224285 09/23/2013 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: $116.00
WESTFIELD IN 46074
CHECK NUMBER: 224285
CHECK DATE: 9/2312013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1125 4351000 140735 58 . 00 AUTO REPAIR & MAINTEN
1125 4351000 140918 58 . 00 AUTO REPAIR & MAINTEN
PADDACK
WRECKER SERVICE, INC.
18702.US 31 North
WESTFIEW, INDIANA 46074,,,-. Ro-ad
(317)846-3206 ;., S, r v• e
TE AM RE ESTE
TIME PO
a. PM C 5
s DG +Nf ... ..,. PHONE
1.
ADDRESS
CITY .STATE:-,.:;::'?:2.;zip
.....,.,
LOCATION OF VEHICLE
Yy_�R,MAKE,MODEL - COLOR MILEAGE- '
STATE PLATE NO. VEHICLE LD.NO. - - TOW SLIP#
14 S
MILEAGE r SERVICE TIME ❑ACCIDENT
START START ❑IMPOUND .
?`BREAKDOWN '
FINISH, '+ FINISH'
Ll SERVICE CA
' � LL
TOTAL _�� ,G ht I`e TOTAL ❑ '
DESCRIPTION OF SERVICES ' ' �' SP sCNALE QUI NT
❑ WINCHING
❑DUAL LINE WINCHING
❑SNATCH BLOCKS'
❑DOLLY
TYPE OF TOW TOWED PER ORDER OF VEHICLE TOWED TO
❑SLING/HOIST TOW ❑STATE POLICE FIR
5r7ow
�-FLAT BED/RAMP ❑LOCAL POLICE
❑WHEEL LIFT ❑SHERIFFDEPT. SECOND TOW
❑ DEALER ❑OWNER' f
STORAGE TOWING CHARGE r 1O
To onus MILEAGE CHARGE ;.
PAID LABOR CHARGE
DRIVER'S
"&CASH: ❑CHECK LIC.NO.
WINCH CHARGE
EXP.
we ❑VISA ❑AMEX ❑DISCOVER DATE SPILL
CONTAINMENT
SPECIAL
CC No. EQUIPMENT
OPERATOR'S SIGNATURE, DAT '
5 ( D CLEAN UP
UNIT NO.
�-7 4 STORAGE
AUTHORIZED St NATURE - - ' DATE SUB-LET
VEHICLE RELEASED TO - DATE /r d
' TO 4L ,-YI1 Not responsible for loss or damage to vehicle O V
�IYI tV! in case of fire,theft or any other cause beyond our control.
P.O.0. Per
G.L.0
Bud
Une
Purchaser .�cas� —Date
- Approval -
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, .1 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 _
DDAC
WRECKER.SERVICE, INC.
18702 US 31 North
ESTFIELD, INDIANA 46074
Road
SEP 17 2m (317) 896-3206
(317) 846-3206
Service
• _ TIME AM RE B ? P.O.NO.
PM I
AME PHONE A
ADD
CITY STATE ZIP
LO(J�ALTION OF VEHICLE
Y IJIi�M �(� f' - SL COLOR }c. M. U �.�.5"
ti;' /
STATE "P. T.E NO VENICE LD.NC�..' r .. TOW SLIP#
T�. ryU4S --(�Sx�1�'� )5�(30�s�� �5
MILEAGE SERVICE TIME, ❑ACCIDENT
START START i)IMPOUND
=FINISH===
. . - BREAKDOWN
7[-]'SERVICE CAL
L-'--a'
TOTAL 162 ---_-
-
.� .GU M,i f TOTAL -. •❑..
DESCRI.����ERVIC t SPECIAL EQUIPMENT
❑SINGLE LINE WINCHING
P.O.# or r ❑DUAL LINE WINCHING
If G.L# ❑SNATCH BLOCKS
❑DOLLY
Line Des ❑
TYPE OF 1VAhacef LE TOWED TO
❑SLING/f1,ISSTTOW. ❑STATE POLICE Date FIR/SST_TOW
,[']FLAT BEAAD/RAMP�aII LOCAL POLICE 7
/❑WHEEL LIFT ❑SHERIFF DEPT. SECOND TOW'
❑ ,i]DEALER ❑OWNER
STORAGE TOWING CHARGE GG
S�
TO DAYS®S
MILEAGE CHARGE 3 �c
PAID LABOR CHARGE
DRIVER'S ,
❑CASH ❑CHECK LIC.NO.
WINCH CHARGE
EXP.
❑MC ❑VISA ❑AMEX ❑DISCOVER DATE SPILL
CONTAINMENT
SPECIAL
CC NO,
EQUIPM ENT
OPERATOR'S SIGNATURE"-""'-'-"`—"-��----DATE'-"-"--' CLEAN UP
JJ " lG I"3
NIT NO.
�-7 STORAGE
AUTHORIZED SIGNATURE DATE
SUB-LET
VEHICLE RELEASED TO DATE _TO L ICjC
® Not responsible for loss damage to vehicle
(0 3 in case of fire,theft or any other cause beyond our control.
n9 service 18'10-886-632? NFB,Inc.t'ete. orough,NH 03458 w,1w_1ecStom Rel.No G 15?504616
Customer Release Form
Liability,Release Form
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.Icivihand•criminal,,'.in a court of law.
Date
Driver's License
Vehicle ID#
Authorizing Signature
Operator Signature
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice of 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.
00351300 Paddack Wrecker Service, Inc. Terms
18702 US 31 North
Westfield, IN 46074
Invoice Invoice Description
Date Number (or note attached invoice(s)or bill(s)) PO * Amount
8/23/13 140918 Tow M06 to PFM $ 58.00
9/16/13 140735 Tow M06 to Maintenance Office $ 58.00
Total $ 116.00
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
f,
20^
Clerk-Treasurer
Voucher No. Warrant No.
00351300 Paddack Wrecker Service, Inc. Allowed 20
18702 US 31 North
Westfield, IN 46074
In Sum of$
$ 116.00
ON ACCOUNT OF APPROPRIATION FOR
101 -General Fund
PO#or Board Members
Dept#
INVOICE NO. ACCT#/TITL AMOUNT
1125 140918 4351000 $ 58.00 1 hereby certify that the attached invoice(s), or
1125 140735 4351000 $ 58.00 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
19-Sep 2013
Signature
$ 116.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund