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317145 10/11/2017
CITY OF CARMEL, INDIANA VENDOR:�.c�NM AY RS BACKFLOW CHECK SERVICE CHECK 20 TAMOUNT: $*...***555.0 ONE CIVIC SQUARE CHECK NUMBER: 317145 �_; CARMEL, INDIANA 46032 CARMEL IN4 032 CHECK DATE: 10/11117 9�<<ON� DESCRIPTION DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT 00 BACKFLOW PREVENTION S 1125 4350100 50422 156295 Voucher No. Warrant No. 359344 Ayers Backflow Check Ser Allowed 20 20 Bennett Rd Carmel, IN 46032 In Sum of$ $ 555.00 ON ACCOUNT OF APPROPRIATION FOR 101 General Fund PO#orBoard Members Dept# INVOICE NO. CCT#/TITL AMOUNT 50422 F 156295 4350100 $ 555.00 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 October 5, 2017 Signature $ 555.00 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund RECMVIRD OC 10 5 2011 INVOICE NO. 156295 BY:..'...l Invoice OLD TO SHIPPED TO ADDRESS ADDRESS Carmel, IN 46032 CITY STATE,TIP �� Z CITY,STATE,ZIP 575_0782 iUM�RORDtffQ 50kDDY� TERMS , OAT(, If �OvNQftts � 33 CfJ2 S3 i 2.- ! ' - 'VtA, N ,'--1r 790-79Z 2'' yv L 2Z7/Q 'f 35ru 00 �4r/ZlX7`5 J� �L !r'�12J Grt"1�t v V70, 1-r3 vN� P: c # G/G Yfi2 v� 0:00 a..dArn$•D8740 55 '`•00 PI4 i .. ........." __..... ., ......... ........._.__... .._._ ._.. ............ __ __. ...._ w a i `BACKFLOW PREVENTION TEST ADDRESS . CITY �1P d z 3� IDEi\CE" .�P31Qiy y` MAKx+; &I►dODELSERL # SIZE 1;OCATION NEXT TEST DATE By— f RF,DUCED PRF3UAL AS$EUBLY DOUBLE CHECK VALVB 0 CHECI£`V#iLVE;#I CHEC%VAI,VF#2 RELIEF VALVElB J PV131SV>3 SVB Held.at PS Held. Held at PSID Opened AIRT DCDA RPDA i?SID Opened;. AG at P8 Closed AV$ tight SUPPLY Leaked Leaked Did Not Did PRESSURE 'CHECK VALVE A" " REPAIRS, CLI,ANED GLEANED CLEANED --= Held, . :bpeii REPLACED REPLACED REPLACED at —PSM Not. Leaked ;.Open CT.F D AIR'GAP REPLACED Pipe k'INAL PSPSID Opened PROTECTION PSM SERVICE i- ' oritainment o estjcTFST Closed at PSIDsolation ' Fir2 tight E]Contain ment Q Irr�gats oz3'' by' Ssolaton I IIVITI&L TEST B'Y TESTER No. I96-Q896 DATE: bone:(31'7)25 6118 Fax:(31 66-0087 TIME " GAUGE: MLDWEST MODEL: 830 CALIBRATED,. 213008 Ayers Backflow Check, Service 24''eENNE17 ROAD°CARMEL,INDIANA 46432, m. BACKFLOW PRLVENTION TEST DRESS CITY tip TF,II�PxarTE: f MARE 3s"&ODEL SERIAL#- SIZE �... s� LOCATIaN NEXT TEST DATE BY REDUCED PRESS IIRE ASCLMBLY DOUBLE CHECK VALVE CHECK VALVE#1 CHECK VALVE#2 RELIEF VALVE PVB/SVB r INMAI, SVB TEST He1d)1L �" SID Held at • PSID Opened � AIR IIn"m �D�A at ASID Opened A4 at. PSID AVB Closed Stlp'P.LY " ^ Leaked Leaked . ODid Not FfiESSURE REPAIRS CLEANED,_� CL�'A=b CI,IeAI,nrT CHECK VALVE AVB Held open, REPLACED REPLACED REPLACED at PAID Not Leaked, Open CLEANED AIRGAP REPIACED Pipe :Size Dist. 7AL, ' PSID PAID 'Opened PROTECTION sEAVId Contal;iment Dmiest16." Closed at PSID ❑Isolation C7 pip tight ix Q ContasnmeA [l Irrigati& by Isolation INITIAL TEST BY: . .