HomeMy WebLinkAbout304199 10/13/16 CITY OF CARMEL, INDIANA VENDOR: 371223
i1 ONE CIVIC SQUARE AT&T CHECK AMOUNT: $*******433.66*
CARMEL, INDIANA 46032 RISK MANAGEMENT CHECK NUMBER: 304199
9''troN 1010 PINE 06-NW CHECK DATE: 10/13/16
SAINT LOUISM MO 63101
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1207 4344000 AMER22201608 433.66 TELEPHONE LINE CHARGE
VOUCHER NO. WARRANT NO. Prescribed by state Board of Accounts City Form No.201 (Rev.1995)
ALLOWED 20 ACCOUNTS PAYABLE VOUCHER
AT&T
RISK MANAGEMENT IN SUM OF$ CITY OF CARMEL
1010 PINE 06-NW An invoice or bill to be properly itemized must show:kind of service,where performed,dates service
SAINT LOLIISM, MO 63101 rendered,by whom,rates per day,number of hours,rate per hour,number of units,price per unit,etc.
$433.66 Payee
ON ACCOUNT OF APPROPRIATION FOR Purchase Order#
Brookshire Golf Course 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
AMER-22-201608- 43-440.00 $433.66 1 hereby certify that the attached invoice(s),or 10/4/16 AMER-22-201608- Repair Phone Service $433.66
20-0015-SZ 20-0015-SZ
1207 101 bill(s)is(are)true and correct and that the 1207 101
materials or services itemized thereon for
which charge is made were ordered and
received except
Monday, October 10, 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 distribution ledger classification if claim paid motor vehicle highway fund. Clerk-Treasurer
Page: 1 of 2
`� - Date: 10/04/20.16
.20 at&t Claim for, Damages
To:
Summary of Charges.
BROOKSHIRE GOLF COURSE
12120 BROOKSHIRE PARKWAY
CARMEL,IN 46032 The labor cost amount claimed includes direct costs and indirect
costs,including but not limited to personnel,equipment,vehicles,
administrative overheads,and an allocation of general corporate
Claim Number: AMER-22-201608-20-0015-SZB overhead.
Charges for Damages to: LABOR COST $410.75
INDIANA BELL TEL CO.,DBA AT&T INDIANA
MATERIALS/UNIT COST ITEMS $22.91
Occured/Discovered On or About: 08/01/2016
Approximate Location: TOTAL AMOUNT DUE: $433.66
1.202 CASTLE ROW OVERLOOK ACTUAL ADDRESS IS 12022
CASTLE ROW OVERLOOK:,CARMEL CITY,IN Breakdown of Charges on next page
How Damage Occured:
GOLF COURSE MOWER HIT PED NEAR THE 9TH HOLE TEE
BOX
Call before you dig
Call 811
For Inquiries Call:800-894-0374 or 800-363-3234(FAX)
This payment is due upon receipt. If payment is not received within 30 days further collection action will betaken. IF A PAYMENT FOR LESS
THAN THE FULL AMOUNT IS RECEIVED,IT WILL BE APPLIED AS A PARTIAL PAYMENT. Please do not pay with telephone bill.
If you are covered by insurance,please forward this to your carrier for payment. Once.your claim has been established with your insurance
company,please contact us at.800-894-.0374 with your claim information,and we will work with your insurance company to resolve. AT&T
accepts checks,money orders or credit card payments. We do not accept cash. Please complete the information below and return in the
enclosed.envelope or you may call 800-894-0374 to pay by phone.
Page:2 of 2
f T Date: 10/04/2016
at&t
Breakdown-of charges.
LABOR COST
DATE OF REG REG OVT. OVT DBL DBL
EMPLOYEE REPAIR HRS' RATE HRS RATE NRS RATE AMOUNT
GF .'08/01/2016 3.50 117.3607846 $410.75
Labor Cost Sub-Total $410.75
MATERIALS .
DESCRIPTION QUANTITY UNIT COST., AMOUNT,
CUSTOMER.TROUBLE TICKET NCSC 1 14.7400000 $14.74
CUSTOMER TROUBLE TICKET NDC 1 8.1700000 .....$8.17
Material.Sub-Total $2291
Total Labor Cost,Materials,'Contractor,Loss of Use,Other Items $433.66
AT&T Risk Management .
1010 Pine,06-NW
St.Louis,MO 6310.1
RETURN SERVICE REQUESTED