225169 10/09/2013 CITY OF CARMEL, INDIANA VENDOR: Page 1 of 1
ONE CIVIC SQUARE PEARSON FORD
CARMEL, INDIANA 46032 10650 N MICHIGAN ROAD CHECK AMOUNT: $5,488.62
•, soy ZIONSVILLE,IN 46077 CHECK NUMBER: 225169
CHECK DATE: 10/9/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2201 4350100 284523 5488 . 62
F� Dealer No:06761
7332001 I ` ��`"`''
Invoice No: 284523 Pearson Ford, Inc. l
0,4/1106 North Michigan Road
Zionsville,
Zionsville, IN 46077
CITY OF CARMEL STREET DEPT INVOICE 317.873.3333
3400 W 131ST ST PAGE 1 www•mylndyford.com
CARMEL, IN 46074-8267 PARTS&SERVICE HOURS
Monday-Friday
Home317-733-2001 Email: 7:00 am-6:00 pm
Bus:
SERVICE ADVISOR:
COLOR YEAR MAKE/MODEL: VIN LICENSE MILEAGE IN /OUT TAG
F1 RED CLE 08 FORD F550 1FDAF57R68EC99105 69120 69120 T687
DEL. DATE PROD. DATE WARR. EXP. PROMISED =:PO NO. RATE PAYMENT INV. DATE
11FEB08 D lODEC07 17:00 24SEP13 BILL 30SEP13
R.O. OPENED READY OPTIONS:w_COMP:G STK:14287 ENG:99R_6.4L V-8 DIESEL
TRN:44B_TORQSHIFT(TM)_5-SPD_AUTO_TRANS A (More. . .)
13 : 55 24SEP13 15 : 38 30SEP13
LINE OPCODE TECH TYPE HOURS LIST NET TOTAL
A OUST STATES THAT THERE IS OIL IN COOLER POSS TURBO ISSUE
R5M OWNER INSPECTION
7342 CFL 1566 . 00 1566 . 00
1 8C3Z*6K682*AARM REMAN TURBOCHARGER ASY 857 . 68 686 . 14 686 . 14
1 8C3Z*6K682*BARM REMAN TURBOCHARGER ASY 1739 . 03 1391 . 22 1391 . 22
1 8C3Z*6K854*A ADAPTOR 184 . 40 147 . 52 147 . 52
1 8C3Z*6K854*B ADAPTOR 184 .40 147 . 52 147 . 52
4 8C3Z*6N640*A GASKET 4 . 80 3 . 84 15 . 36
2 8C3Z*6N640*B GASKET 4 . 80 3 . 84 7 . 68
1 8C3Z*5H267*AA CATALYST ASY 387 . 40 309 . 92 309 . 92
1 8C3Z*9P456*C COOLER - EGR 494 . 27 395 . 42 395 .42
1 8C3Z*9F464*E COOLER - EGR 707 . 12 565 . 70 565 . 70
1 8C3Z*9T514*C KIT - HARDWARE 91 . 35 73 . 08 73 . 08
1 8C3Z*9E933*A GASKET 5 . 28 4 . 22 4 .22
8 *W302649* BOLT 4 . 57 3 . 66 29 .28
4 *W302494* NUT 1 . 83 1 . 47 5 . 88
1 SC3Z*9E933*B GASKET - EGR COOLER 5 . 28 4 . 22 4 .22
1 3C3Z*9F485*BA CONNECTOR 11 . 98 9 . 58 9 . 58
1 7C3Z*6L612*B GASKET 8 . 27 6 . 62 6 . 62
1 8C3Z*12B591*E SENSOR - EXHAUST GAS - TEMPERA 60 . 91 48 . 73 48 . 73
3 VC*7*3 ANTI-FREEZE 16 .47 13 . 18 39 . 54
1 B7A*8287*AA CLAMP - HOSE 1 . 86 1 . 49 1 .49
, , , , 69120 18 . 00 DIAG RR CAB ASSY RR AFTER MARKET EQUIPMENT REPLACE BOTH
, , , , TURBO ASSY REPLACE BOTH EGR COOLERS REPLACE THREE TURBO TUBES
****************************************************
CUSTOMER PAY SHOP SUPPLIES FOR REPAIR ORDER 33 . 50
*********** ATTENTION CUSTOMER **************
MAKE A SERVICE APPOINTMENT FROM THE COMFORT
OF YOUR HOME OR OFFICE ANYTIME, JUST GO TO
MYINDYFORD.COM AND CLICK ON THE SERVICE TAB
IT' S QUICK, EASY AND AVAILABLE 24 HOURS A DAY
*********************************************
DISCLAIMER OF WARRANTIES DESCRIPTION TOTALS
ON BEHALF OF SERVICING DEALER, I HEREBY CERTIFY THAT THE AND LIMITATIONS OF LIABILITY
INFORMATION CONTAINED HEREON IS ACCURATE UNLESS OTHERWISE The fact-y ,s«a.y, ify. is me.,my w rafly LABOR AMOUNT 1566 00
SHOWN. SERVICES DESCRIBED WERE PERFORMED AT NO CHARGE TO .4h,e..,Pe I ,,, his gale. SELLER MAKES NO
OWNER. THERE WAS NO INDICATION FROM THE APPEARANCE OF THE WARRANTY WHATSOEVER AND EXPRESSLY PARTS AMOUNT
VEHICLE OR OTHERWISE, THAT ANY PART REPAIRED OR REPLACED DISCLAIMS ALL WARRANTIES EITHER
EXPRESS OR IMPLIED, INCLUDING ANY GAS,OIL, LUBE 0 00
UNDER THIS CLAIM HAD BEEN CONNECTED IN ANY WAY WITH ANY IMPLIED WARRANTY OF MERCHANTABILITY SUBLET AMOUNT
ACCIDENT, NEGLIGENCE OR MISUSE. RECORDS SUPPORTING THIS OR FITNESS FOR A PARTICULAR PURPOSE.
CLAIM ARE AVAILABLE FOR (1) YEAR FROM THE DATE OF PAYMENT SELLER'S MAXIMUM LIABILITY HEREUNDER MISC. CHARGES 33 50
NOTIFICATION AT THE SERVICING DEALER FOR INSPECTION BY A LIMITED TO THE ORIGINAL SALES PRICE
MANUFACTURER'S REPRESENTATIVE. AND SELLER SHALL HAVE NO QUENTIr7' TOTAL CHARGES
FOR ANY INCIDENTAL OR CONSEQUENTIAL
DAMAGES FOR LOST SALES,LOST PROFITS. LESS INSURANCE
INJURIES TO PERSONS OR PROPERTY OR
OTHER INJURIES OR DAMAGES. SALES TAX
(SIGNED) DEALER,GENERAL MANAGER OR AUTHORIZED PERSON (DATE) CUSTOMER SIGNATURE -'
PLEASE PAY -
THIS AMOUNT
CUSTOMER COPY
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))
09/30/13 284523 $5,488.62
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
Pearson Ford
IN SUM OF $
10650 N. Michigan Road
Zionsville, IN 46077
$5,488.62
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT
Board Members
2201 I 284523 ( 43-510.001 $5,488.62 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
pY T, Js r 12013
QU?tgL Commissioner
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund