187427 07/07/2010 CITY OF CARMEL, INDIANA VENDOR: 353704 Page 1 of 1
O i ONE CIVIC SQUARE RESIDENTIAL HEATING AND AIR CHECK AMOUNT: $4,100.00
CARMEL, INDIANA 46032 1950 E GREYHOUND PASS STE 18 #144
CARMEL IN 46032 CHECK NUMBER: 187427
CHECK DATE: 7/7/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
652 5023990 S12186 4080 4,100.00 REPAIR AC
-J
Residential Heating Air LLC
"CALL THE PRO" I O O Q O
1950 E Greyhound Pass Ste 18 #144
Carmel, IN 46033
(317) 435 3797
SERVICE PICK UP PHONE REPAIR IN DATE OF ORDER AA
STALL 0 DELIVER HOME HOP
ME DATE PROMISED
ADDRESS APARTMENT
Q
CITY DATE OF ORIG. INSTAL
MAKE MODEL SERIAL NO. ❑ESTIMATE
[:]WARRANTY
El CONTRACT
NATURE OF ❑GASH
SERVICE
�ry •e/,v�
REQUEST LOGn !r`^ ❑CHARGE
C.O.D.
QUAN. PART NO DESCRIPTION PRICE AMOUNT
ev I
A �0 3
lug �.s ,�.s
SERVICE PERFORME /J� TOTAL
MATERIAL
l TECHNICAL
SERVICE
(r�`t ry TIME
IJA Q Z O 1; TAX
E OMPLETE ON COMPLETIO
CASH OF WORK TOTAL
�NVOICE COPY I hereby accept above performed i e, and charges, as being satis-
fa ory and acknowledge that equi t ..been left in good condition.
Technician Cusfomer's Signatur 4
L1
VOUCHER,# 1057.,O _WARRANT ALLOWED
353704 IN SUM OF
RESIDENTIAL HEATING AIR
1950 E. Greyhound Pass
Ste 18 #144
Carmel, IN 46033
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
4080 02- 2308 -00 $4,100.00
Depreciation t
o
Voucher Total $4,100.00
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
353704
RESIDENTIAL HEATING AIR Purchase Order No.
1950 E. Greyhound Pass Terms
Ste 18 *144 Due Date 6/30/2010
Carmel, IN 46033
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
6/30/2010 4080 $4,100.00
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