HomeMy WebLinkAbout301716 08/08/16 CITY OF CARMEL, INDIANA VENDOR: 369
(9,
ONE CIVIC SQUARE LEACH & RUSSELL CHECK AMOUNT: $****67,001.37*
CARMEL, INDIANA 46032 9151 FORD CIRCLE CHECK NUMBER: 301716
FISHIRS IN 46038 CHECK DATE: 08/08/16
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1208 4350900 33638 56,340.51 OTHER CONT SERVICES
1208 4350900 37089 1,583.80 OTHER CONT SERVICES
1208 4350900 37159 5,582.65 OTHER CONT SERVICES
1208 4350900 37161 894.41 OTHER CONT SERVICES
1208 4350900 37162 2,600.00 OTHER CONT SERVICES
VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201(Rev.1995)
LEACH & RUSSELL ALLOWED 20 ACCOUNTS PAYABLE VOUCHER
9151 FORD CIRCLE IN SUM OF$ CITY OF CARMEL
An invoice or bill to be properly itemized must show:kind of service,where performed,dates service
FISHERS, IN 46038 rendered,by whom,rates per day,number of hours,rate per hour,number of units,price per unit,etc.
$67,001.37 Payee
ON ACCOUNT OF APPROPRIATION FOR Purchase Order#
Building Operations
Terms
Date Due
PO# ACCT# DATE INVOICE# DESCRIPTION
DEPT# INVOICE# Fund# AMOUNT Board Members DEPT# FUND# (or note attached invoice(s)or bill(s)) AMOUNT
33638 43-509.00 $56,340.51 1 hereby certify that the attached invoice(s),or 5/31/16 33638 $56,340.51
1208 101 1208 101
37089 43-509.00 $1,583.80 bill(s)is(are)true and correct and that the 7/14/16 37089 $1,583.80
1208 101 materials or services itemized thereon for 1208 101
_ 37161 43-509.00 $894.41 7/21/_16_ 37_162 $2,600.00_—__
1208 101 which charge is made were ordered and 1208 101
37162 43-509.00 $2,600.00 received except 7/21/16 37159 $5,582.65
1208 101 1208 101
37159 43-509.00 $5,582.65 7/21/16 37161 $894.41
1208 101 1208 101
Tuesday,August 02,2016
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
,20—
Cost
20Cost distribution ledger classification if claim paid motor vehicle highway fund. Clerk-Treasurer
r
Leach & Russell
Mechanical Contractors, Inc.
9151 Ford Circle I nvo i Ce
Fishers, Indiana 46038
= Phone: (317)841-7877
.o R U SSE L L F
M E C H A N I C A L ax: (317)841-7460
l
Invoice Number: 33638
o City of Carmel Invoice Date: 05/31/2016
for Carmel Utilities Our Job Number 168542
in 30 W. Main Street, Suite 220
Carmel, IN 46032
Job Name: Carmel Energy Center
Your Purchase Order Number: John Duffy
Labor and materials needed for HVAC service in above
location. Replaced fans on all four cooling towers.
(See copy of work order attached)
TOTAL AMOUNT DUE $56,340.51
Submitted To
AUG 0 2 2016
Clerk `treasurer
Terms: Due Upon Receipt
WORK ORDER
TO: G ( ,1n . C �_4, '...._.____ LEACH & RUSSELL
_ .........._ MECHANICAL CONTRACTORS, INC.
_ 9151 Ford Circle
I
Attmntlon: -�G --R±-_ -,-, Fishers, Indiana 46038-3000
JOB LOCATION: ' phone 317 841-7877 Fax 317 841-7460
WORK REOUESTED:
Datta: � � nContracl
'4,{`•-'I.�.C,C1a._ --_-_ _-___ _._
Oil) - EON
6rtra
1. n Time&metarial
MW■rranty
Jab complete
_ --- _ — — — ----—
_ OJob Incompleta
04rJoh ! S-rralNNumber:
(—_—._._----.__..._...—
OTHER CHARGES !j AMOUNT
Truck Charge
QTY MATERIALS AMOUNT
TOTAL OTHER CHARGES
j DATE LABOR ST 1.5 DT AMOP1tT4
64 J
TOTAL MATERIAL HCTOTAL LABOR g at'?
