227343 12/17/2013 CITY OF CARMEL, INDIANA VENDOR: 00351179 Page 1 of 1
ONE CIVIC SQUARE FIRESTONE COMPLETE AUTO CARE
CARMEL, INDIANA 46032 11035 NORTH MICHIGAN ROAD CHECK AMOUNT: $95.99
ZIONSVILLEIN 46077-7725 CHECK NUMBER: 227343
CHECK DATE: 12/17/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1192 4351000 047955 95 . 99 AUTO REPAIR & MAINTEN
WORK ORDER# FIRESTONE COMPLETE AUTO CARE SERVICE ADVISOR
047955 11035 NORTH MICHIGAN ROAD 01 W. SAMMAURO
12/12/13 0130PM ZIONSVILLE, IN. 46077-7725 317.733.2821
CITY OF CARMEL, BUILDING & CODE 2006 FORD ESCAPE HYBRID
1 CIVIC SQ 4-140 2.3L DOHC
CARMEL. IN 4.6032-2584 LIC# 68556 IN VIN # 1 FMCU96H96KA26091
317.571-2418 IN 11/27/13 2:05PM EST, MILEAGE 75,000
Store# 328241 Customer Contact Worksheet
Unit Price Extended Price
Status R Description Farts Labor Job Total Cat. Total - Total
MISCELLANEOUS SERVICES =--___-___ > 129.96 129.96
Auth OR NON-SYSTEM SERVICES 70.00
TOWING SERVICE 1 70.00 0.00
Auth OR COURTESY CHECK 0.00
COURTESY CHECK 1 0.00 0,00
Recmd SF MINI BULB REPLACEMENT 17.98
:3156 WEDGE LAMP 2 2.99 0.00
SMALL BULB LABOR 1 0.00 12.00
Reared PM WIPER BLADES (Front-Both) 41.98
4818 EVOLUTION WIPER BLADE 1 17.99 0.00
4820 EVOLUTION WIPER BLADE 1 17.99 0.00
WIPER BLADE LABOR 2 0.00 3.00
STARTING/CHARGING SYSTEMS _______ ____________________________ __-" ` ' 25.99 155.95
ALlth SF BATTERY& ELECTRICAL CHECK 25.99
ELECTRICAL SYSTEM TEST LABOR 1 0-00 25.99
Symptom: S/C:Dim Lights 0 0.00 0.00
S/C:Doesnt Turn Over-
- Recommended Parts: 111.96
CSDS Reasons Cat. Total Total Labor: 43.99
Originally Requested Service - _________=__> 70-00 70.00 Shop Supplies: 0.00
System Failure - Required > 43.97 113.97 Tax (7.00%): 2.94
Preventive Maintenance- Suggested > 41.98 155.95 Gift Card
---- - Total: 158.89
CFNA payment minimum for Authorized work ==__-______> $19.00
CFNA payment minimum for Total recommendations ==-__> $19.00
ATTM LOSA-
Ate.
.Authorized: Shop Sup: Tax (7.00%): Total `
Authorized: 95.99 0.00 0.00
Jobs Revised Up &< Down >:
Revised Authorization:
Authorized By: Time: Assoc:
THIS ESTIMATE IS VALID FOR 30 DAYS
Labor changes are based on 'Menu Items' of a predetermined amount or the flat rate
charged per the Mitchell Labor Manual @ $93.00/hr.
ALL PARTS ARE NEW UNLESS NOTED OTHERWISE
Page 2 of 2 ..0%ti;nnt7;tudgrFSnnn! ,au33!
VOUCHER NO. WARRANT NO.
ALLOWED 20
Firestone Complete Auto Care
IN SUM OF $
11035 North Michigan Road
Zionsville, IN 46077-7725
$95.99
ON ACCOUNT OF APPROPRIATION FOR
Carmel DOCS
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1192 I 047955 I 43-510.00 I $95.99 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
Frida , e m r
Director
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))
12/12/13 047955 Tow/electrical check $95.99
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