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Home My WebLink About215665 12/18/2012 d CITY OF CARMEL, INDIANA VENDOR: 361690 Page 1 of 1 ONE CIVIC SQUARE HUBLER EXPRESS COLLISION CARMEL, INDIANA 46032 503 W CARMEL DR CHECK AMOUNT: $7,663.81 CARMEL IN 46032 CHECK NUMBER: 215665 CHECK DATE: 12/1812012 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1110 4351000 25512 11234 684 . 54 REPAIRS TO VEHICLE 11 1110 4351000 25464 11298 339.31 REPAIRS TO VEHICLES 1110 4351000 25519 11333 4, 170 . 52 REPAIRS TO CAR 38 1110 4351000 25518 11335 1, 269 .44 REPAIRS TO CAR 19 1110 4351000 26238 11381 736 . 80 REPAIRS TO CAR 70 1110 4351000 25547 11402 463 . 20 REPARIS TO CAR 138 HUBLER EXPRESS COLLISION - Workfile ID: 67d5f083 CARMEL INDIANA'S FIRST CHOICE IN COLLISION REPAIR! 503 W. CARMEL DR., CARMEL, IN 46032 Phone: (317) 569-9884 FAX: (317) 569-9885 Final Bill RO Number: 11402 Customer: Insurance: Adjuster: Estimator: Eric Tobolski UNIT#138,CITY OF CARMEL SELF PAY Phone: Create Date: 11/30/2012 1 CIVIC SQ Claim: N/A CARMEL,IN 46032 Loss Date: (317)571-2559 Deductible: Year: 2012 Style: 4D SED VIN: 2G1WD5E34C1285477 Mileage In: 1773 Make: CHEV Color: WHITE Mileage Out: Model: IMPALA POLICE License: 7224 Job Number: Vehicle Out: 12/14/2012 Line Ver Operation Description Qty Extended Type Labor Type Paint Price$ 1 E01 REAR BUMPER 2 E01 Remove/Install R&I bumper cover 1.5 Body 3 E01 Repair Bumper cover w/dual exh 1.0 Body 3.0 4 E01 Add for Clear Coat 1.2 5 E01 REAR LAMPS 6 E01 Remove/Install License lamp 0.2 Body 7 E01 Flex Additive 1 3.00 Other 8 E01 Hazardous waste removal 1 3.00 Other Estimate Totals Discount$ Markup$ Rate$ Total Hours Total$ Parts 6.00 Labor, Body 48.00 2.7 129.60 Labor,Refinish 48.00 4.2 201.60 Material, Paint 126.00 Subtotal 463.20 Sales Tax 0.00 Grand Total 463.20 Net Total 463.20 Estimate Version Total$ Original 463.20 Insurance Total$: 0.00 Received from Insurance$: 0.00 Balance due from Insurance$: 0.00 T=Taxable Item,RPD=Related Prior Damage,AA=Appearance Allowance,UPD=Unrelated Prior Damage,PDR=Paintless Dent Repair,A/M=Aftermark%Rechr=Rechromed,Reman= Remanufactured,OEM=New Original Equipment Manufacturer,Recor=Re-cored,LKQ=Like Kind Quality or Used,Diag=Diagnostic,Elec=Electrical,Mech=Mechanical,Ref=Refinish,Struc= Structural 12/14/2012 3:17:10 PM Page 1 Final Bill RO Number: 11402 Vehicle: 2012 CHEV IMPALA POLICE 4D SED 6-3.6L-FI WHITE Customer Total$: 463.20 Received from Customer$: 0.00 Balance due from Customer$: 463.20 T=Taxable Item,RPD=Related Prior Damage,AA=Appearance Allowance,UPD=Unrelated Prior Damage,PDR=Paintless Dent Repair,A/M=Aftermarket,Recor=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 12/14/2012 3:17:10 PM Page 2 HURLER EXPRESS COLLISION - Workfile ID: aa4c8770 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: 11333 Customer: Insurance: Adjuster: Estimator: Eric Tobolski CITY OF CARMEL,UNIT#38 TRAVELERS Phone: Create Date: 11/15/2012 1 CIVIC SQ Claim: ERH3727001 CARMEL,IN 46032 Loss Date: (317)733-4600 Deductible: Year: 2011 Style: 4D SED VIN: 2G1WD5EM1B1289817 Mileage In: 36090 Make: CHEV Color: WHITE Mileage Out: Model: IMPALA POLICE License: 5435 Job Number: Vehicle Out: 12/11/2012 Line Ver Operation Description Qty Extended Type Labor Type Paint Price$ 1 E01 FRONT BUMPER&GRILLE 2 E01 0/H front bumper 2.4 Body 3 E01 Remove/Replace Bumper cover w/o fog lamps 1 385.80 OEM 0.0 Body 3.0 4 E01 Add for Clear Coat 1.2 5 E01 Remove/Replace Energy absorber 1 194.27 OEM 0.0 Body 6 E01 Remove/Replace Impact bar 1 124.02 OEM 0.0 Body 7 E01 Remove/Replace Lower grille w/o SS 1 67.60 OEM 0.0 Body 8 S01 Remove/Replace Upper grille w/o SS 1 83.53 OEM 0.0 Body 9 E01 FRONT LAMPS 10 E01 Remove/Install RT Headlamp assy 0.3 Body 11 E01 Remove/Install LT Headlamp assy 0.3 Body 12 S01 Remove/Replace RT Headlamp assy clip 1 5.77 OEM 13 E01 RADIATOR SUPPORT 14 E01 Remove/Replace RT Diagonal brace 1 45.36 OEM 0.3 Body 15 E01 Remove/Replace LT Diagonal brace 1 28.15 OEM 0.3 Body 16 S01 Repair Radiator support 3.0 Body 1.5 17 E01 HOOD 18 E01 Remove/Replace Hood 1 427.72 OEM 1.5 Body 3.2 19 E01 Add for Clear Coat 1.3 20 E01 Add for Underside(Complete) 1,6 21 E01 Add for Clear Coat 0.3 22 S01 Remove/Replace Lock support 1 37.75 OEM 0.2 Body 0.3 23 SO1 Add for Clear Coat 0.1 24 E01 INFORMATION LABELS 25 E01 Remove/Replace Caution label radiator cap 1 34.47 OEM 0.2 Body T=Taxable Item,RPD=Related Prior Damage,AA=Appearance Allowance,UPD=Unrelated Prior Damage,PDR=Paintless Dent Repair,AJM=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 12/14/2012 10:04:10 AM Page 1 Final Bill RO Number: 11333 Vehicle: 2011 CHEV IMPALA POLICE 4D SED 6-3.9L-FI WHITE 26 E01 Flex Additive 1 3.00 Other 27 E01 Repair Pull upper tie bar 3.0 Body 28 E01 Hazardous waste removal 1 3.00 Other 29 E01 Corrosion protection 1 5.00 Other 0.2 Body 30 E01 Cover car 1 5.00 Other 0.2 Body 31 S01 Repair Anchor/Setup/Measure w/report 1.5 Body 32 S01 Remove/Replace A/M CONDENSER 1 287.48 Other 2.6 Body 33 SO1 PILLARS, ROCKER&FLOOR 34 S01 Remove/Install RT Rocker molding 0.8 Body 35 S01 Remove/Install LT Rocker molding 0.8 Body 36 Sol FENDER 37 S01 Repair RT Lower rail 3.9, 5.3 liter 3.0 Body 1.5 38 SO1 Add for Clear Coat 0.3 39 S02 Remove/Replace RT Bumper bracket 1 18.13 OEM 1.0 Body 40 S02 Repair LT Lower rail 3.9, 5.3 liter 2.0 Body 1.5 41 S02 Add for Clear Coat 0.3 42 SO1 AIR CONDITIONER&HEATER 43 S01 Remove/Replace Evacuate&recharge 1.4 Mech 44 S01 Remove/Replace Refrigerant recovery 0.4 Mech 45 SO1 Repair BRACKET FOR TRANS COOLER 1.0 Body 46 S01 Repair UPPER BUMPER SUPPORT 1.0 Body 47 SO1 Two part Seam sealer 1 20.00 Other 0.5 Body 48 S01 Repair PULL RT RAIL END 1.0 Body 49 S02 Remove/Replace Filter 1 34.56 OEM Estimate Totals Discount$ Markup$ Rate$ Total Hours Total$ Parts 1,810.61 Labor, Body 48.00 27.1 1,300.80 Labor, Refinish 48.00 16.1 772.80 Labor, Mechanical 78.00 1.8 140.40 Material, Paint 483.00 Subtotal 4,507.61 Sales Tax 0.00 Grand Total 4,507.61 Net Total 4,507.61 Estimate Version Total$ Original 2,567.79 Supplement S01 1,602.73 Supplement S02 337.09 Insurance Total$: 4,507.61 T=Taxable Item,RPD=Related Prior Damage,AA=Appearance Allowance,UPD=Unrelated Prior Damage,PDR=Paintless Dent Repair,A/M=Aftermarket,Rechr=Rechromed,Reman= Remanufactured,OEM=New Original Equipment Manufacturer,Recor=Re-cored,LKQ=Like Kind Quality or Used,Diag=Diagnostic,Elec=Electrical,Mech=Mechanical,Ref=Refinish,Struc= Structural 12/14/2012 10:04:10 AM Page 2 Final Bill RO Number; 11333 Vehicle: 2011 CHEV IMPALA POLICE 4D SED 6-3.9L-FI WHITE Received from Insurance$: 0.00 Balance due from Insurance$: 4,507.61 Customer Total$: 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=Aftennarket,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 12/14/2012 10:04:10 AM Page 3 0� �1 INDIANA RETAIL TAX EXEMPT PAGE C1 II Carmel CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER J FEDERAL EXCISE TAX EXEMPT 26547 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 M ,12 Hubl@F Eupress Collision Camel Police De partmont VENDOR SHIP -3 Civic Square SM est Carmel Drive To V Camel, IN 4 Camel,, IN 46M (317)571 9 CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION Account 43-MOM 9 Each repairs to vehide $463.20 $463.20 Sub Total: $463.20 - } ��'f _ .v�l are - �� ,'t}� .. _'�• e t ;' T car 138 Driater Send Invoice To: Carmel Police Department Attn:Temsa Andemon 3 Civic Squam Carmel, Its 46032. PLEASE INVOICE IN DUPLICATE DEPARTMENT ACCOUNT _ PROJECT PROJECT ACCOUNT AMOUNT Carmel Police Dept. {,. � 6� PAYMENT $463.2o A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O. NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED. SHIPPING INSTRUCTIONS I HEREBY CERTIFY THAT IS AN UNOBLIGATED BALANCE IN SHIP REPAID. THIS APPROPRIATIONfSUFFICIENT TO PAY FOR THE ABOVE ORDER. • •C.O.D.SHIPMENTS CANNOT BE ACCEPTED. -,-„-,.-d.----�°-�- •PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY vvv�� fff�� SHIPPING LABELS. /i�i e}8 !p Police •THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. 77 CLERK-TREASURER DOCUMENT CONTROL NO. A .V. COPY-SIGN AND RETURN TO CLERK'S OFFICE VOUCHER NO, ALLOWED 20 IN THE SUM OF$ ON ACCOUNT OF APPROPRIATION FOR Board Members PO#or INVOICE NO. ACCT#/TITLE AMOUNT DEPT.# I hereby certify that the attached 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 C0 x j INDIANA RETAIL TAX EXEMPT PAGE 1 of, ., sanel CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER FEDERAL EXCISE TAX EXEMPT 35-60000972 ONE CIVIC SQUARE THI%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 Hublar Express Collision," Camel Pollco Department VENDOR SHIP 3 CIVIC Square 5M West Cartel DdVG � To Cannel, IN 46032 CinrmoI„ Ill 9&M '(397)579 2559 CONFIRMATION B=UNIT PAYMENT TERMS FREIGHT QUANTITY DESCRIPTION UNIT PRICE EXTENSION Account 43.610,00 I Each repairs to vehicle $2,573.79 $2,573.79 Sub Total: $2,573.78 I r car 38 C ouln Send Invoice To: W✓ '�� " � Carmel Police Department Attn:Tessa Anderson 3 Civic Square Carmel, IN 4 PLEASE INVOICE IN DUPLICATE DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT Carmel Police Dept. t�3 PAYMENT $2,573.79 • A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O. NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND VOUCHER HAS THE PROVER SWORN AFFIDAVIT ATTACHED. SHIPPING INSTRUCTIONS I HEREBY CERTIFY✓TH� SHIP REPAID. ATITHERE IS AN UNOBLIGATED BALANCE IN THIS APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER. • •C.O.D.SHIPMENTS CANNOT BE ACCEPTED. �. ORDERED BY •PURCHASE ORDER NUMBER MUST APPEAR ON ALL , SHIPPING LABELS. & P�I� i� 1' •THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE 16 ,9 AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. V 5"x CLERK-TREASURER DOCUMENT CONTROL NO. k- � COPY-SIGN AND RETURN TO CLERK'S OFFICE VOUCHER NO. WARRANT NO..............-__---- ALLOWED 20 _ _..._ _..... __ IN THE SUM OF$ ON ACCOUNT OF APPROPRIATION FOR Board Members PO#or INVOICE NO. ACCT#/TITLE AMOUNT DEPT.# I hereby certify that the attached 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 VOUCHER NO. WARRANT NO. ALLOWED 20 Hubler Express Collision IN SUM OF $ 503 West Carmel Drive Carmel„ IN 46032 $4,633.72 ON ACCOUNT OF APPROPRIATION FOR Carmel Police Department PO#/Dept. INVOICE NO. I ACCT#/TITLE AMOUNT Board Members 25547 11402 43-510.00 $463.20 I hereby certify that the attached invoice(s), or bill(s) is (are) true and correct and that the 25519 11333 43-510.00 $4,170.52 materials or services itemized thereon for which charge is made were ordered and received except Monday, December 17, 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)) 12/14/12 11402 vehicle repairs/car 138 $463.20 12/14/12 11333 vehicle repairs/car 38 $4,170.52 1 hereby certify that the attached invoice(s), or bill(s), is(are)true and correct and I have audited same in accordance with IC 5-11-10-1.6 20 Clerk-Treasurer „ t HUBLER EXPRESS COLLISION — Workfile ID: 344067b2 CARMEL INDIANA'S FIRST CHOICE IN COLLISION REPAIR! 503 W. CARMEL DR., CARMEL, IN 46032 Phone: (317) 569-9884 FAX: (317) 569-9885 Final Bill RO Number: 11381 Customer: Insurance: Adjuster: Estimator: Eric Tobolski UNIT#70,CITY OF CARMEL SELF PAY Phone: Create Date: 11/30/2012 1 CIVIC SQ Claim: N/A CARMEL,IN 46032 Loss Date: (317)571-2559 Deductible: Year: 2010 Style: 4D SED VIN: 2G1WD5EM4A1225348 Mileage In: 54168 Make: CHEV Color: WHITE Mileage Out: Model: IMPALA POLICE License: 15088 Job Number: Vehicle Out: 12/13/2012 Line Ver Operation Description Qty Extended Type Labor Type Paint Price$ 1 E01 FRONT BUMPER&GRILLE 2 E01 Repair Bumper cover w/o fog lamps 6.0 Body 3.0 3 E01 Add for Clear Coat 1.2 4 E01 Overhaul O/H bumper assy 2.4 Body 5 E01 Remove/Install R&I bumper cover 0.0 Body 6 E01 Remove/Install Upper grille w/o SS 0.0 Body 7 E01 Remove/Install Lower grille w/o SS 0.0 Body 8 E01 Flex Additive 1 3.00 Other 9 E01 Hazardous waste removal 1 3.00 Other Estimate Totals Discount$ Markup$ Rate$ Total Hours Total$ Parts 6.00 Labor, Body 48.00 8.4 403.20 Labor, Refinish 48.00 4.2 201.60 Material,Paint 126.00 Subtotal 736.80 Sales Tax 0.00 Grand Total 736.80 Net Total 736.80 Estimate Version Total$ Original 736.80 Insurance Total$: 0.00 Received from Insurance$: 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,Rechr=Re-cored,LKQ=Like Kind Quality or Used,Diag=Diagnostic,Elec=Electrical,Mech=Mechanical,Ref=Refinish,struc= Structural 12/13/2012 3:34:42 PM Page 1 Final Bill RO Number: 11381 Vehicle: 2010 CHEV IMPALA POLICE 4D SED 6-3.9L-FI WHITE Balance due from Insurance$: 0.00 Customer Total$: 736.80 Received from Customer$: 0.00 Balance due from Customer$: 736.80 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,Rechr=Re-cored,LKQ=Like Kind Quality or Used,Diag=Diagnostic,Elec=Electrical,Mech=Mechanical,Ref=Refinish,Struc= Structural 12(13(2012 3:34:42 PM Page 2 HUBLER EXPRESS COLLISION - Workfile ID: 4efO2fc1 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: 11335 Customer: Insurance: Adjuster: Estimator: Eric Tobolski CITY OF CARMEL,UNIT# 19 SELF PAY Phone: Create Date: 11/16/2012 1 CIVIC SQ Claim: N/A CARMEL,IN 46032 Loss Date: (317)571-2523 Deductible: Year: 2010 Style: 4D SED VIN: 2G1WD5EM7A1225909 Mileage In: 45406 Make: CHEV Color: WHITE Mileage Out: Model: IMPALA POLICE License: 15091 Job Number: Vehicle Out: 12/4/2012 Line Ver Operation Description Qty Extended Type Labor Type Paint Price$ 1 SO1 REAR BODY&FLOOR 2 SO1 Repair Rear body panel 2.0 Body 0.3 3 SO1 Add for Clear Coat 0.2 4 SO1 QUARTER PANEL 5 S01 Repair RT Lower panel 2.0 Body 0.6 6 S01 Overlap Minor Panel (0.2) 7 SO1 Add for Clear Coat 0.1 8 E01 REAR BUMPER 9 E01 O/H rear bumper 1.9 Body 10 S01 Remove/Replace Bumper cover w/o dual exh 1 526.63T OEM 0.0 Body 3.0 11 E01 Add for Clear Coat 1.2 12 E01 Flex Additive 1 3.00T Other 13 E01 Hazardous waste removal 1 3.00 Other 14 S01 Repair SET-UP 1.0 Body 15 SO1 Repair ROUGH PULL REAR BODY 1.0 Body 16 S01 Sublet REMOVAL OF TAX FROM LOCKED 1 (47.99) Other ESTIMATE Estimate Totals Discount$ Markup$ Rate$ Total Hours Total$ Parts 532.63 Sublet/Miscellaneous (47.99) Labor, Body 48.00 7.9 379.20 Labor, Refinish 48.00 5.2 249.60 Material, Paint 156.00 Subtotal 1,269.44 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 12/13/2012 3:37:46 PM Page 1 Final Bill RO Number: 11335 Vehicle: 2010 CHEV IMPALA POLICE 4D SED 6-3.9L-FI WHITE �p Sales Tax 47.99 ` Grand Total 1,317.43 Net Total 1,317.43 Estimate Version Total$ Original 1,011.97 Supplement SO 305.46 Insurance Total$: 0.00 Received from Insurance$: 0.00 Balance due from Insurance$: 0.00 Customer Total$: 1,317.43 Received from Customer$: 0.00 Balance due from Customer$: 1,3 3 T=Taxable Item,RPD=Related Prior Damage,AA=Appearance Allowance,UPD=Unrelated Prior Damage,PDR=Paintless Dent Repair,AIM=ARermarket,Recor=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 12/13/2012 3:37:46 PM Page 2 HUBLER EXPRESS COLLISION — Workfile ID: 773flc58 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: 11298 Customer: Insurance: Adjuster: Estimator: Eric Tobolski CITY OF CARMEL UNIT#6 SELF PAY Phone: Create Date: 8/27/2012 3 Civic Sq. Claim: N/A Carmel,IN 46032 Loss Date: (317)571-2600 Deductible: Year: 2010 Style: 4D SED VIN: 2FABP7BV4AX129762 Mileage In: 52958 Make: FORD Color: WHITE Mileage Out: Model: CROWN VICTORIA License: 14839 Job Number: Vehicle Out: 11/28/2012 Line Ver Operation Description Qty Extended Type Labor Type Paint Price$ 1 Sol REAR BODY&FLOOR 2 S01 Repair Rear body panel 2.0 Body 1.0 3 SO1 REAR LAMPS 4 S01 Remove/Install LT Tail lamp assy solid red black molding 0.6 Body 5 S01 Remove/Replace License lamp 1 19.48T OEM 0.2 Body 6 S01 Repair Reflector panel w/o sport pkg. 1.0 Body 0.4 7 Sol Add for Clear Coat 0.1 8 E01 FRONT BUMPER 9 E01 Remove/Replace License bracket 1 18.83T OEM 0.2 Body 10 E01 Hazardous waste removal 1 3.00 Other Estimate Totals Discount$ Markup$ Rate$ Total Hours Total$ Parts 41.31 Labor, Body 46.00 4.0 184.00 Labor, Refinish 46.00 1.5 69.00 Material,Paint 45.00 Subtotal 339.31 Bottomline Discount (5.73) Sales Tax 5.73 Grand Total 339.31 Net Total 339.31 Estimate Version Total$ Original 252.30 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 12/13/2012 3:37:09 PM Page 1 Final Bill RO Number: 11298 Vehicle: 2010 FORD CROWN VICTORIA POLICE 4D SED 8-4.6L-FI WHITE Supplement S01 87.01 Insurance Total$: 0.00 Received from Insurance$: 0.00 Balance due from Insurance$: 0.00 Customer Total$: 339.31 Received from Customer$: 0.00 Balance due from Customer$: 339.31 T=Taxable Item,RPD=Related Prior Damage,AA=Appearance Allowance,UPD=Unrelated Prior Damage,PDR=Paintless Dent Repair,A/M=Afterrnarket,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 12/13/2012 3:37:09 