251559 11/18/15 CITY OF CARMEL, INDIANA VENDOR: 360650
® _ ONE CIVIC SQUARE GRACE REFRIGERATION CHECK AMOUNT: $**.....388 89*
CARMEL, INDIANA 46032 PO Box 606 CHECK NUMBER: 251559
ZIONSVILLE IN 46077-0606 CHECK DATE: 11/18/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4350900 27465 388.89 OTHER CONT SERVICES
D �=yam Invoice
Date Invoice#
Mac 0
PO Box 606 Zlonsvtlle,IN 46077 317-769-3691 Fax 317-769-3330 10/30/2015 27465
www.GraceRei riaerdtton.com
Bill To Ship To
CARMEL FIRE DEPARTMENT#41
2 CIVIC SQUARE
CARMEL,IN 46032
P.O. No. Terms Equip. Name Model# Serial# Install Date
Due on rece... SCOTSMAN C0330SA-IB 10031320010016 9-3-10
Item Qty Description U/M Rate Amount
REGULAR PM SERVICE ON ICE MACHINE
AND WATER FILTER FOR NOVEMBER 2015
I-2000 1 EVERPURI:1-2000.5 MICRON WATER FILTER 89.00 89.00
ICE MACH CL... 16 OZ.ICE MACHINE CLEANER 2.16 34.56
KEY BLAST 0.25 KEY BLAST 27.30 6.83
SHOP SUPPLIES 1 SHOP SUPPLIES 5.00 5.00
SERVICE CAL... 1 INITIAL SERVICE CALL JOSH H.. INCLUDES 146.00 146.00
FIRST HOUR.TRUCK,GAS, INSURANCE
JH 1.25 JOSH HESSELGRAVE S.T. 86.00 107.50
Sales Tax (7.0%)
Pay online at: https:Hipn.intuit.com/6thx9hmz
88.89
Total
$388.89
Grace Refrigeration Sells and Leases the most popular ice machine on
the planet.Scotsman Ice Machines.For a quote call 317-769-3691 Payments/Credits $0.00
Balance Due F
`Scotsman $388.89
E-mail
Building Our Business On TRUST
Steve o GraceRefrigeration.com
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 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))
27465 Sta.41 Ice $388.89
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
20Clerk-Treasurer
VOUCHER NO. WARRANT NO.
ALLOWED 20
Grace Refrigeration
IN SUM OF $
P.O. Box 606
Zionsville, IN 46077
$388.89
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1120 27465 43-509.00 $388.89 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
%inti
7vV—�`! LY of
6
Fire Chief
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund