215135 12/04/2012 �\Mf CITY OF CARMEL, INDIANA VENDOR: 237560 Page 1 of 1
ONE CIVIC SQUARE PEARSON FORD,INC
CARMEL, INDIANA 46032 10650 N MICHIGAN RD CHECK AMOUNT: $2,950.48
ZIONSVILLE IN 46077 CHECK NUMBER: 215135
CHECK DATE: 12/4/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2201 4237000 275683 2, 950 .48 REPAIR PARTS
3175712417 Dealer No:06761
Invoice No: 275683 Pearson Ford, Inc.
10650 North Michigan Road
Zionsville, IN 46077
CITY OF CARMEL STREET DEPT INVOICE 317.873.3333
1 CIVIC SQ PAGE 1 www.myindyford.com
CARMEL, IN 46032-2584 PARTS&SERVICE HOURS
Monday-Friday
Home: Email: 7:00 am-6:00 pm
Bus: 317-571-2417
SERVICE ADVISOR:
COLOR YEAR MAKE/MODEL VIN LICENSE MILEAGE IN /OUT TAG
RED 06 FORD F550 1FDAF57P76ED35492 47124 47124 T1439
DEL. DATE, PROD. DATE WARR. EXP.. PROMISED PO NO: RATE PAYMENT ` INV.DATE
02FEB06 D 02JAN06 17:00 27NOV12 BILL 29NOV12
R.O. OPENED READY OPTIONS:ENG:6.0-Liter
11 : 24 26NOV12 12 : 18 29NOV12
LINE OPCODE TECH TYPE HOURS LIST NET TOTAL
A CUSTOMER STATES AFTER SITTING AWHILE VEH. RUNS REALLY ROUGH HAS NO
POWER AT ALL, ONCE IT WARMS UP ITS OK CHECK AND ADVISE
R5M OWNER INSPECTION
7342 CFL 1190 . 00 1190 . 00
4 4C3Z*9E527*BRM REMAN NOZZLE ASY 266 . 67 266 . 67 1066 . 68
1 6C3Z*9G282*C PUMP ASY - FUEL 421 . 97 421 . 97 421 . 97
1 5C3Z*9D930*A WIRE ASY 238 . 33 238 . 33 238 . 33
, , , , 47124 13 . 50 DIAG REPLACED CYL 2 5 6 8 INJECTORS REPLACE INJECTOR
, , , , HARNESS REPLACE FUEL PUMP ASSY EXTRA TIME FOR RR OF PTO
****************************************************
B PERFORM MULTI-POINT INSPECTION
99P PERFORM MULTI-POINT INSPECTION
7342ISPTS (N/C)
****************************************************
CUSTOMER PAY SHOP SUPPLIES FOR REPAIR ORDER 33 . 50
*********** ATTENTION CUSTOMER **************
DID YOU KNOW THAT WE HAVE A QUICK LANE THAT
CAN SERVICE THE CHEVY, DODGE, TOYOTA ETC IN
YOUR GARGAE AT MORE COMPETITIVE PRICES THAN
YOUR LOCAL DEALER? JUST CALL 733-0410 OR
******** SEE YOUR SERVICE ADVISOR TODAY******
DISCLAIMER OF WARRANTIES ..DESCRIPTION TOTALS
ON BEHALF OF SERVICING DEALER, I HEREBY CERTIFY THAT THE AND LIMITATIONS OF LIABILITY
INFORMATION CONTAINED HEREON IS ACCURATE UNLESS OTHERWISE Tne f-Inry warranty, .f any, is me Holy warranty LABOR AMOUNT 1190 00
SHOWN. SERVICES DESCRIBED WERE PERFORMED AT NO CHARGE TO win resree� In rnia sale. SELLER MAKES NO
OWNER. THERE WAS NO INDICATION FROM THE APPEARANCE OF THE WARRANTY WHATSOEVER AND EXPRESSLY PARTS AMOUNT
VEHICLE OR OTHERWISE, THAT ANY PART REPAIRED OR REPLACED DISCLAIMS ALL WARRANTIES EITHER
EXPRESS OR IMPLIED, INCLUDING ANY GAS, OIL, LUBE 0 on
UNDER THIS CLAIM HAD BEEN CONNECTED IN ANY WAY WITH ANY IMPLIED WARRANTY OF MERCHANTABILITY
ACCIDENT, NEGLIGENCE OR MISUSE. RECORDS SUPPORTING THIS OR FITNESS FOR A PARTICULAR PURPOSE. SUBLET AMOUNT on
CLAIM ARE AVAILABLE FOR (1) YEAR FROM THE DATE OF PAYMENT SELLER'S MAXIMUM LIABILITY HEREUNDER MISC. CHARGES
NOTIFICATION AT THE SERVICING DEALER FOR INSPECTION BY IS LIMITED TO THE ORIGINAL SALES PRICE 33 50
MANUFACTURER'S REPRESENTATIVE. AND SELLER SHALL HAVE NO LIABILITY TOTAL CHARGES
FOR ANY INCIDENTAL OR CONSEQUENTIAL
DAMAGES FOR LOST SALES,LOST PROFITS, LESS INSURANCE n no
INJURIES TO PERSONS OR PROPERTY OR
OTHER INJURIES OR DAMAGES. SALES TAX
(SIGNED) DEALER,GENERAL MANAGER OR AUTHORIZED PERSON (DATE) CUSTOMER SIGNATURE PLEASE PAY
THIS AMOUNT
CUSTOMER COPY
cFavirr iuvni�c x xcur.
VOUCHER NO. WARRANT NO.
ALLOWED 20
Pearson Ford
IN SUM OF $
10650 N. Michigan Road
Zionsville, IN 46077
$3„07'1 37
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO#/Dept. INVOICE NO. I ACCT#/TITLE AMOUNT Board Members
2201 I 275683 I 42-370.001 $3"071 37 I hereby certify that the attached invoice(s), or
c; 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
f Friday, No/v�edber 30, 2012
v
Street-Commissioner
Sireet Corrmi� s!;;ner
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))
11/29/12 275683 $3,071.37
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