233465 06/11/14 CITY OF CARMEL, INDIANA VENDOR: 00351921
® ONE CIVIC SQUARE DUNCAN APPLIANCE SERVICE CHECK AMOUNT: $********56.17*
CARMEL, INDIANA 46032 11404 CENTRAL DRIVE EAST CHECK NUMBER: 233465
CARMEL IN 46032 CHECK DATE: 06/11/14
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4350000 15063 56.17 EQUIPMENT REPAIRS & M
Duncan Appliance Service
11404 Central Drive East
Carmel, IN 45032-4510
317-844-0420 Voice, 888-847-0173 Fax
Name,Address and Telephone Numbers for the Paying Party Invoice Number
CARMEL FIRE DEPARTMENT 15063
2 CIVIC SQUARE Date Order Taken and Completed
CARMEL IN 46032 5/28/14
317-571-2600 6/3/14
Name,Address and Telephone Numbers for the Service Location (if different from above) Item Make and Type
CARMEL FIRE#42 #42 WHIRLPOOL
3610 W 106TH ST[12171 WASHER
CARMEL IN 46032 IPurchase Date
317-733-1480 317-371-3140
Description of Symptoms and/or Customer's Request Model and Serial Numbers
NOT SPINNING, MAKING A"CLICKING NOISE" LS09659PW2
CS3120644
Service Performed
REPLACED CRACKED DRIVE COUPLING,TESTS OK., USED 1 285753A(COUPLER) FROM STOCK, JOB CMPLTD
Parts Used
1 285753A COUPLER 26.17 26.17
Record of Times at Location Payments Received Parts Total
TO 6/3 TUE 10:52 11:18 00:26 26.17
Service Call
Labor
30.00
Technician's Signature Customer Signature
Sales Tax
Tony 0. Invoice Total
56.17
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Prescribed by State Board of Accounts City Form No.201 (Rev. 1995)
r
ACCOUNTS PAYABLE VOUCHER
i
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))
15063 42 Washer $56.17
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
Duncan Appliance Service
IN SUM OF $
11404 Central Drive East
Carmel, IN 46032
$56.17
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1120 15063 43-500.00 $56.17 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
Fire Chief
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund