HomeMy WebLinkAbout229874 03/12/14 0'Coq
F CITY OF CARMEL, INDIANA VENDOR: 366507
;, ® ONE CIVIC SQUARE CIRCUIT SQUARE TV-VIDEO CHECK AMOUNT: $ .`""*464.85*
f CARMEL, INDIANA 46032 9613 N.COLLEGE AVE CHECK NUMBER: 229874
9.y�..oN ;g, INDIANAPOLIS IN 46280 CHECK DATE: 03/12/14
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1096 4350000 14630 154.95 EQUIPMENT REPAIRS & M
1096 4350000 14631 154.95 EQUIPMENT REPAIRS & M
1096 4350000 14632 154.95 EQUIPMENT REPAIRS & M
vp�J
C I9 SQUARE -V1 0
9613 N College Ave
Indianapolis, IN 46280
(31n I -40Q0
D TE
NAME
ADDRESS ! •rr/{tus JL (,�' 4 6 3�0
MAKE MO EL NO. 2 .��'SERIAL NO �� E OF ORIGINAL INSTALLATION
GG
TROUBLE REPORTED
❑ ESTIMATE ❑ CASH
❑ WARRANTY ❑ CHARGE
❑ CONTRACT ❑ C.O.D.
QTY. DESCRIPTION AMOUNT
sg,
FEB 21 2014
IDgI�21 -�-3,5��od BY:
Warrasnty:90 days on new paras TECHNICAL TOTAL
30 days labor on new pagS SERV CE TIME ❑ SHOP ❑ HOME
��-PfeRVTsOR ❑--52'pNiL'ECALL �„J�ilf�i
TECHNICIAN
i
SIGN
TOTAL
Signature al consyqupment
es acceptance of above work as being
satisfactory-and that has been left in good condition.
N
W E
S
COLOR OF HOUSE SIDE OF STREET FLOOR APT. NO.
DELIVER VIA:
DELIVERY INSTRUCTIONS:
li
RECEIVED BY
Before writing on this side, detach carbon,turn over and reinsert between the sheets.
Promissory Notes should be made in duplicate with one copy for customer.
PROMISSORY NOTE
$ Date
For Value Received, I,
Promise to pay to the order of
the sum of
to be paid as follows:
with interest to be paid,at the rate of
per centum per annum,from date payment is due.
L.S.
(FOR SIGNATURE OF CUSTOMER)
L.S.
(ADDITIONAL SIGNATURE IF AVAILABLE)
SIGNED AND SEALED IN THE PRESENCE OF:
(WITNESS)
I=Indianapolis,
- E®
e80
DATE 1 ��
NAME
ADDRESS- 4631.
PHONEDyyT��E PZSED
4
/AE M NO. � SERIAL NO.�� ..y� TE SOF ORIGINAL INSTALLATION
TROUBLE REPORTED C /
❑ ESTIMATE ❑ CASH
❑ WARRANTY ❑ CHARGE
❑ CONTRACT ❑ C.O.D.
QTY. DESCRIPTION AMOUNT
91
hnesS ~ly re�a�r
3c�s�o� '
. IOgl�-a!• 435�oc�v
7BY:
a
s �
Mffibty:90 days on new parts TOTAL^AeTG
..•,..WA429—TECHNICAL
30 days
J lab on ne/w part SERV CE TIME ❑ SHOP ❑ HOME V
��� Pd��r� '/ IE ��// ❑ R2FiRVI E-CALL
= G
�s, f
TECHNICIANSIGNA
TOTAL
Signature abo sj' tes acceptance of above work as being
satisfactory-and tha equipment has been left in good condition;,=,:;:`
N
W E
S
COLOR OF HOUSE SIDE OF STREET FLOOR APT. NO.
DELIVER VIA:
DELIVERY INSTRUCTIONS:
RECEIVED BY
Before writing on this side, detach carbon,turn over and reinsert between the sheets.
Promissory Notes should be made in duplicate-with one copy for customer.
PROMISSORY NOTE
$ Date
For Value Received, I,
Promise to pay to the order of
the sum of
to be paid as follows:
with interest to be paid,at the rate of
per centum per annum,from date payment is due.
L.S.
(FOR SIGNATURE OF CUSTOMER)
L.S.
(ADDITIONAL SIGNATURE IF AVAILABLE)
SIGNED AND SEALED IN THE PRESENCE OF:
(WITNESS)
C! T SQUARE TV-V E®
9613 N College Ave
Indianapolis, IN 46280
(317) 64000
DATE
N
Iule
ADDRESS `t
� � L462.
PHONE DATE PROMI
s7 xo2G
fdAMODEL NO. Q SERIAL NODATE OF ORIGINAL INSTALLATION
TROUBLE REPORTED
❑ ESTIMATE ❑ CASH
❑ WARRANTY ❑ CHARGE
❑ CONTRACT ❑ C.O.D.
QTY. DESCRIPTION AMOUNT
TVF,
ISS �/ YGttY FEB 21 2014
5F
�9to— -L-350000
T.9f?bty:90 days on newPartS
p� TOTAL MO.TE}?h�CS""'
30 daysclabor Vlp9IeiC
�i1 �gfPa'` SERVICE TIME ❑ SHOP ❑ O E
❑ D61•Wt'iT"". ❑ CHATT1'r LL
TECHNICIAN
SIGNATUR TOTAL(-",
OTA
_ Signa r.,.Ib. nst ut ,eptance of above work as being
satisfactory-an d that a pment has been left in good condition.
N
W E
S
COLOR OF HOUSE SIDE OF STREET FLOOR APT. NO.
DELIVER VIA:
DELIVERY INSTRUCTIONS:
RECEIVED BY
Before writing on this side, detach carbon,turn over and reinsert between the sheets.
Promissory Notes should be made in duplicate with one copy for customer.
PROMISSORY NOTE
$ Date
For Value Received, I,
Promise to pay to the order of
the sum of
to be paid as follows:
with interest to be paid,at the rate of
per centum per annum,from date payment is due.
L.S.
(FOR SIGNATURE OF CUSTOMER)
L.S.
(ADDITIONAL SIGNATURE IF AVAILABLE)
SIGNED AND SEALED IN THE PRESENCE OF:
(WITNESS)
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice of 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.
366507 Circuit Square TV-Video Terms
9613 N. College Ave.
Indianapolis, iN 46280
Invoice Invoice Description
Date Number (or note attached invoice(s)or bill(s)) PO# Amount
2/11/14 14630 Fitness Center TV repair XX-69 $ 154.95
2/11/14 14631 Fitness Center TV repair 36580 $ 154.95
2/11/14 14632 Fitness Center TV repair 36580 $ 154.95
Total $ 464.85
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
120
Clerk-Treasurer
Voucher No. Warrant No. '
366507 Circuit Square TV-Video 4 Allowed 20
9613 N. College Ave. y
Indianapolis, IN 46280
In Sum of$
$ 464.85 ti
1
ON ACCOUNT OF APPROPRIATION FOR
109 -Monon Center
PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members
Dept#
1096-21 14630 4350000 $ 154.95 1 hereby certify that the attached invoice(s), or
1096-21 14631 4350000 $ 154.95 bill(s) is (are)true and correct and that the
1096-21 14632 4350000 $ 154.95 materials or services itemized thereon for
which charge is made were ordered and
received except
6-Mar 2014
I
I Signature
$ 464.85 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund
t