HomeMy WebLinkAbout213501 10/09/2012 CITY OF CARMEL, INDIANA VENDOR: 361690 Page 1 of 1
ONE CIVIC SQUARE HUBLER EXPRESS COLLISON CHECK AMOUNT: $2,674.55
CARMEL, INDIANA 46032 503 W CARMEL DR
CARMEL IN 46032 CHECK NUMBER: 213501
CHECK DATE: 10/912012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4351000 10902 2, 674 . 55 AUTO REPAIR & MAINTEN
HUBLER EXPRESS COLLISION - Workfile ID: 5ba31b73
CARMEL
INDIANA'S FIRST CHOICE IN COLLISION REPAIR!
503 W. CARMEL DR., CARMEL, IN 46032
Phone: (317) 569-9884
FAX: (317) 569-9885
Final Bill
RO Number: 10902
Customer: Insurance: Adjuster: Estimator: Eric Tobolski
CITY OF CARMEL TRAVELERS Phone: Create Date: 9/18/2012
1 CIVIC SQUARE Claim: ERH1164001
CARMEL, IN 46032 Loss Date:
(317)571-2500 Deductible: 2,500.00
Year: 2008 Style: 4D SED VIN: 2G1WS583X81357386 Mileage In: 67143
- Maker- CHEV Color: white Mileage Out:
Model: IMPALA POLICE License: 13255 Job Number: Vehicle Out: 9/24/2012
Line Ver Operation Description Qty Extended Type Labor Type Paint
Price$
1 E01 FENDER
2 E01 Remove/Install LT Fender liner 0.0 Body
3 E01 Remove/Replace LT Fender 1 190.96 OEM 2.4 Body 2.2
4 E01 Add for Clear Coat 0.9
5 E01 Add for Edging 0.5
6 S01 Repair LT Fender upper bracket 0.5 Body 0.2
7 E01 FRONT LAMPS
8 E01 Remove/Install LT Headlamp assy 0.3 Body
9 E01 FRONT BUMPER&GRILLE
10 E01 Remove/Install R&I bumper cover 0.9 Body
11 E01 Deduct for Overlap (0.4) Body
12 E01 FRONT DOOR
13 E01 Remove/Install LT Belt w'strip 0.0 Body
14 E01 Remove/Replace LT Door shell 1 826.59 OEM 4.8 Body 3.0
15 E01 Overlap Major Adj. Panel (0.4)
16 E01 Add for Clear Coat 0.5
17 E01 Add for mirror 0.3 Body
18 E01 Remove/Install LT Applique 1st design 0.0 Body
19 E01 Remove/Replace LT Body side mldg 1 129.01 OEM 0.3 Body 0.5
20 E01 Overlap Minor Panel (0.2)
21 E01 Add for Clear Coat 0.1
22 E01 Remove/Install LT Handle,outside w/o chrome 0.0 Body
23 S01 Repair HINGE HALF BODY SIDE LT 0.5 Body
24 E01 Remove/Replace LT Lower hinge 1 94.68 OEM 0.0 Body 0.3
25 E01 Add for Clear Coat 0.1
T=Taxable Item,RPD=Related Prior Damage,AA=Appearance Allowance,UPD=Unrelated Prior Damage,PDR=Paintless Dent Repair,A/M=Aftermarket,Rechr=Rechromed,Reman=
Remanufwtured,OEM=New Original Equipment Manufacturer,Recor=Re-cored,LKQ=Like Kind Quality or Used,Diag=Diagnostic,Elec=Electrical,Mech=Mechanical,Ref=Refinish,Struc=
Structural
10/2/2012 10:18:03 AM Page 1
Final Bill
RO Number: 10902
Vehicle: 2008 CHEV IMPALA POLICE 4D SED 6-3.9L-FI white
26 S01 Repair HINGE HALF BODY SIDE RT 0.5 Body
27 E01 Remove/Replace LT Upper hinge 1 39.51 OEM 0.0 Body 0.3
28 E01 Add for Clear Coat 0.1
29 E01 Remove/Install LT R&I trim panel 0.0 Body
30 E01 PILLARS, ROCKER&FLOOR
31 E01 Remove/Install LT Rocker molding 0.8 Body
32 E01 Repair LT Uniside assy 2.5 Body 1.5
33 E01 Overlap Major Non-Adj. Panel (0.2)
34 E01 Add for Clear Coat 0.3
35 E01 REAR DOOR
36 E01 Blend LT Outer panel 1.0
37 E01 Remove/Install LT Belt w'strip 0.3 Body
38 E01 Remove/Install LT Body side mldg 0.2 Body
39 E01 Remove/Install LT Handle,outside w/o chrome 0.3 Body
40 E01 Repair CLEAN AND REfAPE 0.2 Body
41 E01 Remove/Install LT R&I trim panel 0.4 Body
42 S01 Repair REMOVE DECALS 1.0 Body
43 E01 Remove/Replace A/M CAR COVER 1 5.00 Other 0.2 Body
44 E01 Remove/Replace A/M RESORE CORROSION PROTECTION 1 5.00 Other 0.2 Body
45 E01 Sublet HAZARDOUS WASTE REMOVAL 1 3.00 Other
Estimate Totals Discount$ Markup$ Rate$ Total Hours Total$
Parts 1,290.75
Sublet/Miscellaneous 3.00
Labor, Body 44.00 16.2 712.80
Labor, Refinish 44.00 10.7 470.80
Material, Paint 299.60
Subtotal 2,776.95
Sales Tax 0.00
Grand Total 2,776.95
Deductible (2,500.00)
Appearance Allowance 150.00
Insurer Prepaid Amount (324.55)
Net Total 102.40
Estimate Version Total$
Original 2,824.55
Supplement S01 102.40
Supplement S02 0.00
Insurance Total$: 102.40
Received from Insurance$: 102.40
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
10/2/2012 10:18:03 AM Page 2
Final Bill
RO Number: 10902
Vehicle: 2008 CHEV IMPALA POLICE 4D SED 6-3.9L-FI white
TRAVELERS 9/25/2012 102.40
Balance due from Insurance$: 0.00
Customer Total $: 2,674.55
Received from Customer$: 0.00
Balance due from Customer$: 2,674.55
T=Taxable Item,RPD=Related Prior Damage,AA=Appearance Allowance,UPD=Unrelated Prior Damage,PDR=Paindess 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
10/2/2012 10:18:03 AM Page 3
INDIANA RETAIL TAX EXEMPT PAGE
City ®f Carmel CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 24
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
01170`92
Hublor Eupruss Collision Carmel Policia Department
VENDOR SHIP 3 CIVIC squam
S3 Mat Cufii of DdgQ TO Carmd, IN 46M
Camel„ IN 4= 571
CONFIRMATION BLANKET CONTRACT PAYMENTTERMS FREIGHT
_T
QUANTITY I UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Account 43.690,00
1 Each repairs 4o vehicle $2,824.55 $2;824.55
Sub Totai: $2,824.55
TO y^{
L�
cm21 /P�imroz �U
Send Invoice o: _�.
C @fmQI Pollco Dop rtm ont
Attn:Twosa Andorson
3 Civic Oquzla
Caf mol, IN 46=- PLEASE INVOICE IN DUPLICATE
DEPARTMENT -, ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
Carmel Police Dept. PAYMENT 02,8=24.55
• A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O.
NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND
VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED.
SHIPPING INSTRUCTIONS I HEREBY CERTIFY THATTHERE IS AN UNOBLIGATED BALANCE IN
THIS APP SWFFICIENT TO PAY FOR THE ABOVE ORDER.
•SHIP REPAID. .�/QQQ
•C.O.D.SHIPMENTS CANNOT BE ACCEPTED.
•PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY
SHIPPING LABELS.
•THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE ChIof of Polico
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
CLERK-TREASURER
DOCUMENT CONTROL No- 26235 A.P.V. COPY-SIGN AND RETURN TO CLERK'S OFFICE
VOUCHER NO` WARRANT ND`____-
ALLOWED 20___
|N THE SUM OF$
[^
ON ACCOUNT OF APPROPRIATION FOR
,
`
'
Board Members
IDPO'9' INVOICE NO. ACCT#/TITLt' AMOUNT
| hereby certify that the attached invoica(a), or
bill(s) is (are) true and correct and that the
materials or services itemized thereon for
which charge ia made were ordered and
received except
/
'
20____
`
Signature
` Tioa
'
Cost distribution ledger classification if �
claim paid mom,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))
09/24/12 10902 vehicle repairs $2,674.55
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
Hubler Express Collision
IN SUM OF $
503 West Carmel Drive
Carmel„ IN 46032
$2,674.55
ON ACCOUNT OF APPROPRIATION FOR
Carmel Police Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
I hereby certify that the attached invoice(s), or
`2� I 10902 I 43-510.00 I $2,674.55
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, October 04, 2012
Chief of Police
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund