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