HomeMy WebLinkAbout214543 11/19/2012 CITY OF CARMEL, INDIANA VENDOR: 366706 Page 1 of 1
1 ONE CIVIC SQUARE ALTRA 1 COLLISION CHECK AMOUNT: $2,500.00
CARMEL, INDIANA 46032 PO BOX 501514
roM INDIANAPOLIS IN 46250 CHECK NUMBER: 214543
CHECK DATE: 11/19/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1125 4351000 7471 2, 500 . 00 AUTO REPAIR & MAINTEN
No_ 007471
105507ESSUP BLVD: o INDIANAPOLIS IN 46280
71i" YR. MAKE MODEL EST TIME BILLING: FOR,p jyX p T I AT Q 1_ PM P.O. BOX 501514 e INDIANAPOLIS, IN 46250 v N f� t_ ) ;� ( ,(317) 440-6000 FAX (317)-846-6560 f' 1 DATE PROPOSED TRIM COLOR
NAME
P WK.OR CELL IN OUT
PFVRIz ^ H LICENSE NO. ODOMETER pF E
ADDRESS N HOME LOSS
E INS.CO. FILE NO. CLAIM NO.
CITY STATE ZIP
ADJUSTER PHONE DEDUCTIBLE RI
RE- RE- DETAILS OF REPAIR LINE PARTS LABOR PAINT SU LE ISC.
PAIR PLACE N=NEW U=USED R=REPAIR S=STRAIGHTEN R/C=RECYCLE/RECHROME/RECORE NO.
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Approval Date 13
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I hereby authorize the abww wark-a ipt of copy.
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SIGNED X DATE PAINT HRS. Cc? $ I
LABOR HRS. @ $
LEFT —PRIOR DAMAGE— PARTS
Areas marked by an"X" RIGHT a�O
represent prior damage - -
® and are not included 4® ® PAINT/SUPPLIES
in this estimate.
SUBLET
—CURRENT ESTIMATE— TOWING/STORAGE
CHAR ESMENTAL
SUB-TOTAL
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TAX
A-PDR
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice of 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.
Altra 1 Collision Terms
P.O. Box 501514
Indianapolis, IN 46250
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO# Amount
10/9/12 7471 Auto body repairs Director's truck 29047 $ 2,500.00
J'
Total $ 2,500.00
I 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.
Altra 1 Collision Allowed 20
P.O. Box 501514
Indianapolis, IN 46250
In Sum of$
$ 2,500.00
ON ACCOUNT OF APPROPRIATION FOR
101 -General Fund
PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members
Dept#
1125 7471 4351000 $ 2,500.00 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
15-Nov 2012
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Signature
$ 2,500.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund