227255 12/17/2013 CITY OF CARMEL, INDIANA VENDOR: 367104 Page 1 of 1
ONE CIVIC SQUARE ABRA AUTO BODY&GLASS CHECK AMOUNT: $500.40
CARMEL, INDIANA 46032 503 WEST CARMEL DRIVE
CARMEL IN 46032 CHECK NUMBER: 227255
CHECK DATE: 12/17/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4351000 25716 3385 500 .40 REPAIRS
Date: 12/11/2013
ABRA HE Carmel INVOICE
AUTO BODY & GLASS 503 West Carmel Drive
Carmel, IN 46032 RO #: 3385
(317) 569-9884, (317) 569-9885 (fax) Est: Eric Tobolski
CARMEL PD UNIT#42 12 CHEV CAPRICE POLICE DETECTIVE
3 CIVIC SQUARE Color: WHITE Customer Pay
CARMEL, IN 46032 Type: PC 4D SED Adjustor:
Home: 123-456-7890 VIN: 6G1MK5U29CL611468 Phone:
Work: Prod.Date: 1111 Plate: IN,7182 Claim#: N/A Deductible: 0
Fax: 123-456-7890 Mileage-. 11595 Loss Type: Collision
Engine: 8-6.0L-FI
P=Who Pay s? I = Insurance, C=Customer
Qty Type Description Part# Amount Sup Labor Op Labor Paint P
# Units Units
Parts Other FRONT LAMPS RT Side marker lamp Body R&I 0.2 C
Parts Other .FRONT LAMPS LT Side marker lamp Body R&I 0.2 C
Parts Other FRONT BUMPER RT Trim cover Body R&I 0.1 C
Parts Other FRONT BUMPER Bumper cover from Body Rpr 2.0 2.6 C
vin BL522915
FRONT BUMPER Add for Clear Coat 1.0 C
Parts Other FRONT BUMPER R&I bumper cover Body R&I 1.4 C
Parts Other FRONT BUMPER LT Trim cover Body R&I 0.1 C
FRONT BUMPER CENTER GRILL Body R&I 0.3 C
1 Pnt Mat 'Flex Additive/Adhesion Promoter 3.00 Body Repi C
1 Haz Waste 'Hazardous Waste 3.00 Body C
Pnt/Maf MISC Paint&Materials 115.20 3.6 C
SubTotal 500.40
Taxes 0.00
Grand Total 500.40
Due from Insurance Due from Customer
Sub-Total 0.00 Sub-Total 500.40
Tax 0.00 Tax 0.00
Total 0.00 Total 500.40
Total Amount 500.40
INVOICE #22 12/11/2013 11:17:44 AM RO#3385 ABRA HE Carmel
Page 1
City INDIANA RETAIL TAX EXEMPT PAGE®� C sane l CERTIFICATE NO.003120155 002 0 111111 ..Ca,
�/ 111111 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT
35-60000972 7574A
ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES,A/P
CARMEL, INDIANA 46032-2584 VOUCHER, DELIVERY MEMO, PACKING SLIPS,
17.4
FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL- 1997 SHIPPING LABELS AND ANY CORRESPONDENCE.
PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION
4M '1 3
R1..-
Cannel Police Department
VENDOR SHIP
TO 3 Civic Spin
55W Carmel Drive Carmel, IN MW
Camel. , I �a f el. IN' 2 - 131 d)5d'$g-2&%
CONFIRMATION BLANKET CONTRACT PAYMENTTERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Account 43-510.00
9 Each vehicle repair's $500.40 $500.40
Sub Total: $500.40 AA
0%41 Y ....
On;} e° gam`.•
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fr
4
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% ... •.
Sen%ipinvoic ro fdlta
Cannel Police Department
Attn:Teresa Anderson
3 Civic Square
Camel, IN 46032- PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
Camel Police Dept, PAYMENT
M40
A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O.
NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND
VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED.
SHIPPING INSTRUCTIONS I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN
SHIP REPAID. THIS APPROPRIATION SUFFICIENT.TO-PAY FOR THE ABOVE ORDER.
•
•C.O.D.SHIPMENTS CANNOT BE ACCEPTED.
•PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY
SHIPPING LABELS.
•THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE 5+9 w6 D-11.^
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
5- 116 CLERK-TREASURER
DOCUMENT CONTROL NO., ` A.P.V. COPY-SIGN AND RETURN TO CLERK'S OFFICE
VOUCHER NO...-- _WARRANT NO....-
ALLOWED 20
IN THE SUM OF$
I
,I
i .
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.-------------- -- ------- ---- ----
rt
20
......................................................................._.....-............---..-......................--......-........--.........--........................_...-.-..............---......--
Signature
..................-_._....-.....................-..................... ...........................................................
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
VOUCHER NO. WARRANT NO.
ALLOWED 20
Abra HE Carmel
IN SUM OF $
503 West Carmel Drive
Carmel„ IN 46032
$500.40
ON ACCOUNT OF APPROPRIATION FOR
Carmel Police Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
25716 I 3385 I 43-510.00 I $500.40 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
Wednesday, December 11, 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))
12/11/13 3385 vehicle repairs/car 142-R. White $500.40
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