TOTAL MATERIAL, OTHER&LABOR 3 511
Work Ordered By:
TAX
stgn■ture:
TOTAL gz0 3
ora y ac no vle ge a sa s c ory comp a ono ■ vo pe workan
■pree to render payment upon receipt of invoice.
SERVICE WI RK ORDER 001763
T®: ,� a 'r4/................................................ L ACH RUSSELL
M CHANICAL CONTRACTORS, INC.
91 1 Ford Circle
JOB LOCATION: �^ Fishers, Indiana 46038-3000
YJOP.KPERFORMED: Phone (317) 841-7877 Fax (317) 841-7460
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L T'9-9- `.r-�C°lfiUl t'tifY100 I.T 3
QUOTES/FOLLOW-UP: --- - ---
Truck-Charge
.............................../..
_
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....................................................................._. ..._ ,_ _. ....., ....,....... .., ,.. _,.,...:... _..—
QTY ( MA`'mALs �IMPU\#T
TOTAL O T HER CH.AROES 1
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TOTAL MATERIAL ? TOTAL LABOR,
TOTAL MATERIAL, OTHER`&LABOR�
Work OMorod By: TAX
Slgnatura:
TOTAL
h=by ac no ,' s as a ac ry comp ono "a ova a cfescriSe�work awn —
aproo fo render paymant upon reeolpt of Invotm
LR-OS•Oai5
I
SERVICE WORK ORDER 002902
TO: Cir.�. '.�.............................. LE CH & RUSSELL
..... ..................................................
MECHANICAL CONTRACTORS, INC.
.......................................................................................................
911 Ford Circle
Joe LOCATION: ,
GCMG=t v Fishers, Indiana 45038-3000
� arc
WORK PERFORMED: f ' Phone 317 841-7877 Fax 317 841-7450
..................................................................................,...................,,.,....,.,.„_,...,,.. _fG+rr� tl7akett� �Tnne iL7tslaflal
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• - - Crdai�f�us ( =).i061neornpiate
Pttn.y i Mdde1 Ntitmur .
�lurtEv
Du7:1 b• Fseriall�u�n6er;” -
OTHER. CHARdES" AMOUNT
OUNT
QUOTESIFOLLOWUP: 1�T'r I tk'Charge
. .
.......................—.............................................................
...................................................................................•............ ........
.........................................................................__ _.— _._ .;...,.—_ .:J - ..
QTY_! IVIAT;ERIALS 'AMOUNT
TOTAL OTHER CHARGES
----------.-.._.-._...
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TOTAL,MATERIAL, � _ TOTAL LABOR
TOTAL MATERIAL;OTHER&"LAE36R i
Work ordered By: TAX
signature: TOTAL
ere y se no ge a ea a ae ory comp a ono novo descnGe3 woik a`nd
agree to ronder payment upon recolpt of involes.
LR-06 0615
SERVICE WORK ORDER 001767
TO: L
` ACH & RUSSELL
.....� ..Mai.. �1.�.�./......................................................
M CHANICAL CONTRACTORS, INC.
....................................................................................................
911 Ford Circle
JOS LOCATION: tP t fir l Fishers, Indiana 46036-3000
wORI<PERFORMED: j Phone (317) 641-7877 Fax (317) 641-7460
..,.r.........................................................
.... /R �/••.....T.�a�..... 'J.C.F.!•! rC..,. /.frtlRr:S.::....:,.� _��. 9U61�t:.,.x ..�� Ocontract
�/ t /2 fC _ Extra
Oh....`j..{ ... ��. ... ..��/I j...........:.......... . ORipr Tanen � me 8 Material
I f/�ArsK I =Warranty
........................................................................................................... =Job Complete
G: :efi No_ [slob Incomplete
........................................................................................._.. �.�-- ptlat,=,{r -- Modol Number:
t?ur'J-65- fv—y---�l (Sonat Number.
_, ., ,_.,,,,. ,...... .
.. x��naQ7 ' Y'� 1 ll
................................................................................. ....•-- _
. ....._,._...... ....,._._,.... /
9 :.OTHER C -AR ES AMOUNT
QUOTESWOLLOW-UP: G -
Truck Charge
.
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..................................................................... .. - . -. . .
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QTY. MATtkIALS ........................^
TOTAL:OTHER CHARGES
DATE LAI3: 7RT` ''I' 8F_ Aildi4Uf T=
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TOTAL MATERIAL � , TOTAL LABQR
TOTAL MATR'AL, OTHER &_LABOR
Work Ordered By:
TAX
Signature_ TOTAL
aro y mcknow4edge the oaustectoryomp ono a ove�escrl�erTµork and
agreo to render payment upon rmcelpt of trrvoice.
LR-06-0615
SERVICE W RK ORDER 002894
LACH & RUSSELL
TO:
.........................................................
.......I..................................................... ..................................... MI CHANICAL CONTRACTORS, INC.
9151 Ford Circle
'JOB'LOCATION: I
Fishers, Indiana 46038-3000
WORK PERFORMED:
.............................................................I.,............ Phone (317) 841-7877 Fax (317) 841-7460
....... =Contract
Extra
...... - R,,3n Time&Material
1 'Y ,
FW
arrany
......................................................................... ....... I ! m6f
=Job Complete
j
Grdc Na. E_�IncompItto
Model Number:
!OLr Serial Number-
NuN or. 16ml t
AMOUNT
qTM'E'R CHARGES
QUOTE&FOLLOW-UP. Tr I qk'_Charge�
...................................................................................... ..........
..........
........................................................
.......... .................... ...... ........... ............... ....... .......... r_. ......
......................................................................
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QT-,Y TAATERIAQS
AM
...............
TOTAL OTH'ER CHARGES
ATELA50R' PT- AMOUNT
...........
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TOTAL MATERIAL TOTAL LABOR.
TOTAL MATERIAL,OTHER&.LABOR
Work Ordar*d By: TAX
SIgmatura, TOTAL
11;�ruby==04 comp.jellono f the
ma 1p, E.
LR-06 0615
T Leach & Russell ���0\
Mechanical Contractors, Inc. iZp�
n 9151 Ford Circle l Invoice
Fishers, Indiana 46038
R U B S E L L Phone:(317)841-7877
MECHANICAL Fax:(317)841-7460
Invoice Number: 37089
o City of Carmel Invoice Date: 07/14/2016
for Carmel Utilities Our Job Number 168708
m 30 W. Main Street, Suite 220
Carmel, IN 46032
Job Name: Carmel Energy Center
Your Purchase Order Number: John Duffy
Labor and materials needed for HVAC service in above
location. Replaced actuator and washed condenser coils.
(See copy of work order attached)
TOTAL AMOUNT DUE $1,583.80
Submitted To
AUG 0 2 2016
Clerk Treasurer
i
Terms: Diue Upon Receipt
E-WORK ORDER ®0 1
SERVICE- I •
TO: LEACH & RUSSELL
C,. .........................................."....................I.......................
MECHANICAL CONTRACTORS, INC.
.............................................................................................................. 91 51 Ford Circle
JOB LOCATION: Fishersi,317)
Indiana 46038-3000
WORK P PO ED: �/] hone 841-7877 Fax (317) 841-7460
,(�.. .. ............. . .... JiJ..
•.. Date: Contract
......... .. _ Extra
Time&Material
Bider Taken Warranty
•• ••••••"•"" "' " ' •� ' � Job Complete
f ••.. Customer Job Incomplete
Order No.:
Phone Model Number:
................................................................................................................................... Number:
Our Job Serial Number:
- -
...................... - - -
.....................
..................................................................
............................................. AMOUNT
.•"""""""""""""" OTHER CHARGES
QUOTESIFOLLOW-UP: Truck Charge ........... 5...Co
. ••
.................................................................................................I............
MATERIALS AMOUNT ............I......................
QTY ..............................................................................................................
....................................................
C � g'••'•'"'✓ TOTAL OTHER CHARGES S �a
................... ..
�"�•'"� • � ......�..JZ
...................✓. -..................................................
•••• 'DATE LABOR ST 1.5 DT AMOUNT
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TOTAL MATERIAL 5 -18 80 TOTAL LABOR 'D ®�
TOTAL MATERIAL, OTHER& LABOR 15-03
TAX
Work Ordered By:
TOTAL IS$ aD
5ignatu..
co a agree to render paw ayment upon_recea so is c ipt of nvaice n o e a ove escn a wo an
Ii
I LR-06-0615
TLeach & Russell
aMechanical Contractors, Inc.
r, 9151 Ford Circle ` Invoice
Fishers, Indiana 46038
=10 P hone:(317)841-7877
R U S S E L L
MECHANICAL Fax:(317)841-7460
Invoice Number: 37161
o City of Carmel Invoice Date: 07/21/2016
for Carmel Utilities Our Job Number 168760
m 30 W. Main Street, Suite 220
Carmel, IN 46032 i
Job Name: Carmel Energy Center
Your Purchase Order- Number: - John Duffy - -
Labor and materials needed for HVAC service in above
location. Installed sump pump in cooling tower pit.
