221649 07/02/2013 CITY OF CARMEL, INDIANA VENDOR: 00351300 Page 1 of 1
i ONE CIVIC SQUARE PADDACK WRECKER SERVICE, INC CHECK AMOUNT: $125.00
CARMEL, INDIANA 46032 18702 US 31 NORTH
WESTFIELD IN 46074 CHECK NUMBER: 221649
CHECK DATE: 7/2/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
911 4351000 138465 125 . 00 AUTO REPAIR & MAINTEN
AQ�F
PADDACK
WRECKER SERVICE, INC. ;
18702 US 31 North
WESTFIELD, INDIANA 46074 Road:
(317) 896-3206
-- - (317) 846-3206
SeNice
TIME
AM REOUES 3yjY P.O '
NA l Jd !/_,.11 PHONE -
1 I
ADDRESS
CITY STATE ZIP•:4
LO TION OF VEHI LE ""
G�k !�EC f4Te 9 0;4�061):
YEAR,MAKE,MODEL COLOR MILEAGE .�.�
t;::... ✓)')A > b-4-1 -7 /i4 U 7- 9C.1< r
'STATE PLATE.NO VEr�I�pLE I p NO.� � TO
t_L MILEAGE SERVICE TIME ❑ACCIDENT
START - START ;a•,I:IMPOUND
FINISH' ✓�? ' FINISH El BREAKDOWN ,
❑SERVICE CALL
TOTAL -' TOTAL. - ❑
t DESCRIPTION OF SERVICES 'SPECIAL EQUIPMENT,, a
❑SINGLE LINE WINCHING
❑DUAL LINE WINCHING
., ❑SNATCH BLOCKS
CC El DOLLY
R L
,,0, -F- `I 1/1/� l�t j Str r�U S-0m _ loa!!�7 a-/
TYPE OF TOW TOWED PER ORDER OF VEHICLE TOWED TO '
,i❑SLING/HOISTTOW ❑STATE POLICE FIRST TOW
,FLAT BED/RAMP X.LOCAL POLICE C Pf) SA L I J ��•�
El WHEEL LIFT /❑SHERIFF DEPT. SECOND Tow
❑� '❑DEALER ❑OWNER 1-
STORAGE TOWING CHARGE
To DAYS®$ MILEAGE CHARGE
PAID' LABOR CHARGE
DRIVER'S t•
0 CASH ❑CHECK LIC.NO
WINCH CHARGE
`❑MC ❑VISA ❑AMEX ❑DISCOVER DATE
SPILL
CONTAINMENT
SPECIAL
CC No. EQUIPMENT
OPER�+�°R'S SIGNATURE DATE-
CLEAN)
C >A CLEAN U P
UNIT N0. If j!
CIJ
STORAGE
AUTHORIZED SIGNATURE DATE
SUB-LET
+ VEHICLE RELEASED TO 1°air,:" DATE
' TOTAL
138465 Not responsible for loss r damage to vehicle TL.a M VO u
imcase of fire,theft or any other cause tieyond our control. ,1 1, i
rl.vxder"r(on:NEBS CUST(!,M"printing service i I,eo e!Ita?-aar: N+:»s,Inc Petr:rbornugh,,NH o`.LI!,R wcdw noI s.com 'Reef.No.Ci tnnyOgC;7G
. l
Customer Release Form .-
Liability Release Form - -
I have requested towing, transport recovery or roadside services that,
are not recommended by the company below. If damage or theft of
my vehicle(s) occurs because of this request, I release the company .
below of all resporis'ibiIity, both civil and criminal, in a court of law.
Date
Driver's License.
Vehicle ID# —=
Authorizing Signature
Operator Signature=.--
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))
04/21/13 138465 $125.00
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
Paddack Wrecker Service, Inc.
IN SUM OF $
18702 U.S. 31 North
Westfield, IN 46074
$125.00
ON ACCOUNT OF APPROPRIATION FOR
Project 2013-911 Task 2013-2
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
911 138465 43-510.00 $125.OG 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
Wednesday, June 26, 2013
Major
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund