222365 07/30/2013 CITY OF CARMEL, INDIANA VENDOR: 362147 Page 1 of 1
ONE CIVIC SQUARE CUSTOM TRUCK&AUTO INC CHECK AMOUNT: $484.16
CARMEL, INDIANA 46032 17134 WESTFIELD PARK ROAD
'ti,_oN`o WESTFIELD IN 46074 CHECK NUMBER: 222365
CHECK DATE: 7/30/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4351000 19300 484 . 16 AUTO REPAIR & MAINTEN
CUSTOM TRUCK AND AUTO, INC
17134 WESTFIELD PARK ROAD
WESTFIELD IN 46074
317-896-5956
7/8/2013 1:20 PM page 1
Invoice#19300
FIRE DEPARTMENT CARMEL
1 CIVIC SQUARE
CARMEL IN 46032
-fold here-
Vehicle : 1988 KME ENGINE 40
VIN : 62176 Color : Red
Fleet# : E40
Created : 7/1/2013 9:43:10 AM Odometer In : 0
Complete : 7/2/2013 2:13:59 PM Odometer Out : 0
Invoiced : 7/2/2013 2:13:59 PM
Contact : BOB,(664-0958)•-"
Sry Writer: SW
Qty Code/Tech* -Reference Description Condition• -Unit Price- Price
3 SW* Antifreeze-Extended Life Universal-Gallon $20.13 $60.39
JUW* REFRIGERANT LEAK TEST $8.00
SYSTEM WAS 3 LBS LOW-LEAK TEST FOUND THE COMPRESSOR MANIFOLD O-RINGS LEAKING.
DRIER WAS REPLACED DUE TO AGE.
JUW* R&R DRIER $80.00
1 JUW* A/C Filter Dryer $34.46 $34.46
JUW* RESEALED COMPRESSOR MANIFOLD O-RINGS $40.00
JUW* EVACUATE,CHARGE&PERFORMANCE TEST $80.00
PERFORMANCE RESULTS: 150/10 @ 72 DEGREES
5.5 JUW* REFRIGERANT R134a, New $20.00 $110.00
SW* DIAGNOSE AND REPAIR COOLANT LEAK $60.00
PRESSURIZE COOLANT SYSTEM AND FOUND UPPER RADIATOR HOSE CLAMP TO BE BROKE AND LEAKING REPLACE
BOTH CLAMPS.
Labor $273.00 less discount : $5.00 $268.00
Parts $226.08 less discount : $21.23 $204.85
Sublet/Misc. ....................................................... $0.00
SHOP SUPPLIES ....................................................... $11.31
Charges ....................................................... $0.00
Sales Tax Tax Exempt#0031201550020 $0.00
Total Due $484".16
Tech Certification'#
JUW -
SW .IQ7GR9TN7SEDWI
IIIIIIIIIIIIIIIIIIIIIII II
CUSTOM TRUCK AND AUTO, INC
17134 WESTFIELD PARK ROAD
WESTFIELD IN 46074
317-896-5956
7/8/2013 1:20 PM page 2
Invoice#19300
Vehicle : 1988 KME ENGINE 40
Recommended Service
Service/Notes Due Interval
SERVICE REAR DIFFERENTIAL on 8/25/2010 (Every 100000 miles)
SERVICE DIFFERENTIAL
ROTATE TIRES on 8/25/2010 (Every 8000 miles)
ROTATE TIRES
FUEL SYSTEM SERVICE on 8/25/2010 (Every 30000 miles)
FUEL SYSTEM SERVICE - - -
COMPLETE LUBE,OIL AND FILTER SERVICE on 8/25/2010 (Every 3000 miles)
ENGINE OIL SYSTEM CLEANING on 8/25/2010 (Every 60000 miles or 12 months)
FUEL FILTER SERVICE on 8/25/2010 (Every 30000 miles)
REMOVE OLD FUEL FILTER AND INSTALL NEW FUEL FILTER
TRANSMISSION FLUSH-AUTO on 8/25/2010 (Every 60000 miles)
COMPLETE TRANSMISSION SERVICE
ROTATE AND BALANCE TIRES on 8/25/2010 (Every 8000 miles)
ROTATE AND BALANCE TIRES
COOLANT FLUSH on 8/25/2010 (Every 60000 miles)
FLUSH COOLANT SYSTEM
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`(OU FOR YOUR BUSINESS!
74 R
I VIII IIIIII VIII VIII VIII VIII 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))
19300 VIN 2176 $484.16
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
$484.16
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO#/Dept. INVOICE NO. ACCT#!TITLE AMOUNT Board Members
1120 I 19300 I 43-510.00 I $484.16 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
2920T?
IP-0
Fire Chief
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund