HomeMy WebLinkAbout215466 12/12/2012 CITY OF CARMEL, INDIANA VENDOR: 361690 Page 1 of 1
ONE CIVIC SQUARE HUBLER EXPRESS COLLISON
CARMEL, INDIANA 46032 CHECK AMOUNT: $984.09
`=0 503 W CARMEL DR
CARMEL IN 46032 CHECK NUMBER: 215466
CHECK DATE: 12112/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4351000 25511 11311 984 . 09 REPAIRS TO VEHICLE 16
HURLER EXPRESS COLLISION — Workfile ID: 05d58cOc
CARREL
INDIANA'S FIRST CHOICE IN COLLISION REPAIR!
503 W. CARMEL DR., CARMEL, IN 46032
Phone: (317) 569-9884
FAX: (317) 569-9885
Final Bill
RO Number: 11311
Customer: Insurance: Adjuster: Estimator: Eric Tobolski
CITY OF CARMEL,UNIT# 16 SELF PAY Phone: Create Date: 10/25/2012
3 CIVIC SQUARE Claim: N/A
CARMEL, IN 46032 Loss Date:
(317)571-2500 Deductible:
Year: 2009 Style: 4D SED VIN: 2G1WS57MX91307714 Mileage In: 56654
Make: CHEV Color: WHITE Mileage Out:
Model: IMPALA POLICE License: 14234 Job Number: Vehicle Out: 12/4/2012
Line Ver Operation Description Qty Extended Type Labor Type Paint
Price$
1 E01 FENDER
2 E01 Remove/Replace LT Fender 1 161.00 A/M 2.4 Body 2.2
3 E01 Add for Clear Coat 0.9
4 E01 Add for Edging 0.5
5 E01 Remove/Replace RT Emblem GM 1 7.49 OEM 0.2 Body
6 E01 HOOD
7 E01 Repair Hood 2.0 Body 3.2
8 E01 Overlap Major Adj. Panel (0.4)
9 E01 Add for Clear Coat 0.6
10 E01 FRONT LAMPS
11 E01 Remove/Install LT Headlamp assy 0.3 Body
12 E01 FRONT BUMPER&GRILLE
13 E01 Remove/Install R&I bumper cover 1.4 Body
14 E01 Deduct for Overlap (0.4) Body
15 E01 PILLARS, ROCKER&FLOOR
16 E01 Remove/Install LT Rocker molding 0.8 Body
17 E01 Hazardous waste removal 1 3.00 Other
18 E01 Cover car 1 5.00 Other 0.2 Body
Estimate Totals Discount$ Markup$ Rate$ Total Hours Total$
Parts 176.49
Labor, Body 44.00 6.9 303.60
Labor, Refinish 44.00 7.0 308.00
Material, Paint 196.00
Subtotal 984.09
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
12/4/2012 9:07:02 AM Page 1
Final Bill
RO Number: 11311
Vehicle: 2009 CHEV IMPALA POLICE 4D SED 6-3.9L-FI WHITE
Sales Tax 0.00
Grand Total 984.09
Net Total 984.09
Estimate Version Total$
Original 984.09
Insurance Total $: 984.09
Received from Insurance$: 0.00
Balance due from Insurance$: 984.09
Customer Total $: 0.00
Received from Customer$: 0.00
Balance due from Customer$: 0.00
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
12/4/2012 9:07:02 AM Page 2
C� ®0 INDIANA RETAIL TAX EXEMPT PAGE
I �� �l CERTIFICATE NO.003120155 002 0
� PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT M11
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
1013112012 S'
Hubler Eupro ss Collision Carmel Police Department
VENDOR SHIP 3 Civic SquaFe
603 ftst Carmel Drive To C2fMGI, IN 46032
Carmel,, IN 46032, (317)5711
CONFIRMATION BLANKET CONTRACT PAYMENTTERMS FREIGHT
QUANTITY UNIT g y'yOF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Account 43.610.00
i Each repairs to vehicle
Sib Total:
1 'j F'..1 ., o�} f:-rte _✓ „^ '
V,
Car 18 Broadn
Send Invoice To: -f `
Carrmol Police Departmentw,,T
Attn:Varese Andemon
3 Civic Squam
C 'nel, IN 46032- PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT U
Carmel Police Dept. ;�� PAYMENT
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. ORDERED BY
•PURCHASE ORDER NUMBER MUST APPEAR ON ALL
SHIPPING LABELS. 1410r of Police
•THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETgO.
$ CLERK-TREASURER
DOCUMENT CONTROL NO. A• COPY-SIGN AND RETURN TO CLERK'S OFFICE
VOUCHER NO. WARRANT NO.
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 invoices), 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
20
................_............................................................................._........--------.._._........_......._...__.._._..__..._....._...------.._.
Signature
-......................_....__._......_.....................___..........................._ .._.._...........................--...._....._........._....._..........._. _._
Title
Cost distribution ledger classification if
claim Laid motor vehicle highway fund
VOUCHER NO. WARRANT NO.
ALLOWED 20
Hubler Express Collision
IN SUM OF $
503 West Carmel Drive
Carmel„ IN 46032
$984.09
ON ACCOUNT OF APPROPRIATION FOR
Carmel Police Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
25511 I 11311 I 43-510.00 I $984.09 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
Thursday, December 06, 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))
12/04/12 11311 vehicle repairs $984.09
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