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HomeMy WebLinkAbout214684 11/20/2012 a CITY OF CARMEL, INDIANA VENDOR: 361690 Page 1 of 1 D ONE CIVIC SQUARE HUBLER EXPRESS COLLISON CARMEL, INDIANA 46032 503 W CARMEL DR CHECK AMOUNT: $18,957.28 <,o `? CARMEL IN 46032 CHECK NUMBER: 214684 CHECK DATE: 11/2012012 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1110 4351000 25489 11008 10, 943 . 26 REPAIRS TO CAR 39 1110 4351000 25488 11062 8, 014 . 02 REPAIRS TO CAR 102 HUBLER EXPRESS COLLISION - Workfile ID: 10690b24 CARMEL INDIANA'S FIRST CHOICE IN COLLISION REPAIR! 503 W. CARMEL DR., CARMEL, IN 46032 Phone: (317) 569-9884 FAX: (317) 569-9885 Final Bill RO Number: 11062 Customer: Insurance: Adjuster: Estimator: Eric Tobolski CITY OF CARMEL, UNIT# 102 TRAVELERS Phone: Create Date: 10/16/2012 1 CIVIC SQ Claim: CER0471001 CARMEL,IN 46032 Loss Date: (317)733-4600 Deductible: 2,500.00 Year: 2011 Style: 4D SED VIN: 2G1WD5EM9B1288642 Mileage In: 26972 Make: CHEV Color: WHITE Mileage Out: Model: IMPALA POLICE License: 5633 Job Number: Vehicle Out: 11/1/2012 Line Ver Operation Description Qty Extended Type Labor Type Paint Price$ 1 E01 FRONT LAMPS 2 E01 Remove/Install LT Headlamp assy 0.3 Body 3 E01 FENDER 4 S01 Remove/Replace LT Fender 1 190.96 OEM 2.4 Body 2.2 5 E01 Add for Clear Coat 6 E01 Add for Edging 0.5 7 E01 Remove/Install LT Fender liner 0.0 Body 8 E01 FRONT BUMPER&GRILLE 9 E01 Remove/Install R&I bumper cover 0.7 Body 10 E01 Deduct for Overlap (0.4) Body 11 E01 HOOD 12 E01 Blend Hood 1.6 13 E01 PILLARS, ROCKER&FLOOR 14 E01 Remove/Replace LT Rocker molding 1 197.19 OEM 0.8 Body 2.1 15 E01 Add for Clear Coat 16 S01 Repair LT Uniside assy 10.0 Body 3.0 17 E01 Overlap Major Adj. Panel (0.4) 18 E01 Add for Clear Coat 19 S01 Remove/Replace LT Weatherstrip 1 53.05 OEM 0.0 Body 20 E01 Remove/Install LT Carpet retainer front ebony 0.0 Body 21 E01 Remove/Install LT Carpet retainer rear ebony 0.0 Body 22 S01 Remove/Install RT Rocker molding 0.8 Body 23 E01 FRONT DOOR 24 E01 Remove/Install LT Door w'strip ebony,titanium 0.0 Body 25 S01 Remove/Replace LT Door shell 1 826.59 OEM 4.8 Body 3.0 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 11/12/2012 10:30:05 AM Page 1 Final Bill RO Number: 11062 Vehicle: 2011 CHEV IMPALA POLICE 4D SED 6-3.9L-FI WHITE 26 E01 Overlap Major Adj. Panel (0.4) 27 E01 Add for Clear Coat 28 E01 Add for mirror 0.3 Body 29 S01 Remove/Replace LT Belt w'strip 1 45.38 OEM 0.0 Body 30 S01 Remove/Replace LT Body side mldg 1 129.01 OEM 0.3 Body 0.5 31 Sol Overlap Minor Panel (0.2) 32 E01 Add for Clear Coat 33 E01 Remove/Install LT Mirror assy w/o defogger smooth 0.0 Body 34 S01 Remove/Replace LT Door glass GM +25 1 93.75 Glass 0.0 Body 35 E01 Remove/Replace LT Applique 2nd design 1 54.39 OEM 0.0 Body 36 E01 Remove/Replace LT Handle,outside w/o chrome 1 55.81 OEM 0.0 Body 0.5 37 E01 Overlap Minor Panel (0.2) 38 E01 Add for Clear Coat 39 E01 Remove/Install LT R&I trim panel 0.0 Body 40 E01 Remove/Replace LT Upper hinge 2nd design 1 40.49 OEM 0.0 Body 0.3 41 E01 Add for Clear Coat 42 E01 Remove/Replace LT Lower hinge 2nd design 1 94.68 OEM 0.0 Body 0.3 43 E01 Add for Clear Coat 44 E01 Remove/Replace LT Belt w'strip 1 30.01 OEM 0.0 Body 45 Sol Remove/Replace LT Lock assy all 1 169.96 OEM 0.0 Body 46 E01 Repair UPPER HINGE POST SIDE 0.3 Body 47 E01 Repair LOWER HINGE POST SIDE 0.3 Body 48 S02 Remove/Replace LT Window regulator 1 177.80 OEM 0.0 Body 49 S02 Remove/Replace LT Rear channel 1 31.06 OEM 0.0 Body 50 E01 REAR DOOR 51 S01 Remove/Replace LT Door shell 1 814.86 OEM 4.5 Body 3.0 52 E01 Overlap Major Adj. Panel (0.4) 53 E01 Add for Clear Coat 54 E01 Remove/Replace LT Belt w'strip 1 60.70 OEM 0.0 Body 55 E01 Remove/Replace LT Body side mldg 1 115.27 OEM 0.2 Body 0.4 56 E01 Overlap Minor Panel (0.2) 57 E01 Add for Clear Coat 58 E01 Remove/Install LT Handle,outside w/o chrome 0.0 Body 59 E01 Remove/Install LT R&I trim panel 0.0 Body 60 E01 QUARTER PANEL 61 S01 Repair LT Quarter panel 9.5 Body 2.2 62 E01 Overlap Major Adj. Panel (0.4) 63 E01 Add for Clear Coat 64 E01 ADD FOR LOCK PILLAR 0.5 65 E01 Remove/Install Fuel door 0.3 Body 66 E01 Refinish Fuel door 0.3 67 E01 Add for Clear Coat T=Taxable Item,RPD=Related Prior Damage,AA=Appearance Allowance,UPD=Unrelated Prior Damage,PDR=Paintless Dent Repair,A/M=Aftermarket,Rechr=Rechromed,Remain= 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 11/12/2012 10:30:05 AM Page 2 Final Bill RO Number: 11062 Vehicle: 2011 CHEV IMPALA POLICE 4D SED 6-3.9L-FI WHITE 68 E01 CLEAR COAT 2.5 69 E01 Remove/Install LT Qtr glass GM 1.5 Body 70 E01 Remove/Install LT Wheelhouse liner 0.3 Body 71 E01 REAR LAMPS 72 E01 Remove/Install LT Tail lamp assy 0.4 Body 73 E01 ROOF 74 E01 Remove/Install LT Molding 0.4 Body 75 E01 WHEELS 76 S01 Remove/Replace LT/Front Wheel cover w/POLICE 1 53.37 OEM 0.2 Body 77 S01 Remove/Replace LT/Rear Wheel cover w/POLICE 1 53.37 OEM 0.2 Body 78 Sol RADIATOR SUPPORT 79 S01 Remove/Replace RT Diagonal brace 1 45.36 OEM 0.3 Body 80 S01 Remove/Replace LT Diagonal brace 1 28.15 OEM 0.3 Body 81 E01 REAR BUMPER 82 E01 Repair Bumper cover w/dual exh 1.0 Body 2.6 83 E01 Add for Clear Coat 1.2 84 E01 Remove/Install R&I bumper cover 1.1 Body 85 E01 Remove/Install SPOT LIGHT 0.5 Body 86 E01 Remove/Install POLICE ROOF LIGHTS 0.5 Body 87 E01 Repair REMOVE POLICE DECAL 1.0 Body 88 SO1 Flex Additive 1 2.90 Other 89 E01 Cover car 1 5.00 Other 0.2 Body 90 E01 Sublet FOUR WHEEL ALIGNMENT 1 89.95 Other 91 SO1 Urethane glass kit 1 12.50 Other 92 SO1 Corrosion protection 1 5.00 Other 0.5 Body 93 E01 Repair SET-UP AND MEASURE 2.0 Body 94 E01 Repair CLEAN BROKEN GLASS 2.0 Body 95 E01 Repair UNIBODY FRAME REPAIR 3.0 Frame 96 S01 Repair PULL FRONT END TO SQUARE 6.0 Frame 97 S01 Repair PINCH WELDS- LT SIDE 0.5 Body 0.5 98 S01 Repair PINCH WELDS- RT SIDE 0.5 Body 0.5 99 SO1 Remove/Install BATTERY 0.3 Body 100 S01 Repair GLASS CLEAN-UP 1.0 Body 101• S02 Remove/Replace CLIP 1 6.26 Other Estimate Totals Discount$ Markup$ Rate$ Total Hours Total$ Parts 3,392.87 Sublet/Miscellaneous 89.95 Labor, Body 44.00 49.8 2,191.20 Labor, Refinish 44.00 25.5 1,122.00 Labor, Frame 56.00 9.0 504.00 Material, Paint 714.00 Subtotal 8,014.02 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 11/12/2012 10:30:05 AM Page 3 Final Bill RO Number: 11062 Vehicle: 2011 CHEV IMPALA POLICE 4D SED 6-3.9L-FI WHITE Sales Tax 0.00 Grand Total 8,014.02 Deductible (2,500.00) Appearance Allowance 225.00 Insurer Prepaid Amount (5,964.02) Net Total (225.00) Estimate Version Total$ Original 7,225.59 Supplement S01 1,023.31 Supplement S02 (9.88) Insurance Total$: (225.00) Received from Insurance$: 0.00 Balance due from Insurance$: (225.00) Customer Total $: 8,014.02 Received from Customer$: 0.00 Balance due from Customer$: 8,014.02 T=Taxable Item,RPD=Related Prior Damage,AA=Appearance Allowance,UPD=Unrelated Prior Damage,PDR=Paintless Dent Repair,A/M=Aftermarket,Rechr=Rechromed,Reman= Remanufactured,OEM=New Original Equipment Manufacturer,Recor=Re-cored,LKQ=Like Kind Quality or Used,Diag=Diagnostic,Elec=Electrical,Mech=Mechanical,Ref=Refinish,Struc= Structural 11/12/2012 10:30:05 AM Page 4 HUBLER EXPRESS COLLISION - Workfile ID: 2ae4c294 CARMEL INDIANA'S FIRST CHOICE IN COLLISION REPAIR! 503 W. CARMEL DR., CARMEL, IN 46032 Phone: (317) 569-9884 FAX: (317) 569-9885 Final Bill RO Number: 11008 Customer: Insurance: Adjuster: Estimator: Eric Tobolski CITY OF CARMEL TRAVELERS Phone: Create Date: 10/5/2012 1 CIVIC SQUARE Claim: EUY9382001 Loss Date: (317)571-2523 Deductible: 2,500.00 Year: 2011 Style: 4D SED VIN: 2G1WD5EM1B1290479 Mileage In: 29885 Make: CHEV Color: WHITE Mileage Out: Model: IMPALA POLICE License: 5433 Job Number: Vehicle Out: 10/26/2012 Line Ver Operation Description Qty Extended Type Labor Type Paint Price$ 1 E01 RADIATOR SUPPORT 2 E01 Repair Radiator support 3.5 Body 1.5 3 E01 FRONT LAMPS 4 E01 Remove/Replace RT Headlamp assy clip 1 5.77 OEM 5 E01 Repair ADD FOR POLICE OPTION 0.5 Body 6 S02 Remove/Replace RT Headlamp assy 1 286.90 OEM 0.3 Body 7 E01 Aim headlamps 0.5 Body 8 E01 FRONT BUMPER&GRILLE 9 S02 Overhaul O/H bumper assy 2.6 Body 10 S02 Remove/Replace Impact bar 1 124.02 OEM 0.0 Body 1.0 11 S02 Remove/Replace Lower deflector all 1 67.38 OEM 0.0 Body 12 E01 Remove/Install License bracket 0.0 Body 13 S02 Remove/Replace Energy absorber 1 194.27 OEM 0.0 Body 14 S02 Remove/Replace Bumper cover w/o fog lamps 1 385.80 OEM 0.0 Body 3.0 15 E01 Add for Clear Coat 1.2 16 E01 HOOD 17 S02 Remove/Replace Hood 1 427.72 OEM 1.5 Body 3.2 18 E01 Add for Clear Coat 0.0 19 E01 Add for Underside(Complete) 1.6 20 E01 Remove/Install Insulator 0.0 Body 21 E01 FENDER 22 E01 Blend LT Fender 1.1 23 S02 Remove/Replace RT Fender 1 187.78 OEM 2.4 Body 2.2 24 E01 Overlap Major Adj. Panel (0.4) 25 E01 Add for Clear Coat 0.0 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 11/12/2012 10:32:25 AM Page 1 r Final Bill RO Number: 11008 Vehicle: 2011 CHEV IMPALA POLICE 4D SED 6-3.9L-FI WHITE 26 E01 Add for Edging 0.5 27 E01 Deduct for Overlap (0.4) Body 28 E01 Remove/Install LT Fender liner 0.4 Body 29 S02 Remove/Replace RT Fender liner 1 21.65 OEM 0.0 Body 30 E01 Repair RT Apron panel 1.0 Body 0.0 31 E01 Repair RT Front panel 1.5 Body 0.3 32 E01 Add for Clear Coat 0.1 33 S02 Remove/Replace RT Upper rail 1 141.67 OEM 3.5 Body 0.7 34 E01 Overlap Minor Panel (0.2) 35 E01 PILLARS, ROCKER&FLOOR 36 E01 Remove/Install LT Rocker molding 0.8 Body 37 E01 Remove/Replace RT Rocker molding 1 187.98 OEM 0.8 Body 1.7 38 E01 Add for Clear Coat 0.4 39 E01 Repair RT Uniside assy 3.0 Body 1.2 40 E01 Overlap Major Adj. Panel (0.4) 41 E01 Add for Clear Coat 0.3 42 E01 WHEELS 43 S02 Remove/Replace RT/Front Wheel cover w/POLICE 1 52.48 OEM 44 S02 Remove/Replace RT/Front Wheel,steel w/o threaded insert 1 209.18 OEM 0.3 Body 45 Sol FRONT SUSPENSION 46 S02 O/H frt susp rt 3.0 Mech 47 S01 Remove/Replace RT Strut w/POLICE 1 118.72 OEM 0.0 Mech 48 S02 Remove/Replace LT Lower cntrl arm w/POLICE 1 90.73 OEM 1.0 Mech 49 S02 Remove/Replace RT Knuckle w/POLICE 1 177.73 OEM 0.0 Mech 50 S02 Deduct for Overlap (0.4) Mech 51 S02 Remove/Replace RT Lower cntrl arm w/POLICE 1 90.73 OEM 0.0 Body 52 S02 Deduct for Overlap 0.0 Body 53 E01 ELECTRICAL 54 E01 Remove/Install Battery 0.3 Body 55 S01 Remove/Replace Horn low note 1 69.80 OEM 0.2 Body 56 SO1 Remove/Install Battery tray 0.2 Body 57 S01 Remove/Install ELECTRIC COMPONETS ON RT APRON 1.5 Body 58 S02 Remove/Replace Pressure sensor 1 72.44 OEM 0.2 Mech 59 E01 FRONT DOOR 60 S02 Remove/Replace RT Body side mldg 1 126.87 OEM 0.3 Body 0.4 61 S02 Overlap Minor Panel (0.2) 62 E01 Add for Clear Coat 0.1 63 S02 Remove/Replace RT Door shell 1 812.82 OEM 4.8 Body 2.6 64 E01 Overlap Major Adj. Panel (0.4) 65 E01 Add for Clear Coat 0.4 66 E01 Add for mirror 0.3 Body 67 E01 Remove/Install RT Belt w'strip 0.0 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 11/12/2012 10:32:25 AM Page 2 t Final Bill RO Number: 11008 Vehicle: 2011 