251013 11/04/15 r Cqq .
CITY OF CARMEL, INDIANA VENDOR: 00351470
ONE CIVIC SQUARE BURGESS MECHANICAL CHECK AMOUNT: $'""""'835.00'
=4 CARMEL, INDIANA 46032 12220 SOUTHEASTERN AVE CHECK NUMBER: 251013
•*iroN, INDIANAPOLIS IN 46259 CHECK DATE: 11/04/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 15592 835.00 OTHER EXPENSES
y Burgess Mechanical Corporation Invoice1 12220 Southeastern Ave.
Indianapolis, IN 46259 1' '
10/15/2015 15-592
® (317)862-4395
jb@burgessmechanical.com
www.burgessmechanical.com Due on receipt 10/15/2015
City of Carmel Utilitlies
96o9 Hazel Dell Parkway
Indianapolis,IN 4628o
$835.00
Phase detach top portion and return with your payment.
Date Activity •int
lo/o6/2015 15-592/PM Service on Boiler at the Carmel Waste Water Plant: 680.00
Performed yearly PM, Combustion Check, and Operating&safety check on West hot
water boiler.
Cleaned and checked air flow switch,and flame scanner. Checked gas train vent valve
for l00%shut off.
Fired burner up.Checked combustion with flue gas analyzer and found int burning
clean and efficient.
lo/o6/2015 Flue Gas Analyzer 75.00
lo/o6/2015 Truck/Fuel Charge 80.00
Delinquent accounts are subject to reasonable legal and collection fees. $835-001
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
00351470
BURGESS MECHANICAL Purchase Order No.
12220 SOUTHEASTERN AVE Terms
INDIANAPOLIS, IN 46259 Due Date 10/29/2015
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
10/29/201! 15-592 $835.00
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 # 156558 WARRANT # ALLOWED
00351470 IN SUM OF $
BURGESS MECHANICAL
12220 SOUTHEASTERN AVE
INDIANAPOLIS, IN 46259
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO# INV# ACCT# AMOUNT Audit Trail Code
'15-592 01-7362-06 $835.00
Voucher Total $835.00
Cost distribution ledger classification if
claim paid under vehicle highway fund