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Home My WebLink About238966 11/05/14 1y W.C4gyf %�� • CITY OF CARMEL, INDIANA VENDOR: 00350650 ONE CIVIC SQUARE WILLIAMS COMFORT AIR INC CHECK AMOUNT: $********94.00* ,� q, CARMEL, INDIANA 46032 1077 3RD AVE,S.W. CHECK NUMBER: 238966 °M,��oN-fib. CARMEL IN 46032 CHECK DATE: 11/05/14 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 651 5023990 94.00 OTHER EXPENSES Williams Comfort Air YOUR SERVICE ORDER # , P/j Q Shelby '� Shelby Air DATE/ / ATrN SUPERVISOR 1077 3rd Avenue SW, Carmel, IN 46032 TECH NUMBER air conditioning"& 317-452-4543•Fax:317-848-8744 servic6@WilliamsComfortAir.com TECH NAME HVAC License#: H0002400 a heaUn "LoA N lambing&more 877-599-HEAT(4328) INVOICE NUMBER 30- 3 9 9 9 9 p /o rIJ / EQUIPMENT IDENTIFICATION CONDITION 1-5 (5 BEST) INTERNAL USE ONLY Customer Name: 0 dA-Ir 1."'A u � t lModel ---- – Job Location: � 2 b..� City: '�i — State:_Zip: � �0 AFI Call Note: I"` HMI/C#: 5 I HMI/C#: AC HP Email: Source Qty. Materials Used Evap y Payee: 2 Therm Address: 3 City: State:—Zip: / 4 Hum HMNC#: HM1/C#: a"tdjed ❑Elect 5 Small: Filter x�� x ❑Pur 6 . Code Qt Status Description Total $ CAIRfree Savings Agreement: j ,r at t t,,t r This program has been explained. ❑ Current participant Exp. ❑ Decline participation Customer's Initials Why participate in our CAIRfree . maintenance program? You will receive a discount on our standard pricing for all repair services as well as equipment discounts and I have received a detailed proposal via the preferred SUMMARY OF FINDINGS. initials PAYMENT/AC�jEPTANCE OF WORK PERFORMED - $ jPA assurance that all manufacturer and WilliamsComfort Air/Shelby Air warranties will remain valid for the duration of the warranty period. ❑ CREDIT CARD fi CASH ❑ CHECK ❑ GIFT CARD TODAY'S PAYMENT I have $ � $ $ discussed the CAIRfree Agreement with the customerhave gagvena Authorization Code ttII Check Number REMAINING BALANCE $ copy of this invoice to the customer. I have Signature �d �4 fr` Date/ �/ satisfactorily done all work detailed in the Your CAIRfree SAVINGS Today proposal in compliance with Williams Comfort My signature above acknowledges that all work has been satisfactorily completed.I agree to the _- __ __ _...__ __ ____ Air standards of excellence in workmanship total charges that are now due and the payment method.Williams Comfort Air(WCA)retains ownership of all material listed until payment is made in full.Terms include 1.5%monthly service charge and in compliance with applicable building if not paid in 30 days.If this invoice is not paid within 30 days,a lien against my property may be pursued and I will be responsible for practical attorney fees,collection costs and interest.WCA is codes. not responsible for insured losses.Customer agrees that WCA may scan,fax,email,image or otherwise convert this document into an electronic format of any type or form,now known or developed Technician's Signa(ure in the future,and any unaltered or unadulterated copy of this document produced from such electronic format will be legally binding upon all the parties and equivalent to the original for all purposes. CUSTOMER COPY Prescribed by State Board of Accounts Form No.301-S(Rev.1997) ACCOUNTS PAYABLE VOUCHER TO ADDRESS Invoice Date Invoice Number Item Amount 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 Mo. Day Yr. Signature Title 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. /1 w/,, Mo. Day Yr. Officer Title Voucher No. Warrant No. ACCOUNTS PAYABLE DETAILED ACCOUNTS MUNICIPAL WASTEWATER UTILITY ANOT. CARMEL, INDIANA Favor Of 10`7-7 v s w C �Pme ( TN Total Amount of Voucher $ Deductions Amount of Warrant $ 00 Month of Yr VOUCHER RECORD Acct.No. Collection System Pumping Treatment&Disposal Customer Accounts Administrative&General Reclaimed Water Treatment Reclaimed Water Distribution Total Allowed Board Members Filed BOYCE FORMS•SYSTEMS 1-800-382-8702 325