CHEV IMPALA POLICE 4D SED 6-3.9L-FI WHITE 68 S02 Remove/Replace RT Mirror assy w/o defogger smooth 1 161.92 OEM 0.0 Body 0.5 69 E01 Overlap Minor Panel (0.2) 70 E01 Add for Clear Coat 0.1 71 E01 Remove/Install RT Handle, outside w/o chrome 0.0 Body 72 E01 Remove/Install RT R&I trim panel 0.0 Body 73 S01 Remove/Replace RT Upper hinge 2nd design 1 40.49 OEM 0.0 Body 0.3 74 SO1 Add for Clear Coat 75 E01 WINDSHIELD 76 E01 Remove/Install Washer reservoir 0.5 Body 77 E01 REAR DOOR 78 E01 Remove/Install RT Belt w'strip 0.3 Body 79 E01 Repair RT Outer panel 2.5 Body 1.9 80 E01 Overlap Major Adj. Panel (0.4) 81 E01 Add for Clear Coat 0.3 82 E01 Remove/Install RT Body side mldg 0.2 Body 83 E01 Remove/Install RT R&I trim panel 0.4 Body 84 E01 Repair RT Handle,outside w/o chrome 0.4 85 E01 Overlap Minor Panel (0.2) 86 E01 Add for Clear Coat 0.1 87 E01 Repair RT Body side mldg 0.7 Body 0.3 88 E01 Overlap Minor Panel (0.2) 89 E01 Add for Clear Coat 0.1 90 E01 QUARTER PANEL 91 E01 Remove/Install RT Wheelhouse liner 0.3 Body 92 S01 Repair RT Quarter panel 10.0 Body 1.9 93 E01 Overlap Major Adj. Panel (0.4) 94 E01 Add for Clear Coat 0.3 95 E01 ADD FOR LOCK PILLAR 0.5 96 E01 CLEAR COAT 2.3 97 E01 Remove/Install RT Qtr glass GM 1.5 Body 98 E01 Refinish ADDITIONAL CLEAR COAT RT UPPER 0.5 RAIL 99 E01 ROOF 100 E01 Remove/Install RT Molding 0.4 Body 101 S02 Remove/Replace RT Molding 1 120.58 OEM 0.0 Body 102 E01 REAR LAMPS 103 E01 Remove/Install RT Tail lamp assy 0.4 Body 104 E01 REAR BUMPER 105 E01 0/H rear bumper 1.9 Body 106 S02 Remove/Replace Bumper cover w/dual exh 1 526.63 OEM 0.0 Body 3.7 107 E01 Overlap Major Non-Adj. Panel (0.2) 108 E01 Add for Clear Coat 0.7 109 E01 Sublet FOUR WHEEL ALIGNMENT 1 89.95 Other 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 11/12/2012 10:32:25 AM Page 3 Final Bill RO Number: 11008 Vehicle: 2011 CHEV IMPALA POLICE 4D SED 6-3.9L-FI WHITE 110 E01 Sublet BALANCE WHEEL/TIRE 1 15.00 Other 111 E01 Remove/Replace A/M CAR COVER 1 5.00 Other 0.2 Body 112 E01 Remove/Replace A/M RUBBER VALVE STEM 1 2.50 Other 113 E01 Remove/Replace A/M FLEX ADDITIVE 1 3.00 Other 114 E01 Remove/Replace A/M RESTORE CORROSOIN PROTECTION 1 10.00 Other 0.5 Body 115 E01 Remove/Replace A/M GLASS INSTALLATION KIT 1 15.00 Other 116 E01 Remove/Install ROOF POLICE LAMP 0.5 Body 117 E01 Repair SET UP AND MEASURE 2.0 Body 118 S01 Repair UNIBODY FRAME REPAIR 4.0 Frame 119 E01 Sublet HAZ WASTE 1 3.00 Other 120 E01 Repair REMOVE POLICE DECALS 2.0 Body 121 S01 MATCH INSUR EST REFINISH 1 28.40 Other 122 S02 Remove/Replace FREIGHT CHARGES 1 37.99 Other 123 S02 Remove/Replace FREIGHT CHARGES 1 32.96 Other 124 S02 Sublet REPAIR SIR LIGHT 1 673.20 Sublet Estimate Totals Discount$ Markup$ Rate$ Total Hours Total$ Parts 4,836.91 Sublet/Miscellaneous 781.15 Labor, Body 44.00 54.1 2,380.40 Labor, Refinish 44.00 34.2 1,504.80 Labor, Frame 56.00 4.0 224.00 Labor, Mechanical (Sol) 0.0 0.00 Labor, Mechanical (S02) 68.00 3.8 258.40 Material, Paint 957.60 Subtotal 10,943.26 Sales Tax 0.00 Grand Total 10,943.26 Deductible (2,500.00) Appearance Allowance 225.00 Net Total 8,668.26 Estimate Version Total$ Original 9,144.16 Supplement Sol 582.41 Supplement S02 1,441.69 Insurance Total $: 8,668.26 Received from Insurance$: 0.00 Balance due from Insurance$: 8,668.26 Customer Total $: 2,275.00 T=Taxable Item,RPD=Related Prior Damage,AA=Appearance Allowance,UPD=Unrelated Prior Damage,PDR=Paintless Dent Repair,A/M=Aftermarket,Rechr=Rechromed,Reman= Remanufactured,OEM=New Original Equipment Manufacturer,Recor=Re-cored,LKQ=Like Kind Quality or Used,Diag=Diagnostic,Elec=Electrical,Mech=Mechanical,Ref=Refinish,Struc= Structural 11/12/2012 10:32:25 AM Page 4 Final Bill RO Number: 11008 Vehicle: 2011 CHEV IMPALA POLICE 4D SED 6-3.9L-FI WHITE Received from Customer$: 0.00 Balance due from Customer$: 2,275.00 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 11/12/2012 10:32:25 AM Page 5 INDIANA RETAIL TAX EXEMPT PAGE City O Carmel CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER FEDERAL EXCISE TAX EXEMPT 2US 35-60000972 ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES,A/P CARMEL, INDIANA 46032-2584 VOUCHER, DELIVERY MEMO, PACKING SLIPS, SHIPPING LABELS AND ANY CORRESPONDENCE. FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL- 1997 PURCHASE ORDER DATE DATE REQUIRED REQUISITIO7 t VENDOR NO. L DESCRIPTION 10IM12 Hublor smProag Celllseon Carmel Police Dopartment VENDOR SHIP 3 Chic Square gysyWest[C��@rjpel Drive TO Carmel, Il�a�4Q6M C ial, IN 4C{kDv'�G (3 A7)571.2 9 CONFIRMATION BLANKLCONTRACT PAYMENTTERMS FREIGHT QUANTITY U DESCRIPTION UNIT PRICE EXTENSION Account 43. 90.0 9 Each repairs to vehicle $7,225.59 $7,225.59 Sub Total: $7,225.59 -4 r 102 f Hughes 't ® Send In To: Camel Police Department Attu: Teresa Anderson 3 Civic Square Carrel, IN 41332- PLEASE INVOICE IN DUPLICATE DEPARTMENT ACCOUNT PROJECT I PROJECT ACCOUNT AMOUNT Cannel Police Dept. PAYMENT $7,225.59 • A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O. NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED. SHIPPING INSTRUCTIONS I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN THIS APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER. •SHIP REPAID. •C.O.D.SHIPMENTS CANNOT BE ACCEPTED. r` + •PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY SHIPPING LABELS. � \ \ g •THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE '� "�` 1 Chief of Police AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. 