191214 10/27/2010 CITY OF CARMEL, INDIANA VENDOR: 360650 Page 1 of 1
ONE CIVIC SQUARE GRACE REFRIGERATION
CARMEL, INDIANA 46032 PO BOX 606 CHECK AMOUNT: $310.02
i? ZIONSVILLE IN 46077 -0606
CHECK NUMBER: 191214
CHECK DATE: 10127/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4350000 21226 310.02 EQUIPMENT REPAIRS M
GRACE REFRIGERATION Invoice
317 769 3691
P O BOX 606 Date Invoice
ZIONSVILLE IN 46077 -0606
9/28/2010 21226
Bill To Ship To
CARMEL FIRE DEPARTMENT #45
10701 N. COLLEGE AVE.
INDIANAPOLIS, IN 46280
P.O. No. Terms Equip. Name Model Serial Install Date
Due on receipt SCOTSMAN CO330SA -IA 07031320016247 4 -20 -07
Item Qty Description Rate Amount
CLEANED ICE MACHINE AND CHANGED WATER
FILTERS
1 -2000 1 EVERPURE 1-2000.5 MICRON WATER FILTER 69.42 69.42
K -20 1 K -20 COURSE WATER FILTER 11.85 11.85
ICE MACH CLE... 10 OZ. ICE MACHINE CLEANER 2.05 20.50
SERVICE CALL... 1 INITIAL SERVICE CALL JOE W.. INCLUDES FIRST 149.00 149.00
HOUR, TRUCK. GAS, INSURANCE
JW 0.75 JOE W. S.T. 79.00 59.25
Subtotal $310.02
Building Our Business On TRUST Sales Tax (7.0 $0.00
Total $310.02
Payments /Credits $0.00
Balance Due $310.02
E -mail
gracerefrig a tds.net
VOUCHER NO. WARRANT NO.
ALLOWED 20
Grace Refrigeration
IN SUM OF
P.O. Box 606
Zionsville, IN 46077
$310.02
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO# I Dept. INVOICE NO. ACCT #(TITLE AMOUNT Board Members
1120 21226 43- 500.00 $310.02 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
OCT 2 5 2010
Fire Chief
Title
Cost distribution ledger classification if
claim paid motor 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 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))
21226 Sta. 45 $310.02
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
Clerk- Treasurer