220171 05/21/2013 CITY OF CARMEL, INDIANA VENDOR: 00351210 Page 1 of 1
ONE CIVIC SQUARE GLASS DOCTOR INDIANAPOLIS
? CHECK AMOUNT: $314.47
CARMEL, INDIANA 46032 7753E 89TH STREET
INDIANAPOLIS IN 46256 CHECK NUMBER: 220171
CHECK DATE: 5/21/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 13491 314 .47 OTHER EXPENSES
GLASS DOCTOR - INDIANAPOLIS
7753 E 89TH ST.
INDIANAPOLIS IN 46256
(317)577-5416 (317)636-2006
Fax:(317)577-5899
Tax# 26-2969258
Invoice: 13491
Date: 04/04/2013
Sold To: Scheduled: 04/03/2013 09:00
CARMEL UTILITIES ATTN: BLAINE
MALLABER
9609 HAZEL DELL PARKWAY
INDIANAPOLIS IN 46280
H(317)571-2634 225
Csr: KAREN Tech: PATRICK ... S13535 Terms: NET 10...
Vehicle: 2006 FORD F SERIES F250 4 DOOR CREW CAB
4ty Part/Description List Price Material Labor Item Total
1 DW01537GBY-Windshield Green Tint/Blue Shade 227.95 98.28 130.00 228.28
(w/Molding attached)(3/4 Moulding)(Solar)(W/Third
Visor Frit)(Aftermarket)
1.00 HAH000004-Adhesive(Nags)(Urethane,Dam,Primer) 14.95 0.00 14.95
(2.00)
1.00 WFS D1319-Moulding(Precision)Black(Reveal) 59.20 56.24 0.00 56.24
l SURCHARGE-Environmental/Disposal Fee 0.00 0.00 15.00 15.00
Notes: Install completed. Please remit payment.
Thank you for choosing Glass Doctor to "fix your panes!"
VIN #
i
Signature
Material Labor Tax Total Deductible Payments ace
169.47 145.00 11.86 326.33 0.00 0.00 3 3
vers:9.0.13 Page: 1
43 1
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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 of service rendered, by whom, rates per day, number of units,
price per unit, etc.
Payee
00351210
GLASS DOCTOR Purchase Order No.
7753e 89th st Terms
Indianapolis, IN 46256 Due Date 5/14/2013
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
5/14/2013 13491 $314.47
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
Date Officer
VOUCHER # 135538 WARRANT # ALLOWED
00351210 IN SUM OF $
GLASS DOCTOR
7753e 89th st
Indianapolis, IN 46256
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO# INV# ACCT# AMOUNT Audit Trail Code
7S,0o
13491 01-73W-02 $145.00
13491 01-7500-02 $169.47
Voucher Total $314.47
Cost distribution ledger classification if
claim paid under vehicle highway fund