2 Z54 8 8 CLERK-TREASURER DOCUMENT CONTROL NO. A.P.V. COPY-SIGN AND RETURN TO CLERK'S OFFICE VOUCHER NO. WARRANT ALLOWED 20 IN THE SUM OF$ ON ACCOUNT OF APPROPRIATION FOR Board Members PO#or INVOICE NO. ACCT#ITITLE 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 INDIANA RETAIL TAX EXEMPT PAGE City ®;I' 3 C°�rme l CERTIFICATE NO.003120155 002 0 1i �V CR.tt JJLL PURCHASE ORDER NUMBER FEDERAL EXCISE TAX EXEMPT 35-60000972 ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES,A/P CARMEL, INDIANA 46032-2584 VOUCHER, DELIVERY MEMO, PACKING SLIPS, SHIPPING LABELS AND ANY CORRESPONDENCE. FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL 1997 PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION 10012 HublarExpross Collision Carrel Police Department VENDOR SHIP 3 Civic Square TO 5M watt Carmel Drivo Car l, IN 460 Carmel„ IN 4 (317)671-2559 CONFIRMATION =UNIT PAYMENT TERMS FREIGHT QUANTITY DESCRIPTION UNIT PRICE EXTENSION Account 43,610.00 4 Each repairs to vehide $9,144.16 $9,144.16 Sub'Total: $9,144.16 Al Sb car 391 Matthews f �' Send Invoice To: 4` % Central police Department Attn. 'Teresa Anderson 3 Civic Square Camel, IN 42m PLEASE INVOICE IN DUPLICATE DEPARTMENT ACCOUNT PROJECT I PROJECT ACCOUNT AMOUNT Cannel Police Dept. PAYMENT $9,144.16 • A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O. NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED. SHIPPING INSTRUCTIONS •.I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN THIS APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER. •SHIP REPAID. Ya •C.O.D.SHIPMENTS CANNOT BE ACCEPTED. ORDERED BY "_:°"� •ti\-y1-tZ-.:.S.. Y •PURCHASE ORDER NUMBER MUST APPEAR ON ALL _.., SHIPPING LABELS. d, Chief R6ilcc •THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE 'a ' AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. L-.,. DOCUMENT CONTROL NO. . °.P COPY-SIGN AND RETURN TO CLERK'S OFFICE r VOUCHER NO. WARRANT ALLOWED 20 IN THE SUM OF$ 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 I VOUCHER NO. WARRANT NO. ALLOWED 20 Hubler Express Collision IN SUM OF $ 503 West Carmel Drive Carmel„ IN 46032 $18,957.28 ON ACCOUNT OF APPROPRIATION FOR Carmel Police Department PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members 25489 11008 43-510.00 $10,943.26 I hereby certify that the attached invoice(s), or bill(s) is (are) true and correct and that the 25488 11062 43-510.00 $8,014.02 materials or services itemized thereon for which charge is made were ordered and received except Thursday, November 15, 2012 Chief of Police 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)) 10/26/12 11008 vehicle repairs $10,943.26 11/01/12 11062 vehicle repairs $8,014.02 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