208642 05/10/2012 CITY OF CARMEL, INDIANA VENDOR: 357405 Page 1 of 1
ONE CIVIC SQUARE CENTRAL TRANSMISSION INDIANA CHECK AMOUNT: $1,975.00
CARMEL, INDIANA 46032 5086 w 106TH ST
ZIONVILLE IN 46077 CHECK NUMBER: 208642
CHECK DATE: 5/10/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4351000 104065 1,975.00 AUTO REPAIR MAINTEN
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Repair Order Number 1 04065
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3/30/2012
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5086 W. 106th Street Zionsville, IN 46077 317 733 -0939
CITY OF CARMEL os CHEVY IMPALA
VIN CURRENT MILEAGE
2 CIVIC SQUARE
2G 1 WT58K869379051 102261
CARMEL IN 46032 COLOR LIC. TRANS TYPE
RED
SERVICE TYPE
2 Year Or 24,000 Mile Warranty
PART DESCRIPTION OR QUANITY COST EACH P OR L EXT. COST
LABOR DESCRIPTION l
TORQUE CONVERTOR 1.00 275.00 P 275.00
OVERHAUL KIT 1.00 142.33 P 142.33
SOLENOIDS 1.00 95.00 P 95.00
HARD PARTS 1.00 548.32 P 548.32 I
FLUID 12.00 2.95 P 35.40
FILTER 1.00 14.95 P 14.95
LABOR 14.40 60.00 L 864.00
TECH COMMENTS TOTAL PARTS 1111.00
TOTAL LABOR 864.00
TOTALTAX 0.00
Thank you for your business! GRAND TOTAL 1975.00
Payments
DATE Balance 1975.00
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))
104065 C4504 $1,975.00
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
VOUCHER NO. WARRANT NO.
ALLOWED 20
CTI
IN SUM OF
5086 West 106th Street
Zionsville, IN 46077
$1,975.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members
1120 I 104065 I 43- 510.00 I $1,975.00 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 MAY 7 2012
c
Fire Chief
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund