPPLIES 30.00 any other person to assume for it any liability
TOTAL MISC 30.00 in connection withdhe sale of said products.
I hereby agree to pay Tom Wood Ford
TOTALS attorney's fees if collection hereof becomes
necessary.
TOTAL LABOR 479.80 Not responsible for car or contents in case of
fire or theft or freezing or any other cause.
TOTAL PARTS.... 29.33 Storage will be charged 48 hours after repairs
CASH CHECK CK NO. TOTAL SUBLET... 60.00 are comp leted.
TOTAL G.O.G..... 0.00 p
VISA MASTERCARD TOTAL MISC CHG.: 30.00
TOTAL MISC DISC 0 -00
OTHER CHARGE TOTAL. TAX...... 0.00
TOTAL INVOICE 599.13
THANK YOU FOR YOUR BUSINESS!! x
CUSTOMER SIGNATURE
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END OF INVOICE 10:03am
TW F -4020
Prescribed by State Board of Accounts City Form No. 201 (Rev 1999
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice or bill to be properly itemized must show, kind of service, where
performed, dates of service rendered, by whom, rates per day, number of units,
price per unit, etc.
Payee
305700
TOM WOOD FORD Purchase Order No.
3130 E. 96th Street Terms
Indianapolis, IN 46240 Due Date 9/17/2009
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
9/17/2009 239368 $599.13
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
Date Officer
ii
VOUCHER 093061 WARRANT ALLOWED
305700 IN SUM OF
TOM WOOD FORD
3130 E. 96th Street
Indianapolis, IN 46240
Carmel Water Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
239368 01- 6500 -07 $599.13
C�
I
U
Voucher Total $599.13
Cost distribution ledger classification if
claim paid under vehicle highway fund