208413 04/25/2012 CITY OF CARMEL, INDIANA VENDOR: 00352025 Page 1 of 1
ONE CIVIC SQUARE P F M TRUCK CARE
Y CARMEL, INDIANA 46032 1402 WEST HANNA AVE CHECK AMOUNT: $61.04
INDIANAPOLIS IN 46217 CHECK NUMBER: 208413
CHECK DATE: 4/25/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1192 4351000 5002887 61.04 AUTO REPAIR MAINTEN
SOUTH— 1402 W. Hanna Ave., Indianapolis, IN 46217
Truck Car Care Center 317- 784 -7777 Fax 317 788 -5860
Car Truck Care Center FISHERS 9501 Corporation Dr., Indianapolis, IN 46256
4900 W. O Mitsubishi Fuso
Z/ONSV/LLE 4900 W. 106th St., Zionsville, IN 46077
Group OnSite Services 317- 733 -7777 Fax 317 733 -3979
Date 1117112 Page 1 PO Issued by:: Invoice #5002887
Customer: CITY OF CARMEL DEPT OF COMM. SERVI Vehicle: 2008 FORT ESCAPE *R5002887*
Address: ONE CIVIC SQUARE Unit 3
City: CARMEL, IN 46032- VIN 1 FM6U59H88KB45502 LicP
Phone 1 317 571 -2418 Ext Engine: 4 -140 2.3L DOHC Trans: AUTO
Phone 2 317 571 -2426 Ext FAX Mileage 32705 Loc
Retail Customer Job Job Job
Job Description Part Description Price Price Extended Labor Parts Subtotal
Service Requests:
HERE NOW WAITING
1.PM
2.LR FLAT REPAIR
3.TIRE ROTATION
4. RF TURN BULB BLINKS FAST
Estimate Approvals:
Original Approval Date: 1/11/2012 3:11:00 PM Reason: TIRE LOF AIR FILTER
Amount: $227.43 Auth By: CITY OF CARMEL WASTWATER Contacted By Phone
Phone: (317) 571 -2645 By: 694
MOUNT BALANCE ONE TIRE Declined 0.00
1.00 P235/70SR16 XL DEST. L Declined Declined Declined
Warranty: 0
Size:
Not on File
5 Quart LIGHT DUTY GAS "A "PM SERVICE: CHANGE ENGINE OIL WITH UP TO 5 QTS OF 21.61 13.34 34.95
MOTOR OIL, REPLACE OIL FILTER AND LUBRICATE CHASSIS WHERE POSSIBLE, WITH
"A" SERVICE. PERFORMED SERVICE PER INSPECTION SHEET.
*additional parts are an extra charge
4.50 5 W20 OIL 1.49 1.26 5.67
1.00 OIL FILTER 9.05 7.67 7.67
Addition required fluids and parts, not included in package price: 0.00 21.57 21.57
1.00 AIR FILTER 25.45 21.57 21.57
Payments:
(On Account), $61.04, on 01/17/12
OK Bad Recommendation OK Bad Recommendation OK Bad Recommendation
0 SCHLD SEVICES OK 0 COOLING SYS OK 0 LIGHTING OK
u MAINTENANCE OK a CHARGING SYS OK a STEERING OK
a A/C HEATING OK a DRIVE TRAIN OK a SUSPENSION OK
a BATTERY OK a EMISSIONS OK a TIRES OK
a BELTS HOSES OK a EXHAUST OK a TRANSMISSION OK
a BRAKES OK a FLUIDS OK a DOT OK
mo xf n e ..awx•_
SOUTH— 1402 W. Hanna Ave., Indianapolis, IN 46217
Truck Car Care Center 317 784 -7777 Fax 317 -788 -5860
Car Truck Care Center FISHERS 9501 Corporation Dr., Indianapolis, IN 46256
�S_f 0 p 317- 577 -7777
Mitsubishi Fuso ZIONSVILLE 4900 W. 106th St., Zionsville, IN 46077
Group OnSite Services 317 733 -7777 Fax 317 733 -3979
Date 1/17/12 Page: 2 PO Issued by:: Invoice #5002887
Customer: CITY OF CARMEL DEPT OF COMM. SERVI Vehicle: 2008 FORT ESCAPE *R5002887*
Address: ONE CIVIC SQUARE Unit 3
City: CARMEL, IN 46032- VIN 1 FM6U59H88KB45502 LicP
Phone 1 317) 571 -2418 Ext Engine: 4 -140 2.3L DOHC Trans: AUTO
Phone 2 317) 571 -2426 Ext FAX Mileage: 32705 Loc
Retail Customer Job Job Job
Job Description Part Description Price Price Extended Labor Parts Subtotal
I hereby authorize the repair work to be done along with the necessary parts Labor: $21.61
and materials and hereby grant you and /or your employees permission to operate Parts: $34.91
the vehicle herein described on streets, highways or elsewhere, at your des- Sublet: $0.00
cretion, for the purpose of testing and /or inspection. An express mechanics Other Fees: $0.00
lien is hereby acknowledged on the above vehicle to secure the amount of re Shop /EPA $4.52
pairs thereto. I understand that dealer /owner is not responsible for delays Subtotal: $61.04
consequences. Not responsible for damage or articles left in car in case of Sales Tax: $0.00
fire, theft or any other cause beyond our control. A 2% service charge will be
added to the monthly account balance with a storage charge of $5.00 a day for Paid By: Total: $61.04
vehicles left beyond 21 days. Any warranty must be performed by us or with On Account Paid: $0.00
our prior approval. Warranty is limited to the original invoice amount. Pay Ref:
Due $61.04
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))
01/17/12 Flat tire repair, oil change
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
pfm Truck and Car Care Center
IN SUM OF
4900 W. 106th Street
Zionsville, IN 46077
ON ACCOUNT OF APPROPRIATION FOR
Carmel DOCS
PO# Dept. INVOICE NO. I ACCT #/TITLE AMOUNT Board Members
1192 43- 510.00
c�,�.v 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
Thursday, April 2012
A recto r -51
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund