224765 10/08/2013 gtif CITY OF CARMEL, INDIANA VENDOR: 367104 Page 1 of 1
ONE CIVIC SQUARE ABRA AUTO BODY&GLASS CHECK AMOUNT: $2,211.30
,? CARMEL, INDIANA 46032 503 WEST CARMEL DRIVE
CARMEL IN 46032 CHECK NUMBER: 224765
CHECK DATE: 10/8/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4351000 25423 2998 1, 506 . 60 VEHICLE REPAIRS
1110 4351000 25392 3008 704 . 70 CAR REPAIRS
Date: 09/27/2013
ABRA HE Carmel INVOICE
503 West Carmel Drive
AUTO SODY4 GLASS Carmel, IN 46032 RO #: 2998
(317) 569-9884, 317) 569-9885 (fax) Est: Eric Tobolski
CARMEL PD UNIT#78 11 CHEV IMPALA POLICE
1 CIVIC SQUARE Color: WHITE Customer Pay
CARMEL, IN 46032 Type: PC 4D SED Adjustor:
Home: 317-571-2559 VIN: 2G1WD5EM4131289813 Phone:
Work: Prod Date: 0411 Plate: IN 5637 Claim#: N/A Deductible: 0
Fax: Mileage-. 39514 Loss Type: Collision
En ine: 6-3.9L-Fl
P=Who Pays? I = Insurance,C=Customer
Qty Type Description Part# Amount Sup Labor Op Labor Paint P
# Units Units
Parts Other FENDER RT Fender Body Rpr 5.0 2.2 C
FENDER Add for Clear Coat 0.9 C
FENDER Add for Edging 0.5 C
FENDER REMOVE DECAL Body Rpr 0.5 C
Parts Other FENDER RT Fender liner Body R&I 0.4 C
4 Parts AM FENDER A/M RT Fender liner retainer KT13769 7.52 Body Repl C
Parts Other FRONT BUMPER&GRILLE R&I Body R&I 1.4 C
bumper cover
Parts Other FRONT BUMPER&GRILLE Bumper Body Rpr 3.5 3.0 C
cover w/o fog lamps
FRONT BUMPER&GRILLE Add for 1.2 C
Clear Coat A
Parts Other FRONT BUMPER&GRILLE Upper Body R&I 0.2 C
grille w/o SS
Parts Other FRONT BUMPER&GRILLE Lower Body R&I 0.2 C
grille w/o SS
1 Parts OEM FRONT LAMPS RT Headlamp assy 25958360 270.68 Body Repl 0.3 C
FRONT LAMPS Aim headlamps Body 0.5 C
Parts Other PILLARS, ROCKER&FLOOR RT Body R&I 0.4 C
Rocker molding
'Car Cover Body 0.3 C
1 PntMat, 'Corrosion Protection 8.00 Body 0.2 C
1 Pnt Mat 'Flex Additive/Adhesion-Promoter 8.50 Body Repl C
1 Haz Waste 'Hazardous Waste 5.00 Body C
Pnt/Mat MISC Paint&Materials 234.00 7.8 C
SubTotal 1,506.60
Taxes 0.00
Grand Total 1,506.60
Due from Insurance Due from Customer
Sub-Total 0.00 Sub-Total 1,506.60
Tax 0.00 Tax 0.00
Total 0.00 Total 1,506.60
Total Amount 1,506.60
INVOICE #22 09/27/2013 10:30:17 AM RO#2998 ABRA HE Carmel
Page 1
Date: 09/27/2013
ABRA HE Carmel INVOICE
AUTO BODY &,GLASS 503 West Carmel Drive RO #: 3008
Carmel, IN 46032
(317) 569-9884, (317) 569-9885 (fax) Est: Eric Tobolski
UNIT#70 CARMEL PD 10 CHEV IMPALA POLICE
3 CIVIC SQUARE Color: WHITE Customer Pay
CARMEL, IN 46032 Type: PC 4D SED Adjustor:
Home: 317-570-2559 VIN: 2G1WD5EM4A1225348 Phone:
Work: Prod Date: 0310 Plate: IN 15088 Claim#: N/A Deductible: 0
Fax: Mileage-. 68851 Loss Type: Collision
Engine: 6-3.9L-F]
P=Who Pays. I =Insurance,C=Customer
Qty Type Description Part# Amount Sup Labor Op Labor Paint P
# Units Units
1 Pnt Mat 'FlexAdditive/Adhesion Promoter 2.30 Body Repl C
Parts Other FRONT BUMPER&GRILLE Bumper Body Rpr 8.0 3.0 C
cover w/o fog lamps
FRONT BUMPER&GRILLE Add for
Clear Coat 1.2 C
1 Haz Waste 'Hazardous Waste 3.00 Body C
Pnt/Mat MISC Paint&Materials 126.00 4.2 C
SubTotal 704.70
Taxes 0.00
Grand Total 704.70
Due from Insurance Due from Customer
Sub-Total 0.00 Sub-Total 704.70
Tax 0.00 Tax 0.00
Total 0.00 Total 704.70
Total Amount 704.70
INVOICE #22 09/27/2013 01:06:17 PM RO#3008 ABRA HE Carmel
Page 1
- CO INDIANA RETAIL TAX EXEMPT PAGE
ito f `:C armel CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT °
35-60000972
ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES,A/P
CARMEL, INDIANA 46032-2584 VOUCHER, DELIVERY MEMO, PACKING SLIPS,
SHIPPING LABELS AND ANY CORRESPONDENCE.
FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL- 1997
PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION
I IM2013
Abra HE Cali al Carmel Police Department
VENDOR TOHIP 3 Chic l quaro
503 Mot Camel Drive Carmel, IN
Camel„ IN 4M2 (397)571-2%9
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY
�y gig UNIT OF MEASURE DESCRIPTION - UNIT PRICE EXTENSION '
Account 43-5 10.00
4 Each vehicle repairs $704.70 $704.70
Sub Total: $704.70
" � `
} �
~ g
mMn
I sk
•
a
Sentl Invok e TO I'
Carmel Police Department
Attu: 'Teresa Anderson
3 CNIc Square
Carmel, IN Ate- PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
Cel Police Dept, PAYMENT '$704.70
• A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O.
NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND
VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED.
SHIPPING INSTRUCTIONS I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN
THIS APPROPRIATION f,SHIP REPAID. SUFFICIENT TO PAY FOR THE ABOVE ORDER.
• s '
•C.O.D.SHIPMENTS CANNOT BE ACCEPTED. ��_�..�
• ORDERED BY
PURCHASE ORDER NUMBER MUST APPEAR ON ALL
SHIPPING LABELS. ppee
•THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE h1of of f Y'p�
olice
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
2%5 3 9 2 CLERK-TREASURER
DOCUMENT CONTROL NO. A. V. COPY-SIGN AND RETURN TO CLERK'S OFFICE
VOUCHER NO. WARRANT NO.
ALLOWED 20
IN THE SUM OF$
ON ACCOUNT OF APPROPRIATION FOR
Board Members
PO#or INVOICE NO. ACCT#/TITLE AMOUNT
DEPT.# 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------_-------_
20
.... ................................................................................................................................_..........._....-.....__..............-........-....
Signature
--.....--..-.....-------.:...........-...............-......-.-......- ............-......._..-.........__.....................-..
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
INDIANA RETAIL TAX EXEMPT PAGE
City o Carmel CERTIFICATE NO.003120155 002 0 li PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT
35-60000972 �
ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES,A/P
CARMEL, INDIANA 46032-2584 VOUCHER, DELIVERY MEMO, PACKING SLIPS,
SHIPPING LABELS AND ANY CORRESPONDENCE.
FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL- 1997
PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION
9},18M3
Abra.HE Camel Camel Police Department
VENDOR TOIP 3 Civic squam
503 West Carmel Wye Camsl, IN 4
C mcl„ IN 46W2 (W)571- 9
CONFIRMATION BLANKET CONTRACT PAYMENTTERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Account 43.610.00
t
1 Each vehicle repairs $1,506.60 $1,506.60
Sub Total: $1,506.60
ip
.•� N
' v
(05'
_V411 pgi
"•
. ree a l
"94 ejMan
Send Ih olce To:
Call Police Department
Attn. Tease Anderson
3 Civic squam
Carmel, IN 46M. PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT I PROJECT ACCOUNT AMOUNT
Carmel Police Dept. PAYMENT $115M.60
• A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O.
NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND
VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED.
SHIPPING INSTRUCTIONS I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN
THIS APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER.
•SHIP REPAID. S "z_
•C.O.D.SHIPMENTS CANNOT BE ACCEPTED. , "
•PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY°"— 'ti:a.�
SHIPPING LABELS. �a
•THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE' •`i Chief
of Polk@
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
J° 3 CLERK-TREASURER
DOCUMENT CONTROL NO. 'A70. COPY-SIGN AND RETURN TO CLERK'S OFFICE
VOUCHER NO. WARRANT
ALLOWED 20
IN THE SUM OF$
ON ACCOUNT OF APPROPRIATION FOR
Board Members
PO#or INVOICE NO. ACCT#/TITLE AMOUNT
DEPT.# 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..----------------...---...-------...
20
........................._........--......................._..........................-..........-................................................
Signature
..........-......-..............................................................._...................... ........._....-.......................
...................... ......................................
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
VOUCHER NO. WARRANT NO.
Abra HE Carmel ALLOWED 20
IN SUM OF $
503 West Carmel Drive
Carmel„ IN 46032
$2,211.30
ON ACCOUNT OF APPROPRIATION FOR
Carmel Police Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
25392 3008 43-510.00 $704.70 I hereby certify that the attached invoice(s), or
bill(s) is (are) true and correct and that the
25423 2998 43-510.00 $1,506.60
materials or services itemized thereon for
which charge is made were ordered and
received except
Thursday, October 03, 2013
Chief of Police
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))
09/27/13 3008 car 70/Cash $704.70
09/27/13 2998 car 78/Wiegman $1,506.60
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
20
Clerk-Treasurer