PM Page 2 HURLER EXPRESS COLLISION - Workfile ID: 688ed98d 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: 11234 Customer: Insurance: Adjuster: Estimator: Eric Tobolski CITY OF CARMEL,UNIT# 119 TRAVELERS Phone: Create Date: 11/13/2012 1 CIVIC SQ Claim: EVU2839001 CARMEL,IN 46032 Loss Date: (317)571-2500 Deductible: Year: 2010 Style: 4D UTV VIN: IFMCU9DG4AKD28701 Mileage In: 29388 Make: FORD Color: GREY Mileage Out: Model: ESCAPE 4X4 XLT License: 430BTD Job Number: Vehicle Out: 11/14/2012 Line Ver Operation Description Qty Extended Type Labor Type Paint Price$ 1 E01 REAR BUMPER 2 E01 Overhaul O/H bumper assy 1.5 Body 3 E01 Remove/Replace Bumper cover 1 222.49 OEM 0.0 Body 2.8 4 E01 Add for Clear Coat 1.1 5 E01 Remove/Replace Absorber w/o trailer tow 1 96.05 OEM 0.0 Body 6 E01 Remove/Install Top pad 0.0 Body 7 E01 Flex Additive 1 3.00 Other 8 E01 Hazardous waste removal 1 3.00 Other Estimate Totals Discount$ Markup$ Rate$ Total Hours Total$ Parts 324.54 Labor, Body 45.00 1.5 67.50 Labor, Refinish 45.00 3.9 175.50 Material, Paint 117.00 Subtotal 684.54 Sales Tax 0.00 Grand Total 684.54 Net Total 684.54 Estimate Version Total$ Original 684.54 Insurance Total$: 684.54 Received from Insurance$: 0.00 Balance due from Insurance$: 684.54 T=Taxable Item,RPD=Related Prior Damage,AA=Appearance Allowance,UPD=Unrelated Prior Damage,PDR=Paintless Dent Repair,A/M=Aftermarket,Recor=Rechromed,Reman= Remanufactured,OEM=New Original Equipment Manufacturer,Recor=Re-cored,LKQ=Like Kind Quality or Used,Diag=Diagnostic,Elec=Electrical,Mech=Mechanical,Ref=Refinish,Struc= Structural 12/13/2012 3:35:39 PM Page 1 Final Bill RO Number: 11234 Vehicle: 2010 FORD ESCAPE 4X4 XLT 4D UTV 6-3.01--FI GREY Customer Total$: 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=Aftennarket,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 12/13/2012 3:35:39 PM Page 2 INDIANA RETAIL TAX EXEMPT PAGE City, ®f Carmel CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER FEDERAL EXCISE TAX EXEMPT 2 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 MV2012 Hubler Ettpross Collision Cwmel Pollee Department VENDOR SHIP 3 CIVIC scum 603 mgt Ca>mol DrIVQ To Carmel, IN Carmol„ IN 4m (317)671 CONFIRMATION BLANKET CONTRACT PAYMENTTERMS FREIGHT QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION Account 43.6io.09 9 Each repairs to vehicle $870.46 $870.40 Saab Total: $870.46 a,q y' b Br•; -. fa c. .Po •a cor 70 I Cash � ' r Send Invoice To: Camel Pollco Dopartmont Attn: Tessa Anelorson 3 Civic Square Caumol, IN 46032= PLEASE INVOICE IN DUPLICATE DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT Cannel Police Dept. l PAYMENT $870.46 • A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O. NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED. SHIPPING INSTRUCTIONS I HEREBY CERTIFY T A�eTlfHERE IS AN UNOBLIGATED BALANCE IN •SHIP REPAID. THIS APPROPRIATI• y FFICIENT TO AY FOR THE ABOVE ORDER. •C.O.D.SHIPMENTS CANNOT BE ACCEPTED. •PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY SHIPPING LABELS. •THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE e?of Police AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. CLERK-TREASURER DOCUMENT CONTROL NO. 2 6 2 3 8 A.P.V. COPY-SIGN AND RETURN TO CLERK'S OFFICE VOUCHER WARRANTNO____- ALLOWED 20___ |N THE SUM OF$ ON ACCOUNT{}F APPROPRIATION FOR G` ` Board Members PO#pr INVOICE NO. ACCT#/TITLE- AMOUNT | hereby certify that the attached immice(s), or bill(s) is (on*) true and correct and that the materials nr services itemized thereon for which charge ia made were ordered and reoeivedexoop�______________'___________ ' ` ' 20____ ' . . . _�_______ Signature Title ' Cost distribution ledger classification if � claim paid motor vehicle highway fund Ci ' INDIANA RETAIL TAX EXEMPT PAGE ty o . �'�„x °�anal CERTIFICATE NO.003120155 002 0 1i CL.� 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 `It/1012 Hubl @r Exprost; Collision Cafm@l Police Depattment VENDOR SHIP 3 CIVIC squa m TO Mat Car-ftiel Ddy@ J Camel, IN 46n2 Carmel„ IN 46032 671*666 CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION Account 4MiO.00 1 Each repairs to vehicle $965.12 $985.12 Sub Total: $985.12 �F VAI C:51, 19 1 Howard Send Invoice To: Camel Police Diapartmont Attn: Terasa Anderson 3 Civic Square Carmel, IN 46Mv PLEASE INVOICE IN DUPLICATE DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT Carmel Police Dep#m r $I •92 PAYMENT ' A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O. NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED. SHIPPING INSTRUCTIONS I HEREBY CERTIFY T,HATT SHIP REPAID. HERE IS AN UNOBLIGATED BALANCE IN THIS APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER. • •C.O.D.SHIPMENTS CANNOT BE ACCEPTED. • ORDERED BY PURCHASE ORDER NUMBER MUST APPEAR ON ALL SHIPPING LABELS. /�a •THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE Chl f of Police AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. 55 18 CLERK-TREASURER DOCUMENT CONTROL NO. A.P.V. COPY-SIGN AND RETURN TO CLERK'S OFFICE VOUCHER NO.._� _WARRANT ALLOWED 20 IN THE SUM OF$ ON ACCOUNT OF APPROPRIATION FOR Board Members PO#or INVOICE NO. ACCT#/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 INDIANA RETAIL TAX EXEMPT PAGE City ® I' Qarmel CERTIFICATE NO.003120155 002 0 JA 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 9MM12 Hublor Exproos Collision Carfrtcl Policc Dpaftmont VENDOR SHIP 3 Civic Square 503 West Camel Drive TO Carmel, IN 46432 Camel„ IN 460 ' (347)571 CONFIRMATION BLANKET CONTRACT PAYMENTTERMS FREIGHT Account UNIITOF MEASURE DESCRIPTION UNIT PRICE EXTENSION Account 9 Each repairs to vehicle $236.40 $238A0 Sub Total: $238.40 'I Elsher —_ • ��f.-a. ... � � a'3 tic Send Invoice To. Camel Police Department Attn: Taresa Anderson 3 Civic Squam Camel, IN 46032- PLEASE INVOICE IN DUPLICATE DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT Carmel Police Dept. �� PAYMENT x•40 J A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O. / NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND U VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED. SHIPPING INSTRUCTIONS I HEREBY CEJR�IFYj�HATTHERE IS AN UNOBLIGATED BALANCE IN SHIP REPAID. THIS APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER. • •C.O.D.SHIPMENTS CANNOT BE ACCEPTED. • ORDERED BY PURCHASE ORDER NUMBER MUST APPEAR ON ALL ij .. SHIPPING LABELS. Uchlefof Police •THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. 25 4 6 4 CLERK-TREASURER DOCUMENT CONTROL NO. A.P.V. COPY-SIGN AND RETURN TO CLERK'S OFFICE VOUCHER NO. WARRANT NO.-...__-.._-_-.._ ALLOWED 20 __.--_ -------------.--._..._ _ __�-. IN THE SUM OF$ ON ACCOUNT OF APPROPRIATION FOR Board Members PO#or INVOICE NO. ACCT#/TITLE AMOUNT DEPT.