218815 04/09/2013 CITY OF CARMEL, INDIANA VENDOR: 362147 Page 1 of 1
ONE CIVIC SQUARE CUSTOM TRUCK&AUTO INC
(i
CARMEL, INDIANA 46032 17134 WESTFIELD PARK ROAD CHECK AMOUNT: $95.68
ti oN. WESTFIELD IN 46074 CHECK NUMBER: 218815
CHECK DATE: 4/912013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4351000 17921 95 . 68 AUTO REPAIR & MAINTEN
CUSTOM TRUCK AND AUTO, INC
17134 WESTFIELD PARK ROAD
WESTFIELD IN 46074
317-896-5956
4/1/2013 11:51 AM page 1
Invoice# 17921
FIRE DEPARTMENT CARMEL
1 CIVIC SQUARE
CARMEL IN 46032
-fold here-
Vehicle : 2008 GMC Truck C4500 1 1/2 Ton Truck 6.6 L 403 CID V8 Tag/State : 74803/ IN
VIN : 1GDE4V1958F407045 Color : Red
Fleet# : 2737
Created : 3/4/2013 4:34:43 PM Odometer In : 93
Complete : 3/8/2013 3:39:27 PM Odometer Out : 93
Invoiced : 3/20/2013 4:02:56 PM
Contact : BOB (664-0958)
Qty Code/Tech' Reference Description Condition Unit Price Price
TZ' HEAVY DUTY TIREINSTALL $80.00
MOUNT AND BALANCE FRONT STEER TIRES
1 TZ' LARGE TIRE DISPOSAL $12.00 $12.00
Labor ...................................I................... $80.00
Parts ....................................................... $0.00
Sublet/Misc. ....................................................... $0.00
SHOP SUPPLIES ....................................................... $3.68
Charges ....................................................... $12.00
Sales Tax Tax Exempt#0031201550020 $0.00
Total Due $95.68
Tech Certification#
TZ
Any warranties on the item/items sold are those made by the manufacturer. The seller, Custom Truck
and Auto, Inc., hereby expressly disclaims all warranties, either express or implied, including any
implied warranty of merchantability or fitness for a particular purpose, and Custom Truck and Auto,
Inc., neither assumes nor authorizes any other person to assume for it any liability in connection with
the same of this item/items.
PAYMENT IS DUE AT TIME OF REPAIRS UNLESS OTHER ARRANGEMENTS HAVE BEEN MADE
WITH MANAGEMENT.
THANK YOU FOR YOUR BUSINESS!
I III I II III IIIII IIIII IIII IIIII IIII IIII
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))
17921 $95.68
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
VOUCHER NO. WARRANT NO.
ALLOWED 20
Custom Truck & Auto, Inc.
IN SUM OF $
17134 Westfield Park Road
Westfield, IN 46074
$95.68
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO#/Dept. INVOICE NO. I ACCT#/TITLE I AMOUNT Board Members
1120 I 17921 I 43-510.00 I $95.68 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
APR - 8 2013
Fire Chief
Title
C'r,-qt-rIiQtribution ledger classification if
I
iid motor vehicle highway fund