��' a�•3r 1 DATE: �..�, .� ���"�` TESTER No. I95-0896 � Phone:(317)"258-6118 Fait:(3176=0087 TIME, 1 GAUGE MIDWEST MODEL; 830A05, 6Fr� CALIBRATED: ' 21300$ a.• Ayers Backflow Check Service z 20 BENNETT ROAD•CARMEL,INDIANA 48032 . BACKFLOW PREVENTION TEST , ADDRESS CITY ZIP "; BtTSTNE ENC33 �: TXL�HONE SERIAL"# r t FEST DATE BY REDUCED PRESSURE ASSEMBLX DQUBLE CHECK"VALVE CHECK VALVW#jr, CHECK VALVE #2 RELIEFVALVE PVB/SVS " TEST Held"at> SIA" '$eld at PSiD" DCDA C?Peried AiR INLET RPDA ` at PSID Opened,, at Closed p82D Avg SUPPLY Did-atLeakedr Leaked_ D1d'Not PRESSURE REPAIRSCLEANED CLEARED- CLEANED CHECK VALVE AVB REPI+ACED'r ,";, Held_ Open REPLACED REPLACED at Not Leaked Open" CLH)k EA AIR GAP, REPLACED Pipe Dist. T'SID _PSM Opened PROTECTION SERiCE TEST ohtainment .DcxneSsbiG Closed " at PSTD isolation [=1 Fire tiot - p Containment qs , by Isolation TNITIAB TEST$Y, 'A go" IJg_Q896 DATE: Plione:(317)2f8 61 .8..• Fax.(31.'7)iwe-0087 TIME COMMFN!PS: - J�SJez r " GAUGE: MIDWEST MODEL: 830 6__.' 213008 CALIBRATED Ayers Backflow Check Service 20 SENNETT ROAD•CARMEL,INDIANA 46032 F b y . ,.....;- �. BACIUWW PREVENTION TEST ADDRESS CITY 1p IWI f� 1411 71 TEEPscu+rE MAKE,*MODEL SERIAL# SIZE l , -t q 21 - . LOCATION NEXT�EsT"DA3'E$ ! ,; ` . REDUCLP PRESSURE ASSEMBLY DOUBLE CHEGI�VALE CHECK VALVE CIIECK"VALVE #2 REIN'VALVE IrtTBfSVB P" T IZ�TiTIAL 8VB �, Held '..—PSM Heid atPSID Opened �, DCDA RPDA atPSID OpenedAG Closed at PQID AVP tight SUP.PLy Did Not wed=—.— Leaked. 4jePRESSLIR�s REPAIRS; CLEAM CLEANED CLEANED cxiECI VALVE AMB REPLACED REPLACED REPLACED Held Open at PSID Not Leaked Open CLEAN3.;D_ AZR t3AP REPLACED Pipe Size Dist. ' =I+!SNAIA PSID PSID Opened` q�PROTEGTIQN SERVICE TEST Containment Domestic Closed 8t PSID u lsdi tioa 0 Fire tight ❑-Containment © Irrigat"iRn, by Isolation IN1TtAL TEST BY. , TESTER No 19"896 DATE: Phone:(317),@38-6118 Fax;(3IZ.Y.b66-'087 TIME —� cors GAUGE-. MIDWEST MODEL: 830 RO � � CALIBRATED: 21,3008 Ayers Backflow Check Service 20 BENNETT ROAD CARMEL,INDIANA 46032 " BACKFLOW PREVENTION TEST A3yDR� CITY B %FtE8ID1�NCE TELEPHONE 'MAKE,dr M(7Dffi, SERIAL#_ SIZE LOCATION ' NEXT TEST D14'ME BY ' . REDUCED PRESSURE ASSEMBLY 00ABLE CHECK VALVE CHECK VALVE#1 CHECK VALVE #2 RELIEF VALVE PVi3XSVB PVB INX'i`IAL TEST Held$t,�a`" PSID 'Held at NM OpenedAIR INLET M 'MIX RPDA at PSID Opened, A4 Closed at tight SUPPLY. Did Not Did_1+Toti PRESSURE Leaked Leaned , PAIRS OLRA.NED CLEANED CLEANED CHECK VALVE AVB RE Heide Open REPLACED REPLACED Not Leaked Open CLEANED ' AIR'iGAP.. REPLACED Pipe,,, Dist- AL PSID Opened PROTECTION SEitVICE Containment Closed at-MID Do�tie6a o T EST' , tight ❑YSO�atlOn [j' ire ❑ Containment ❑ Irrigation {L by .,Isolation jMl LLL TEST BY 1 R TESTER No. I98-0856 s, DATE: ! . PhD�e�(317), 58 6II8 l±ax:(3 566=0087 TIME GAUGE: MIDWEST MODEL: 830 .3.0,586 CALIBRATED 2`13508 .- Ayers Backflow Check Service 20 BENNETT ROAD-CARMEL,INDIANA 46032 �; .'. ::3 BACnW. W. PREVENTION TEST ADDRESS Ci'PY ziP vsn�s mExCE TBLEPE?NE . 8r 3daDEL, SERIAL# %ticA'1'zoN NEXT,7'EST If if REDUCED PRESSURE ASSEMBLY DOVALE:CHECK VALVE CHECK VALVE#1 CHECK VALVE #2 RELIED'VAI,VS PSTB/SVB PVB _ :�3I3'IAL , BUB HeiCl.at PS7b Held at P8ID DCDA T: Opened AIR".I1�TLET RPDA is at ' SID Opened AD AVB Closed. st. SID• -_» tight SUPPLY LeakedLeaked Did_Not Dido PRESSURE 0.p= QUM REPAIRS CLXAN= CLEANED CLEANED CHECK VALVE AVH Held Open u. ALT! ACED` REPLACED REPLACED at P8ID — .. _ Not Leaked- Open CLEANED AIR GAP REPLACED !.Pipe IBize ;Dist. _ ICTAL PSID PBID 'opened PRQTECTION SERVICE'. ontai7nment TEST ClosedDaeiest At PSID ❑"T'soiatian ; (3 Fixe tight ❑ Contai.nmeht p Irrigation by Isolation INITIAL TEST BY: TESTER No. 195-0898 DATE: ' Phone:(3I7j 258-8118 Fax:(317)886-0087 TIME GAUGE,.*, MIEW.EST MODEL: 830 -30t668 CALIBRATED: x � Ayers Backflow.Check Service 20 BENNETT ROAD•CARMEL,INDIANA 46032 n 4 3 F 94 BACKFLOW PREVENTION TEST AIllRES3 7°° CITY .. T�I�PHOE9E &MdDEI. SERIAL#' ,SIDE MAHE LOCATIQN NEXT TEST DNTE I' , ,., REDUCH0,PPES3trAN ASSEMBLY DOUBLE CHECK VALVE ! CIMOK VALVE;#1- CHECK VALVES #2 RELIEF VALVE FSB/SVR PVB INITIAL TEST Held;;t L-�hSID Field at PSID Opened AIR INLET DCI3tA RPDA r"> $tPSID rppe4edAG at PQI�j'> AyB Closed ---� tight � ST3PPLY 'PRESSE Leaked Leaked `" C$ECK VALVE AVB REPAIRS "CLEANED CLEANED CLEANED Held Open _' r REPLACED REPLACED REPLACED FSID Not Leaked " open t CLF,AW AIR CAP REPLACED Ripe Size, Dist. FINAL = PSID' PSID Opened PROTECTIONSERV3CE '3'ESTontninmeat Dr�ties t�, Closed,:- at PSID T�olation tight ❑Cosi,tainnent p I"rrigatlon by'"_Tsolaton INI`T'IAL TEST'BY TESTER No, I9$70896 DATE; Phone;(317):258-6118 FAx:(317) -0©8'7 TIME 3©58 GAUGE". MIT)L1E.S,T MODEL; 830 008. CALIBRATEDs j . Ayers Backflow Check Service 20 BENNETT ROAD-CARMEL,INDIANA 460'32 j' y �IIY(f WiYf9YIliY]Y(fii%IPfiIY II1111fliliWli�1111'iLY�YXYY�ir.....