(See copy of work order attached)
TOTAL AMOUNT DUE $894.41
I
Submitted To
AUG 0 2 2016
Clerk `treasurer
Terms: Due Upon Receipt
SERVICE WORK ORDER 002 0
TO: ....esLEACH & RUSSELL
..............................................................................................................
MECHANICAL CONTRACTORS, INC.
9151 Ford Circle
JOB LOCATION: Fishers, Indiana 46038-3000
WORK PERFORMED: Phone (317) 841-7877 Fax (317) 841-7460
............................._..I.._......... ......................................................................................
..........I......... .^..TP.4`..,........isGl.!b?..�v .....1.^.......LGO� .................. Date: 7 // QContract
I Z Q Extra
M!y.....�1.t.1.•................................................................................... Order Take �� Time&Material
BY: i M Warranty
Customer Complete
Order No.: Job Incomplete
............................................................................................................................
Phone Model Number:
Number:
.............. Our Job Serial Number:
Number: �`
...................................................................................................................................
OTHER CHARGES AMOUNT
QUOTESIFOLLOWUP:
Truck Charge
............................................................................................................................. ............................................................................................................. ......
................................................................................................................................... .......................................................................................................................................................
.................................................................................................................................. .................................................................................................................. ....................................
.................................................................................................................. .........I..........................
QTY MATERIALS AMOUNT
.................................................................................................................. ....................................
..............................i1 ..-..z.S.`.�S..........................._.._
�.x...l..�.��.... A1 ....�:�. ..............._.. .! .. TOTAL OTHER CHARGES 5500
...... ,� DATE LABOR ST 1.5 DT AMOUNT
.................... ..........................................
...................... �b..-... ..1.. ...✓............................................................ ... ' ......... ......... ......... ...........$d....
Z
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............................................................................................................................... ................................................................. ............................................ ....................................
TOTAL MATERIAL a9el TOTAL LABOR S q0 00
TOTAL MATERIAL, OTHER& LABOR qj
Work Ordered By: TAX
Signature: TOTAL 89q q'
ereT� yacknowledge e comp a ion o e above described workan
agree to render payment upon receipt of invoke.
LR-06-0615
T Leach & Russell
Mechanical Contractors, Inc. �o
n 9151 Ford Circle Invoice
Fishers, Indiana 46038
=
Phone:(317)841-7877
R U S 3 E L 1.
MECHANICAL Fax: (317)841-7460
Invoice Number: 37162
o City of Carmel Invoice Date: 07/21/2016
for Carmel Utilities Our Job Number 168757
m 30 W. Main Street, Suite 220
Carmel, IN 46032
Job Name: Carmel Energy Center
Your Purchase Order Number: John Duffy
Labor and materials needed for HVAC service in above
location. Responded to equipment alarm. Chiller#6 had
pop-off. Recovered and recharged unit.
(See copy of work orders and report attached)
TOTAL AMOUNT DUE $2,600.00
ubmitted To
AUG 02 2016
Clerk Treasurer
i
Terms: DIue Upon Receipt
SERVICE WORK ORDER 003798
TO: LEACH & RUSSELL
...... .........
MECHANICAL CONTRACTORS, INC.
9151 Ford Circle
JOB LOCATION: Fishers, Indiana 46038-3000
WORK P FORMED-
/Phone (317) 841-7877 Fax (317) 841-7460
a ... p .0 .......... Date: =Contract77 `� — EMre
G Order Take Time&Material
......................... ........
By:...........
�.................:... �........ ... . . .. .. . ... .......... b Incompletel
arranty
Customer ob Complete
.... . ...... r Order rLT_-ildo
..... / ........ o m Mo I Number:
........... ............... .
umber:
�/ K 1,,,,, rJob Serial m
c. �6R7 7 a r�
. ........... ......... .......~... ....... ........ ...... ......
Number:
I
I
OTHER CHARGES AMOUNT
QUOTESIFOLLOWUP:
Truck Charge c5 ®0
................................................................................................................................... .................................................................................................................. ....................................
,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, ,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, ,,,,,,,,,,,,,,,,,,,,,I—,..........
.................................................................................................................................. .......................................................................................................................................................
......................................................................................................................... .................................................................................................................. ....................................
.................................................................................................................. ....................................
QTY MATERIALS AMOUNT
....................................................................................................................................................
......9.. ..............��. ...................................a
...............................................................................................................................
TOTAL OTHER CHARGES S5
DATE LABOR ST 1.5 DT AMOUNT
.............................................I.. °®....CAP.....................M... 0.. �-./ .. I.�.p .. ... .. �f�.�.. . .... y.os a®
............................................................................................................................... 7-Y.II . .- ..W ..... .. .....✓.................................. 1a 00
............................................................................................................................. 1-8..........w... fsk.i.r... .... ...................a......a...... ........... ..
........................................................................................................................... ................................................................. ............................................ ....................................
............................................................................................................................... ................................................................. .................................................................................
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.............................................................................................................................. ................................................................. .................................................................................
............................................................................................................................. ................................................................. .................................................................................
............................................................................................................................... ................................................................. ............................................ ....................................
TOTAL MATERIAL 135000 TOTAL LABOR c /1&5
TOTAL MATERIAL,OTHER& LABOR 07&00 p
Work Ordered By: TAX
Signature: TOTAL Q�
ere y acknowledge �
3gethesatis ac-f story completion of thea ove escn a woTerr an
agree to render payment upon receipt of invoice.
LR-06-0615
i
Leach & Russell
Mechanical Contractors, Inc.
a9151 Ford Circle Refrigerant
Fishers, Indiana 46038X10 J®baits ReportPhone: (317) 841-7877
M H
E C H A N I C A L
u s e Fax: (317) 841-7460
M
Customer's Address: Job Number: Job Description
Recovery 7rBS.
Tye of Refrigerant:
Q Recycle LBS.
System Capacity(in pounds):
Disposal LBS.
Industrial Commercial
O Refrigerant O H.V.A.C. Add t�CJ LBS.
�f,..- 5�: �• 'F 'KS L-;x r�r .:F .' + r ya't ,� S' hS x �,=y�' i�: .gux to i a .°' k��t..e v�'i^.„ �`�� "».
�II�!�,at t: r. .7 . w,$ ,4 �� ,+i s,.a�,r, ,�.nr?u,Y ..?6 ,7'r...�-r •.� t�t�'a;Z:,,y�,�u'r. �, i€g,b,'r. x_5, r...?;:� "&-�? '�sav�!Jr �;.
Manufacturer: f Last Known Refrigerant Addition:
Model: Serial Number: Location of Equip ent::
Leak Lo tion:
r�D A 0)T
Leak Ikepaired Description o Repair:
Yes_ Vlty
Reason NOT Repaired:
Q No
�.��F�����`�.{ ��i Id C a t '4 �t' _,r,8�,�`r.;: .,.���r.'�,:r."� °:�.w. � ��:h��r...'�i h�k�� �_`r !. • ?��, Y"ci''r«' t
Type of Recovery Machine: -Vacuum Level Meets EPA Requirements
O Yes O No
O Acid Tested If not,please explain:
O Moisture Tested
Comments:
Reason: Approximate Amount Vented:
W. r i
If deficiencies/discrepancies noted are not corrected, you may be in violation of Federal/State clean air regulations!
Comments:
E! a z<-1,1 e r� 1 1 • x,
Name Date
Service Technician Certification Number Date
T Leach & Russells
a Mechanical Contractors, Inc.
9151 Ford Circle Invoice
Fishers, Indiana 46038
R U S S E L L Phone: (317)841-7877
MECHANICAL Fax:(317)841-7460
Invoice Number: 37159
o City of Carmel Invoice Date: 07/21/2016
Carmel Utilities Our Job Number 168509
m 30 W Main Street, Suite 220
Carmel, IN 46032
Job Name: Carmel Energy Center
Your Purchase Or-der.-Number: - John Duffy- -- - -
Labor and materials needed for HVAC service in above
location. Set temporary chiller and put up prima ,ry fence
around chiller.
(See copy of work order attached)
TOTAL AMOUNT DUE $5,582.65
I
Submitted 'T®
AUG 0 2 2016
Clerk `Treasurer
Terms: Due Upon Receipt
' I
_ f
Y' i
SERVICE- WORK ORDER 0017
TO: ..o �.. /........................................... LEACH & RUSSELL
MECHANICAL CONTRACTORS, INC.
9151 Ford Circle
JOB LOCATION: fishers, Indiana 46038-3000
WORK PERFORMED: Phone (317) 841-7877 Fax (317) 841-7460
................ �/- �// / . .
T.,� 1�1t/��`,I�.CAI.<`( ' �fe� ..�l.�c%]`'...df1. . Dte: S ��� xtract
....... ....... QE
/ l� Odder Taken e&Material
/ BY i c� it< � =Warranty
..................................................................................................................................
Customer =deb Complete
Order No.: =Job Incomplete
Phone Model Number:
Number:
............................................................................................................,...._...._,_ ur Job SerialNumbe r:
—
ON
umber: -
...................................................................................................................................
OTHER.CHARGES ' AMOUNT
QUOTESIFOLLOW-UP: Truck Charge o
................................................................................................................................ ....................................................................................X................. .........�..I.. :. ......
................................................................................................................................... .� .ne- w .)....................................................... .......95415P
j am. ..-TuO.d.....R. . .�.S...-.. .��.Q. .........
......................................................................................:.................I...................... X1.$..... ..7..
............................................................................................................................... ........................................................................................................... ..................... ......
... ..... .. .. ..... ..
.................................................................................................................. ...
QTY MATERIALS AMOUNT
... . ............ ..... ..
. .�9�..`...ZZ® ..! .......................................... TOTAL OTHER CHARGES c, $�
..............................................................................................................................
DATE LABOR ST 1.5 DT AMOUNT
1 :., C /� ............! ..................................... .s"/6........... !!;� ........... ..�................................... .....� ® ..
.. ... .... .................. ..........
..
1............4 -l.....,C..�...... . ... a.
. .....................)A..... . .s..-o...........��.f'o���............. .�................. .......... .............. .
I...........rakol -t..... .sa e.. ,.... .................1�...)o .s�........... P................ ............. ......... ........ ®... ...
1.......... .....rf.1nkr..oLk............... ...0.d. ... !S'r7. ... .... .......... .......... ........0�.7 ...�...
•
dill
.......................................................................... .... '5:1............�:................. ................ .......... .......... .......... ..................... ..61
. ...... .....
8. .X10..... .1 ....................... 1.1... .�. s`/.1.......... .... /o, ........ ..3.................................... ......... ®.. ..
..
. ®w re
Lio
............................................................................................................................... ......................
1 . ...... ....................... .. .. .............................. ...............� .Q�...
............................................................................................................................... ' .'.� ........ .�... s .... ... ................................... ...........d �..10
............I.... ................................................................. ..................... ....... . ............... ...................................... .......... .......... .......... ..................... ......
I......I... ................................................................. ..................... i.................... ...................................... .......... .......... ......... .........I...........
.......................................................................................... ..... i........
.............
TOTAL MATERIAL 15 coq -WI TOTAL LABOR qSj .18-70001
TOTAL MATERIAL, OTHER&LABOR 55
Work Ordered By: TAX s
Signature: TOTAL S
hereby ac now a ge a sa is ac ory comp a ono e above described wo an
agree to render payment upon receipt of invoice.
LR-06-0615
VOUCHER # 162206 WARRANT# ALLOWED
351017 IN SUM OF $
KIRBY RISK ELECTRICAL SUPPLY
27561 NETWORK PLACE
CHICAGO, IL 60673-1275
Carmel Water Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO# INV# ACCT# AMOUNT Audit Trail Code
- - - - -- --- — ------ - - -- --
- yy -�-1r s1`-6200=04 --- - - - �p2�351.1/5/*'
Voucher Total
Cost distribution ledger classification if
claim paid under vehicle highway fund
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
351017
KIRBY RISK ELECTRICAL SUPPLY Purchase Order No.
27561 NETWORK PLACE Terms
CHICAGO, IL 60673-1275 Due Date 7/30/2016
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
7/30/2016 108780166.1 235.15
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
Date Officer