# I hereby certify that the attached 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 20 ..................................................... _._...-....._.........-......_-------------....-......_..-.-.._.... Signature ...................................................... ........_..._......................................--........._. -. Title Cost distribution ledger classification if claim paid motor vehicle highway fund INDIANA RETAIL TAX EXEMPT PAGE Cit-y of. �°,�rme l CERTIFICATE NO.003120155 002 0 CSJS PURCHASE ORDER NUMBER FEDERAL EXCISE TAX EXEMPT 25512 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 `101W201 Hubler Express Collision Carmel Polito Oepaftment VENDOR SHIP 3 Civic Square 603 Wost Carmol Dfive TO Carmel, IN 46032 Camel,, IN 46032 671D26% CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE - EXTENSION Account 43.510;00 9 Each repairs to vehide $384.54 $884.54 Stab Taal: $884.54 5 g car 110 McIntyre Send Invoice To: aY Carmel Police De0artment Attn: Teresa Anderson 3 Civic Squaw Carmel, IN 46032- PLEASE INVOICE IN DUPLICATE DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT Carmel Police Dept. \ � PAYMENT x.54 . � . • A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O. NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED. SHIPPING INSTRUCTIONS I HEREBY CERTIFY�T,HAT�THERE IS AN UNOBLIGATED BALANCE IN SHIP REPAID. THIS APPROPRIATION>SUFFICIENT TO PAY FOR ABOVE ORDER. • •C.O.D.SHIPMENTS CANNOT BE ACCEPTED. • ORDERED BY PURCHASE ORDER NUMBER MUST APPEAR ON ALL SHIPPING LABELS. 9f of Police •THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. 2 5 031 2 CLERK-TREASURER DOCUMENT CONTROL NO. A.P.V. COPY-SIGN AND RETURN TO CLERK'S OFFICE VOUCHER NO._____._..._..._..WARRANT NO._.-._._-_.-__ -) ALLOWED 20 IN THE SUM OF$ ON ACCOUNT OF APPROPRIATION FOR Board Members PO#or INVOICE NO. ACCT#/TITLE AMOUNT DEPT.# I hereby certify that the attached 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 20 _................._.._......_...................................._........._........._.....---.........._..._....................._........._........---....................._...... Signature .................................-..............._.._............................__..._.........................._..........._. Title Cost distribution ledger classification if claim paid motor vehicle highway fund VOUCHER NO. WARRANT NO. ALLOWED 20 Hubler Express Collision IN SUM OF $ 503 West Carmel Drive Carmel„ IN 46032 $ 17 DI ON ACCOUNT OF APPROPRIATION FOR Carmel Police Department PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members 25512 11234 43-510.00 X6 ' �84.54 I hereby certify that the attached invoice(s), or ��Y) -3/ bill(s) is (are) true and correct and that the 25464 11298 43-510.00 238.4$— p,�6q,4 materials or services itemized thereon for 25518 11335 43-510.00 ?#3- Which charge is made were ordered and 26238 11381 43-510.00 ✓$736.80 received except ! Friday, December 14, 2012 —A W51 J 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)) 11/14/12 11234 vehicle repairs/car 119 $684.54 11/28/12 11298 vehicle repairs/car 6 $238.40 12/04/12 11335 vehicle repairs/car 19 $1,317.43 12/13/12 11381 vehicle repairs 1 car 70 $736.80 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