HomeMy WebLinkAbout210403 07/05/2012 CITY OF CARMEL, INDIANA VENDOR: 361690 Page 1 of 1
ONE CIVIC SQUARE HUBLER EXPRESS COLLISON
CARMEL, INDIANA 46032 503 W CARMEL DR CHECK AMOUNT: $948.15
CARMEL IN 46032 CHECK NUMBER: 210403
CHECK DATE: 7/5/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4351000 26128 10377 948.15 REPAIRS TO VEHICLE
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HUBLER EXPRESS COLLISION W orkfile ID: 1d328b3e
CARMEL
C INDIANA'S FIRST CHOICE IN COLLISION REPAIR!
p 503 W. CARMEL DR., CARMEL, IN 46032
Phone: (317) 569 -9884
V� FAX: (317) 569 -9885
Final Bill
RO Number: 10377
Customer: Insurance: Adjuster: Estimator: Alex Brumfield
CITY OF CARMEL SELF PAY Phone: Create Date: 6/20/2012
3 CIVIC SQUARE Claim:
CARMEL, IN 46032 Loss Date:
(317) 733 -4600 Deductible:
Year: 2010 Style: 4D SED VIN: 2G1WD5EMXAl224043 Mileage In:
Make: CHEV Color: WHITE Mileage Out:
Model: IMPALA POLICE License: 15085 Job Number: Vehicle Out: 6/21/2012
Line Ver Operation Description Qty Extended Type Labor Type Paint
Price
1 E01 REAR BUMPER
2 E01 Remove /Replace Bumper cover w /dual exh 1 535.55 OEM 1.9 Body 3.0
3 E01 Add for Clear Coat 1.2
4 E01 Flex Additive 1 3.00 Other
5 E01 Hazardous waste removal 1 3.00 Other
Estimate Totals Discount Markup Rate Total Hours Total
Parts 541.55
Labor, Body 46.00 1.9 87.40
Labor, Refinish 46.00 4.2 193.20
Material, Paint 126.00
Sub total 948.15
Sales Tax 0.00
Grand Total 948.15
948.15
Net Total
Estimate Version Total
Original 948.15
Insurance Total 0.00
Received from Insurance 0.00
Balance due from Insurance 0.00
Customer Total 948.15
Received from Customer 0.00
Re gyred LKQ Uke K \t\d Qt1aG\y 0, USed, D1ag Diagnostic, Elec Electrical, M ch
Taxable Item, RPD Related Prior Damag
e Appearance AlloWance.UPD Unrelated Prior Damage, PDR Paintless Dent Repair, A/M Aftermarket, Rechr Rechromed, eman page 1
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City INDIANA RETAIL TAX EXEMPT PAGE
CERTIFICATE NO. 003120155 002 0 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 28921
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.
'URCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION
411912012 T_
Hublor Estpm s Collision Cannol Pollco Dopagtmont
VENDOR SHIP 3 Chic squm
SW Woot Cwnol Ddvo T O Cannel, IN 66032
C@fmol„ IN 68032 (397) 579
CONFIRMATION BLANKET CONTRACT PAYMENTTERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
kccoun$ 63 -690.00
9 Each ropairs 4o vehicle $605.80 $605.80
Sub Total: $605.80
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3 CIVIC squam PLEASE INVOICE IN DUPLICATE
Carol, IN 41 AMOUNT
ACCOUNT PROJECT PROJECT ACCOUNT
DEPARTMENT PAYMENT M.80
AIP VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O.
1 NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND
Q
VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED.
l 1 r V 1 I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN
THIS APPROPRIATI FFICIENT TO PAY FOR ABOVE ORDER.
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CHIP REPAID• T MUST APPEAR ON TITLE
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SHIPME
ORDER NUMBER A 9 (ER 99, Nc 1
URONASE PNO��e�EN����PEt�.
GOMp`\PNGE CLERK-T S N
�H�ee�N�� COPY ;SIGN AND RETURN TO CLERK'S OFFICE
a��aC�S� N O �,No•
OGUMEN'S CO
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VOUCHER NO. WARRANT NO.—.-----
ALLOWED 20
IN THE SUM OF
ON ACCOUNT OF APPROPRIATION FOR
3
r
Board Members
PO# or DEPT. INVOICE NO. ACCT #/TITLE AMOUNT 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))
06/20/12 10377 repairs to car 46 Vanderbeck $948.15
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. WA RRANT N
ALLOWED 20
Hubler Express Collision
IN SUM OF
503 West Carmel Drive
Carmel„ IN 46032
$948.15
ON ACCOUNT OF APPROPRIATION FOR
Carmel Police Department
PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members
26128 I 10377 I 43- 510.00 I $948.15 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
Wednesday, June 27, 2012
Chief of Police
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund