209191 05/22/2012 CITY OF CARMEL, INDIANA VENDOR: 361690 Page 1 of 1
ONE CIVIC SQUARE HUBLER EXPRESS COLLISION
CARMEL, INDIANA 46032 503 W CARMEL DR CHECK AMOUNT: $2,212.27
CARMEL IN 46032
CHECK NUMBER: 209191
CHECK DATE: 5/22/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4351000 26138 10104 2,212.27 REPAIRS TO VEHICLES
HUBLER EXPRESS COLLISION Workfile ID: 4e7214b9
CARMEL
INDIANA'S FIRST CHOICE IN COLLISION REPAIR!
503 W. CARMEL DR., CARMEL, IN 46032
Phone: (317) 569 -9884
FAX: (317) 569 -9885
Final Bill
RO Number: 10104
Customer: Insurance: Adjuster: Estimator: Robert Trimpl
CARMEL POLICE DEPARTMENT City of Carmel Phone: Create Date: 3/26/2012
3 CIVIC SQUARE Claim: 99
CARMEL, IN 46032 Loss Date:
(317) 571 -2500 Deductible:
Year: 2007 Style: 41D SED VIN: 2GiWS55R979403878 Mileage In: 123
Make: S .1 1 C:,icr: White Mileage Out:
M ode l: IMPALA POLICE License: 12624 Job Number: Vehicle Out: 5/
Line Ver Operation Description Qty Extended Type Labor Type Paint
Price
1 E01 FRONT DOOR
2 E01 Remove /Replace RT Door shell 1 826.59 OEM 4.8 Body 3.0
3 E01 Add for Clear Coat 1.2
4 E01 Remove /Install RT Belt w'strip 0.0 Body
5 E01 Remove /Replace RT Body side mldg 1 92.00 A/M 0.3 Body 0.5
6 E01 Overlap Minor Panel (0.2)
7 E01 Add for Clear Coat 0.1
8 E01 Remove /Install RT Applique 0.0 Body
9 E01 Remove /Install RT Mirror assy w/o defogger 0.0 Body
10 E01 Remove /Install RT Run channel 0.0 Body
11 E01 Remove /Install RT Handle, outside 0.0 Body
12 E01 Remove /Install RT Lock assy LS, POLICE 0.0 Body
13 E01 Remove /Install RT R&I trim panel 0.0 Body
14 S01 Remove /Replace RT Upper hinge 1 40.49 OEM 0.0 Body 0.3
15 Sol Add for Clear Coat 0.1
16 SO! I Rernove /Replace RT Lower hinge 1 93.39 OEM 0.0 3ody 0.3
17 S01 Add for Clear Coat 0.1
18 E01 REAR DOOR
19 E01 Blend RT Outer panel 1.0
20 E01 Remove /Install RT Belt w'strip 0.3 Body
21 E01 Remove /Install RT Applique front 0.3 Body
22 E01 Remove /Install RT Applique rear 0.3 Body
23 E01 Remove /Install RT Body side mldg 0.2 Body
24 E01 Remove /Install RT Run channel 0.2 Body
25 E01 Remove /Install RT Handle, outside 0.3 Body
T Taxable Item, RPD Related Prior Damage, AA Appearance Allowance, UPD Unrelated Prior Damage, PDR Paintless Dent Repair, A/M Aftermarket, Rechr Rechromed, Reman
Remanufactured, OEM New Original Equipment Manufacturer, Recor Re- cored, LKQ Like Kind Quality or Used, Diag Diagnostic, Elec Electrical, Mech Mechanical, Ref Refinish, Struc
Structural
5/9/2012 3:22:21 PM Page 1
Final Bill
RO Number: 10104
Vehicle: 2007 CHEV IMPALA POLICE 4D SED 6- 3.9L -FI White
26 E01 Remove /Install RT R &I trim panel 0.4 Body
27 SO1 PILLARS, ROCKER FLOOR
28 S01 Remove /Install RT Rocker molding 0.8 Body
29 E01 FENDER
30 E01 Blend RT Fender 1.1
31 E01 Remove /Replace RT Emblem GM 1 5.00 OEM 0.2 Body
32 S01 Alignment RT Fender 1.0 Body
33 E01 FRONT LAMPS
34 E01 Remove /Install RT Headlamp assy 0.3 Body
35 E01 Remove /Replace Aim headlamps 0.5 Body
36 E01 FRONT BUMPER GRILLE
37 E01 Remove /Install R&I bumper cover 0.7 Body
38 E01 Hazardous waste removal 1 3.00 Other
39 E01 Corrosion protection 1 10.00 Other 0.2 Body
40 E01 Cover car 0.2
41 E01 Repair Clean off Decales 1.0 Body
42 SO1 Repair Clean retape molding (each) 0.3 Body
Estima T ota l s Di scou n t M a rk up R ate Total Hours T ota l
Parts 1,070.47
Labor, Body 46.00 12.1 556.60
Labor, Refinish 46.00 7.7 354.20
Material, Paint 231.00
Subtota 2,212.27
Sales Tax 0.00
Grand Total 2,212.27
Net Total 2,212.27
Estimate Version Total
Original 1,920.99
Supplement S01 291.28
Insurance Total 2,212.27
Received from Insurance 0.00
Balance due from Insurance 2,212.27
Customer Total 0.00
Received from Customer 0.00
Balance due from Customer 0.00
T Taxable Item, RPD Related Prior Damage, AA Appearance Allowance, UPD Unrelated Prior Damage, PDR Paintless Dent Repair, A/M Aftermarket, Rechr Rechromed, Reman
Remanufactured, OEM New Original Equipment Manufacturer, Recor Re- cored, LKQ Like Kind Quality or Used, Diag Diagnostic, Elec Electrical, Mech Mechanical, Ref Refinish, Struc
Structural
5/9/2012 3:22:21 PM Page 2
INDIANA RETAIL TAX EXEMPT PAGE
C of Carmel CERTIFICATE NO. 003120155 002 0 PU SE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT C
35- 60000972
ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES, A/P
CARMEL, INDIANA 46032 -2584 VOUCHER, DELIVERY MEMO, PACKING SLIPS,
FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL 1997 SHIPPING LABELS AND ANY CORRESPONDENCE.
'U, CHASE DER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION
G Y G
H lorb itpreas C oll ision one" p al ice epa nmernt
3 Civic Sguaro
VENDOF6M Mgt CZMQI Dr1V0 TOIP Catrmol, IN 4
C2mol, IN 46M (w) 671
CONFIRMATION BLANKET I CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
L9Ct OUn
1 Each repairs 4® vehicle $1,920.99 $1,920.99
Sub Total: $1,920.99
lk
car 90 OSrlan 41
asp(
Send Invoice To:
Cwt ®I Pollce Department
Attn: Toms@ Anderson
3 Civic s qum
Carmel, IN 46032-
PLEASE INVOICE IN DUPLICATE
O�rnn�l QE�f�4fLlIN� ACCOUNT PROJECT PROJECT ACCOUNT �q �'PM OPJNT
PAYMENT
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 THERE IS AN UNOBLIGATED BALANCE IN
SHIP REPAID.
THISAPPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER.
C.O.D. SHIPMENTS CANNOT BE ACCEPTED. r..,..+
1
•PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY ll0 a l�rg
SHIPPING LABELS. ,4 J
THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945 TITLE^
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
CLERK TREASURER
DOCUMENT CONTROL NO. 2 6 1 3 8 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 INVOICE NO.. ACCT #/TITLE AMOUNT
DEPT. I 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
20
Signature
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))
05/10/12 10104 vehicle repairs $2,212.27
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 N
ALLOWED 20
Hubler Express Collision
IN SUM OF
503 West Carmel Drive
Carmel„ IN 46032
$2,212.27
ON ACCOUNT OF APPROPRIATION FOR
Carmel Police Department
PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members
26138 I 10104 I 43- 510.00 I $2,212.27 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, May 17, 2012
A A Chief of Police
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund