HomeMy WebLinkAbout241945 02/10/15 0�y''ti+q,,F CITY OF CARMEL, INDIANA VENDOR: 366507 CHECK AMOUNT: $*******309.90*
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ONE CIVIC SQUARE CIRCUIT SQUARE TV-VIDEO
9 =Q CARMEL, INDIANA 46032 9613 N.COLLEGE AVE CHECK NUMBER: 241945
,�iroN INDIANAPOLIS IN 46280 CHECK DATE: 02/10/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1096 4350000 14742 154.95 EQUIPMENT REPAIRS & M
1096 4350000 14743 154.95 EQUIPMENT REPAIRS & M
RCUI ° SQUARE 'V-V EO
9613 N College Ave
: . Indianapolis,IN 46230
(317) 344.4000 2
DATE
NAME,
ADDRESS 14 7,4.9,. .
'T TT
PHONE DATE
MAKE MODEL NO. SE A 0. DATE OF ORIGINAL INSTALLATION
j�o,,�/, s _r�z. � lJlo2
TROUBLE REPORTED
7JAN
ESTIMATE CASH
❑ WARRANTY ❑ CHARGE
3.0 2015 ❑ CONTRACT ❑ C.O.D.
QTY. _ DESCRIPTION AMOUNT
x1G f
i
y
TOTAL
'arra t1:90days on new parts
30 days labor on new pans SERV CIE TIME ❑ SHOP ❑ HOME
TECHNICIAN DA]C+£GwrEF�177
SIGNATURE -
TOTAL
Signature above constitutes acce tan_c of_ oye work as Ing
satisfactory-arid that equipment as b eft in goon con.Ilion.
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-ot-e-copy-farcastomer. —
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)
9613 N College Ave
Indiana alis, ltd 46280
(3$ ) 13 .4000
DATE
ADDRESS C/'•L// x.. :14 PH E DATE P M ED
pG> .
MAKE , X MOD NO � SERIAL NJ�v y / DATE OF ORIGINAL INSTALLATION
TROUBLE REPORTED7JA
ESTIMATE ❑ CASH
WARRANTY ❑ CHARGE
® 2015 ❑ CONTRACT ❑ C.O.D.
QTY. BY: DESCRIPTION AMOUNT
17
90 days on new pads TOTAL
30 ds Payor on new pari TECHNICAL [:] SHOP ❑ HOME .
I SERVICE TIME v I
TECHNICIAN
SIGNATURE "
` TOTAL:. / y �
Signature above n Itutes acceptant f ove work as being
satisfactory-and at equipment has bee 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)
i
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
1/7/15 14742 Fitness TV monitor repair 37931. $ 154.95
1/7/15 14743 Fitness TV monitor repair 37931 $ 154.95
Total $ 309.90
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.
366507 Circuit Square TV-Video Allowed 20
9613,N. College Ave.
Indianapolis, IN 46280
In Sum of$
1
$ 309.90
ON ACCOUNT OF APPROPRIATION FOR
109 -Monon Center
f
i
PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members
Dept#
1096-21 14742 4350000 $ 154.95 1 hereby certify that the attached invoice(s), or
1096-21 14743 4350000 $ 154.95,, 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
I,
,I
February 5, 2015
Signature
$ 309.90 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund