210367 07/05/2012 CITY OF CARMEL, INDIANA VENDOR: 362830 Page 1 of 1
ONE CIVIC SQUARE GIBBS AUTO INTERIORS, LLC
CARMEL, INDIANA 46032 18318 US HIGHWAY 31 NORTH CHECK AMOUNT: $200.00
WESTFIELD IN 46074 CHECK NUMBER: 210367
CHECK DATE: 7/5/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4351000 2573 200.00 AUTO REPAIR MAINTEN
Gibbs Auto Interiors Invoice
18318 US Hwy 31 N
Date Invoice
Westfield, IN 46074
6/18/2012 2573
Bill To Ship To
CARMEL FIRE DEPT
2 CIVIC SQUARE
CARMEL, IN 46032
P.O. Number Terms Rep Ship Via F.O.B. Project
6/18/2012
Quantity Item Code Description Price Each Amount
Car Seats Labor TRUCK SEAT REPAIR 150.00 150.00
Car Seats Material MATERIALS 50.00 50.00
7.00% 0.00
Total $200.00
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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))
2573 C4591 $200.00
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
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VOUCHER NO. WARRANT NO.
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ALLOWED 20
Gibbs Auto Interiors
IN SUM OF
7201 E. 86th Street
Indianapolis, IN 46250
$200.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members
1120 I 2573 I 43- 510.00 I $200.00 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
JUN ,2012
Fire Chief �E
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund