224075 09/10/2013 F CITY OF CARMEL, INDIANA VENDOR: 00351300 Page 1 of 1
ONE CIVIC SQUARE PADDACK WRECKER SERVICE, INC
�? CARMEL, INDIANA 46032 18702 US 31 NORTH CHECK AMOUNT: $318.00
*!rfah.io. WESTFIELD IN 46074 CHECK NUMBER: 224075
CHECK DATE: 9110/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4351000 140921 73 . 00 AUTO REPAIR & MAINTEN
1120 4351000 555872 245 . 00 AUTO REPAIR & MAINTEN
PADDACK . .
WRECKER SERVICE, INC.
18702 US 31 North
WESTFIELD, INDIANA 46074 Road
(317) 896-3206
(317)846-3206 Service
r,ar;
TIME AM ReU•FSTEH,aY PM
• .„YI NAME PHONE LAY 'ic
ADDRESS 1y`
CITY STATE ZIP
LCCA1—TIL OF MILE
)'AR,MAKE,MOD/F�' (_ COLOR MIL,E/AG/E A
�() L//fie 0C/ V/F•F
S-{ATE P{AT�N� VEHIQLE LD.N� ` TOW SLIP#
61 tj
MILEAG i SERVICE TIME El ACCIDENT
START. -_`� ,. - START _ ❑IMPOUND .
BREAKDOWN t
FINISH FINISH. ❑SERVICE CALL
TOTAL �'G+G. TOTAL El
DESCRIPTION.OF SERVICES SPECIAL EQUIPMENT
❑SINGLE LINE WINCHING
❑DUAL LINE WINCHING '
❑SNATCH BLOCKS '
❑DOLLY
El
TYPE OF TOW ' TOWED PER ORDER OF VEHICLE TOWED TO
❑SLING/HOIST TOW -❑STATE POLICE FIR T TOW
,2rFLAT BED/RAMP ❑LOCAL POLICE
❑WHEEL LIFT ❑SHERIFF DEPT. SECOND TOW
❑ ❑DEALER eOWNER'
STORAGE r'O
_ TOWING CHARGE
Ic G
To onus®5 MILEAGE CHARGE
PAID LABOR CHARGE
DRIVER'S
❑CASH ❑CHECK' LIC.NO. '
WINCH CHARGE
EXP.
❑MC ❑VISA ❑AMEX ❑DISCOVER DATE SPILL
CONTAINMENT
SPECIAL
CC No. EQUIPMENT
O RATOR'SSIGNATURE DAT CLEAN UP
G��ySTORAGE
AUTHORIZED SIGNATURE DATE
SUB-.LET
VEHICLE RELEASED TO DATE TOTAL 7.�� V�
Not responsible for loss damage to vehicle
140921 in case Thank You
of fire,-theft or any other cause beyond our control.
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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 responsibility, both civil and criminal, in a court of law.
Date
Driver's License
Vehicle ID#
Authorizing Signature
Operator'Signature
PADDACK'S
HEAVY TRANSPORT SERVICE
18702 US 31 N
WESTFIELD, INDIANA 46074
(317) 896-3206
Fax: (317) 867-0651
Dare Time AM Requested 8y � P.O.No.
FID
Name s Phone
Address
City State Zip
Location t Location 2
Destination t Destination 2
--fz>M
Description
a
'7 0G2 11N►� L
Mileage Start Finish Tot_
Service Time Start Finish - O Total
Services Provided
FA
Pis
Remove Driveline Secure Air Ride E-J Cage Brakes
Landoll Trailer ❑ Low Boy Trailer D HD Rollback ❑
STORAGE FROM j
_ Transport Charge
Mileage Charge 0
To DAYS @ s Hr. Charge
PAID BY DRIVER'S
CASH ❑ CHECK LIC.NO. Permit Fees
EY.P
C!COM CHECK CI MC C1 VISA 'L,—j AMEX DATE Labor Charge Ll/O
Winch Charge
CC NO. Storage
OPE Rv 'S SIGNATURE DAT
Y- 30-6
TRUCK NO. Subtotal
AUTHORIZED SIGNATURE DATE � C.
Total =--
555872
VOUCHER NO. WARRANT NO.
ALLOWED 20
Paddack's Heavy Transport
IN SUM OF $
18702 US Highway 31 North
Westfield, IN 46074
$318.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1120 140921 43-510.00 j $73.00 1 hereby certify that the attached invoice(s), or
1120 555872 43-510.00 $245.00 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
SEP., - 9 2093
IqXW-L-7'J7147
Fire Chief
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))
140921 VIN 8081 $73.00
555872 VIN 7045 $245.00
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