226778 12/03/2013 CITY OF CARMEL, INDIANA VENDOR: 237560 Page 1 of 1
ONE CIVIC SQUARE PEARSON FORD,INC
CARMEL, INDIANA 46032 CHECK AMOUNT: $773.87
�`. •rc 10650 N MICHIGAN RD
*�.tbn Lod ZIONSVILLE IN 46077 CHECK NUMBER: 226778
CHECK DATE: 12/3/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2201 4237000 286107 773 . 87 REPAIR PARTS
Dealer No:06761
3175712653
Invoice No: 286107 Pearson Ford, Inc.
10650 North Michigan Road
Zionsville, IN 46077
CITY OF CARMEL INVOICE 317.873.3333
760 3RD AVE SW PAGE 1 www.mylndyford.com
CARMEL, IN 46032-2072 PARTS&SERVICE HOURS
Monday-Friday
Home: Email: 7:00 am-6:00 pm
Bus:
SERVICE ADVISOR:
COLOR YEAR MAKE/MODEL VIN LICENSE MILEAGE IN/OUT TAG
RED 06 FORD F550 1FDAF56P86EC57936 102105/1021051 T332
DEL.DATE PROD.DATE WARR.EXP. PROMISED PO NO. RATE PAYMENT INV.DATE
05MAY06 D 05APR06 1 17:00 14NOV13 BILL 15NOV13
R.O.OPENED READY OPTIONS:W-COMP:G ENG:6.0 Liter
16 :04 14NOV13 15 : 02 15NOV13
LINE OPCODE TECH TYPE HOURS LIST NET TOTAL
A CUST STATES THAT THE EXHAUST IS SOMKING BADLY
DIESEL DIESEL PERFORMANCE / HARD START / NO-START
DIAGNOSIS
7342 CFL 435 . 00 435 . 00
1 4C3Z*9E527*BRM REMAN NOZZLE ASY 292 . 86 263 . 57 263 . 57
1 3C3Z*9C995*AA RETAINER - INJECTION VALVE 46 .45 41 . 80 41. 80
, , , 1102105 5 . 00 DIAG REPLACE CYLINDER 2 INJECTOR
****************************************************
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
*********************************************
ON BEHALF OF SERVICING DEALER, I HEREBY CERTIFY THAT THE DISCLAIMER OF WARRANTIES DESCRIPTION TOTALS
AND LIMITATIONS OF LIABILITY
INFORMATION CONTAINED HEREON IS ACCURATE UNLESS OTHERWISE Tne ra o� a enp, .rte., m ov,.rx enp LABOR AMOUNT 4 0
SHOWN. SERVICES DESCRIBEDWERE PERFORMEDAT NO CHARGE TO ah� Fs 1.mi, sale. 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 A I. 1,1. INC r�s ErrHER
EXPRESS OR IMPLIED, MLUDING ANY GAS,OIL,LUBE 0 00
UNDER THIS CLAIM HAD BEEN CONNECTED IN ANY WAY WITH ANY RVLIED WARRANTY OF MERCHANTABILITY
ACCIDENT, NEGLIGENCE OR MISUSE. RECORDS SUPPORTING THIS OR FITNESS FOR A PARTICULAR PURPOSE. SUBLET AMOUNT n nn
CLAIM ARE AVAILABLE FOR 1 YEAR FROM THE DATE OF PAYMENT SELLER'S MAXIMUM LIABILITY HEREUNDER
� ) MISC.CHARGES
NOTIFICATION AT THE SERVICING DEALER FOR INSPECTION BY s LIMITED To HA HAV`AI SALES PRICE so
MANUFACTURER'S REPRESENTATIVE. AND NYIN SHALL HAVE NO LIAR L TOTAL CHARGES
FOR ANY INCIDENTAL OR CONSEQUENTIAL 77 R7
DAMAGES FOR LOST SALES,LOST PROFITS, LESS INSURANCE
INJURIES TO PERSONS OR PROPERTY OR n nn
OTHER INJURIES OR DAMAGES. SALES TAX n on
(SIGNED) DEALER,GENERAL MANAGER OR AUTHORIZED PERSON (DATE) CUSTOMER SIGNATURE PLEASE PAY
THIS AMOUNT
CUSTOMER COPY
SERVICE INVOICE 02 XS12C
VOUCHER NO. WARRANT NO.
ALLOWED 20
Pearson Ford
IN SUM OF $
10650 N. Michigan Road
Zionsville, IN 46077
$773.87
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT
Board Members
2201 f 286107 I 42-370.001 $773.87 1 hereby certify that the attached invoice(s), or
f I 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
Tues a , N r 013
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))
11/14/13 286107 $773.87
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