250671 10/21/15 v% t CITY OF CARMEL, INDIANA VENDOR: 00350685
;; ® ij ONE CIVIC SQUARE FELLOWSHIP REFRIGERATION CHECK AMOUNT: $*****1,250.00*
CARMEL, INDIANA 46032 2557 SHELBY ST CHECK NUMBER: 250671
9M,r�N :? INDIANAPOLIS IN 46203 CHECK DATE: 10/21/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 076706 1,250.00 OTHER EXPENSES
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CI�IIEOk LII.SV: AMOUNT
ai El `.COMPRESSOR HEATING AND COOLINGO co ( " ❑;SUCTION F!§I -
M ❑HEAD PSI ' 5602 ELMWOOD AVE. STE. 216
❑VOLTS '- � AMPS •
nfJ_ECTFlICALC NNECTIO'NSa: INDIANAPOLIS, INDIANA 46203 *7!
MI
,, 0 60NTAGTS fKit Td,CLEAN (317) 78.7-6221
p� DATE ORDERED
i tp 1 ❑OIL LEVEL B CONDITION {
Q v I '❑ ''CONDENSER COIL NAME
❑GLEV611.A CHECK FIN COND.• /j A/] 6f E��)LTrCDt16n£(3
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N�JI '❑ REFRIGERANT STREET
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(/o PHONE
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J 'FWAND MOTOR VM.OP,CEL/L6A❑VOLTS " AMPS
Z r-❑ELECT(JICALCONNECTIOS
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'❑CONTACiS 113M&CLEAN -WARRANTY
❑FAN PULLETS(A0JU5U8ELT) 0 CONTRACT
1 ❑CHECK;LUSE BEARINGS a MOTOR CONTRACT
.
i ❑CFM -- _LcGF� r ❑NORMAL
❑” EVAPORATOR COILJ68 Jwl' ❑RES 0 COMM.
i ❑CIEAN COR IT,CHECK FIN' LOCATION El
❑ENT 09—IF(LVOPB_'r DESCRIPTION OF.WORK -
❑ENT WE—'F_,LVG WS_•F
i 'CONDENSATE AREAS oRlGlra�`
❑
❑INSPECT a CLEAN DRAIN PAN -
' INSPECT a CLEAN bRALN
O 'AIR FILTERS•
U � E:1 CLEANED! ❑REPLACED -
Z? FlLTF.RSIZE {Z, }ROrtTPO!-LiEn
vir'a E( F-1. 'HEATINGASSY.- -- �—_
Z x `�' ❑BURNER a HEAT E%CHANGERM 91 '
OO,S- ❑FUEL SUPPLYa PRESSURE.
LLF� � ❑PILOT ASSEMBLY r� -�Li..^rr4I�1 AL-OLL)
1/I o a
FLAME AD.Il15TMENr
ZV� I ❑PRIMARY NELAYa FLUE
?4w� ❑FANR LIMB SWITCH OPER. --��-,
mZ � ❑BLO7WERASSEM6LY TOTAL PARTS
VALVE - pF -CFi PIP
❑RV
❑stRIPHEAT' ,' •- - .IH W'RiTcORCDD?= AMOUNT-
m1=Q�= ; PARTS WARRANTY - A
IL^ ❑"DEFROST CYCLE
g= ❑ ELECTRICAL COMP.'TS All parte as recorded are Warranted, per - -- -- --• --- - - --- - --_ - -. __
C manufacturer speo8lcadohs. E
❑'RELAvS '❑coNtacTaRs LABOR GUARANTY S _ _� _
❑OVERLOAD [_]PRESS.SWITCH Tha labor char 0�a8 rdCOrded'here.reiallVe t0 ffie V—..——_— ^ FlEGIli.4R V OWE.
❑ THERMOSTAT g F TECH v HRS.
equipment serviced as noted;is guaranteed toi•a R #1 HRS.CV IHR.= a /HR._
1 ❑O.K. ❑ REPLACE. period of 30 days. +' M nErEn wu:++.us4oe REGULAR i OVERTIME
'.'❑;RELOC•ATE " _ We do not 61 course,guaranty other porta than those • TECH - I HRS.
TRAVEL TIME we supply.It repairs later become necessary due to !f2 HRS.ca n,q._ MR._
other&elective parts,they Will be charged aeparatsly:L TOTAL TL-CHNICIAN CERT, TOTAL-
O
TIME 1 D OTHER CHARGES 5 SIGNATURE
CHARGES
N r
'ARRIVED ENVIRONMENT CHECK LIST - •o 0 o sus
OPPARTED CHRG,TYPE SYSTEM E CHANGED ❑' i HAVE THE AUTHORITY TO ORDER THE ABOVE WORK AND DO SO TOTAL -�J/I/1
rD , I cooe R ,O CITY § 0 OUT(OR , ORDER AS OUTLINED ABOVE.IT IS AGREED THAT THE SELLER WILL
m W O I TRAVEL R M U REPLACED?. YES NO RETAINTITLETO ANY EQUIPMENT OR MATERIAL FURNISHED UNTIL _
N O , TIME ,E ❑ ❑ I OISt FINAL 14 COMPLETE PAYMENT IS MADE,AND IF,SETTLEMENT IS NOT TRIP
W 00 a _ RECOVERED? CITY M P
r ' - MILEAGES F YES NO t M MANTLED? ❑ MADE AS AGREED,THE SELLER SHALL HAVE THE RIGHT TO CHARGE
' YESNO REMOVE SAME AND THE SELLER WILL BE HELD HARMLESS FOR
E REFRIGERANT DISPOSAL ANI DAMAGES RESULTING FROM THE REMOVAL THEREOF.
ENDING
Uj R Q RECYCLED? ❑ QTY,CC rs T 6 TAX
START'- (. 1 1 . aMc OUR PERSONNEL
_J
G RECLAIMED? L-yyy^��FgggJ T�NLpppJ QTY. RECOMEND:
1--�T
Q F•J OTAL E RETURNED TO IU' S5
iLJ THISSYSTEM? OTY• ° e
a R YES HD / p,R
4 DISPOSAL AUTHORIZED SIGNATURE LV
r % lMLo N _ a OWNER'S INDICES ABOVE ORDERED WORK H EE MPLETED AND I ACKNOWLEDGE RECEIPT OF MY COPY. DATE ITJi:
NON USEABLE "I'S
NO CITY ACCEPTED DECLINED
§ TRIP T
+.+ CHARGE •
(D]DISPOSAL DISPOSAL /� 1z
L-II0 e"Aq1_4- PraLz��c�rs.PnyAPt>�` se Trx, 1�af
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 of service rendered, by whom, rates per day, number of units,
price per unit, etc.
Payee
350685
FELLOWSHIP REFRIGERATION Purchase Order No.
5602 ELMWOOD AVE. Terms
SUITE 216 Due Date 10/13/2015
INDIANAPOLIS, IN 46203
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
10/13/201! 076706 $1,250.00
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
Date Officer
VOUCHER # 156459 WARRANT # ALLOWED
350685 IN SUM OF $
FELLOWSHIP REFRIGERATION
5602 ELMWOOD AVE.
SUITE 216
INDIANAPOLIS, IN 46203
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO# INV# ACCT# AMOUNT Audit Trail Code
076706 01-7362-06 $1,250.00
Voucher Total $1,250.00
Cost distribution ledger classification if
claim paid under vehicle highway fund