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HomeMy WebLinkAbout182939 03/03/2010 CITY OF CARMEL, INDIANA VENDOR: 359977 Page 1 of 1 ONE CIVIC SQUARE MR ROOTER CARMEL, INDIANA 46032 P O BOX 191 CHECK AMOUNT: $1,486.43 MUNCIE IN 47308 CHECK NUMBER: 182939 CHECK DATE: 3/3/2010 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1207 4350100 03377 1,486.43 BUILDING REPAIRS MA CONTRACT AND INVOICE CHECK-U C Customer Name: Central Indiana plumbing, Inc. fax 765.287.9916 0 Indianapolis 317.849.8690 License CO 50700211 WATER PRESSURE READINGS Time of Reading I] AM PM P L U M a 1 N G APPROXIMATE START DATE: W2 //Z) APPROXIMATE END DATE'' A l l PRV PSI ADDRESS a ORDER BATHROOM_ PASS FAIL KITCHEN PASS FAIL Sink Drainage Kit. Sink Drainage Customer Name:, I j Customer Name I Faucet Faucet/Sprayer 1:1 Go tc f r C �i' 2 Address Address Trap Basket Strainer Li �l r E.S.O. Valves 13 Rim Leakage City St. FC Zip Job Phone City Cn tart ❑Advantage Plan Member ❑Estimate Anti Scald Valve E.S -O. Valves Zip Other Phone Shower Drainage L3 Cont. Waste Trap V/ 33 FaService Prev. El Maint Opportunity Call f FaucetDiverter Li El Air Gap :1 El Would you like to receive E -mail T hn'cian(s) Person E.S.O. Valves Q L3 Disposer E -mail offers Yes No Address: Tub Drainage El Water Filter PA Y MENT FauceUDiverter 13 ❑Owner f�'lenant E.S.O. Valves LAUNDRY PASS FAIL N Cash n Check illed Check or Credit card referral Exp. Date: Auth. Code: El Residential 0 Toilet Operations Q Sink Drainage r E.S.O. Valves Faucet SERVICE r t e BATHROOM_ PASS FAIL Trap El L3 E.S.O. Valves I agree that initial price quoted prior to start of work does not include any additional or unforeseen tasks. Nor materials which may be found to be necessary Sink Drainage Wash Mach. -Drain I�K �a'� to complete repairs or replacements. I also agree to hold Mr. Rooter® or its assigns harmle ss for parts deemed corroded, unstable or unreliable for com- Faucet pletion of stated work to be done. I hereby authorize Mr. Rooter" to perform proposed work and agree to all agreement conditions as displayed on the,face Trap Hoses Cold Hoses -Hot and reverse sides of this docume L nd further ac ledge that this invoice is due upon receipt. independently owned and operated franch' e. E.S.O. Valves 11 I Date Submitted nician 'gnature r­ t^/ r Shower- Drainage L3 I Ctomer Tech To us Authori Signature X Print 1 t FauceUDiverter Q OUTSIDE PASS FAIL X Pri o/f a 2ab Authorized Signature X Print Anti -Scald Vatve Meter Inspection E.S.O. Valves Q Faucet "WARRANTY. t AND Tub Drainage Faucet l 1 1 �J�l g� FauceUDiverter Faucet Co 1 1 f� d E.S.O. Valves Anti- Siphon t�v �G l�� f��, Toilet Operations L1 Lawn Sprinkler Sys. J t� CttJ rJ le t� 1.0 S� E.S.O. Valves Clean Out 1 scJ 1 WATER HEATER ❑Gas L3 Electric ❑Propane ❑BTU Hot water PSI PASS FAIL T P Valve U C ivt Brand Water Supply II Tank Q w�L cc a a. to u Date of manufacture Boiler Drain Expansion Tank Gallons Timer `ly 120 H dronic Heating ❑P OF Video Inspection ❑Y ON cvo. c r r u. r' 1 c.110.� ie ��e Sc• o ca y 9 P l3abu` a T I �Vc ✓t .n C Sl OTHER G.lYG v ;1�t G -r r ti C A rI 1 71 Approved ❑Declined COMMENTSlRECOMMENDATIONS Approved Declined Approved Declined S S Acceptance of work performed: I find the service and materials performed installed have been completed in accordance with this Advantage I understand this inspection is performed with the intent to expose all possi- agreement. I agree to pay reaSQnable attorney fees, toll ctivn fees and court costs in the event of legal action pursuant to collection Plan ble plumbing problems but by no means carries any guarantee. Neither Mr. Never an overtime charge! Rooter, any entity associated with Mr. Rooter, nor the service technician per Of am due. 24 Hours a day 7 Days a Week Customer Signature X t forming this inspection shall be liable for an an idenntifiedorunidentified plumbing y damages which may arise from g p g problem, but shall be the sole responsi- TAX do hereby state that the above work has been done in a rkmanlike manner and to applicable codes. bility of the property owner, www.MrRooter.com Independently owned operated. 3 X Technician Signature X Truck l/ trj Customer Signature Direct Customer Inquiries to Operations Mgr. at 888 -949- 448 FRANCHISE COPY I VOUCHER NO. WARRANT NO. ALLOWED 20 00r. Rooter Plumbing IN SUM OF P.O. Box 191 Muncie, IN 47308 $1,486.43 ON ACCOUNT OF APPROPRIATION FOR Brookshire Golf Club PO# Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Members 1207 03377 43- 501.00 $1,486.43 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 Wednesday, February 24, 2010 Director, Brook ire Golf Club Title Cost distribution ledger classification if claim paid motor vehicle highway fund I Prescribed by State Board of Accounts City Form No 201 (Rev, 199: 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)) 02/22/10 03377 Flush Drain $1,486.4 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