191618 11/10/2010 CITY OF CARMEL, INDIANA VENDOR: 00351921 Page 1 of 1
0 ONE CIVIC SQUARE DUNCAN APPLIANCE SERVICE CHECK AMOUNT: $494.20
CARMEL, INDIANA 46032 11404 CENTRAL DRIVE EAST
CARMEL IN 46032 CHECK NUMBER: 191618
CHECK DATE: 11/10/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4350000 02459 310.00 EQUIPMENT REPAIRS M
1120 4350000 02469 184.20 EQUIPMENT REPAIRS M
Duncan Appliance Service
11404 Central Drive East
Carmel, IN 48032 -4510
317 844 -0420 Voice, 888 847 -0173 Fax
Name, Address and Telephone Numbers for the Paying Party Invoke Number
CARMEL FIRE DEPARTMENT 02469
2 CIVIC SO Date Order Taken and Completed
CARMEL, IN 46032 10/15/10
317 -571 -2600 11102110
Name, Address and Telephone Numbers for the Service Location (if different from above) Item Make and Type
CARMEL FIRE #44 44 GE
5032 E 131 ST ST [19 *14] COOKTOP ELECTRIC
CARMEL, IN 46033 Purchase Date
�4, 317 -571 -2632 317 -409 -0909
Description of Symptoms and/or Customer's Request Model and Serial Numbers
THE MIDDLE SIZE AREA OF THE MULTI -RING SIZE BURNER WILL NOT HEAT UP. P13975SM2SS
SR2505220
Service Performed
ORDERED PART, ORDRD 1 WB30T10126 (ELEMENT HALIANT 12T). SAVED TCKT [SDLINK12469A.PNG] (VIA SDM)I REMOVED TOP AND REPLACED
DEFECTIVE RIGHT FRONT BURNER ASSEMBLY. TESTED UNIT, ALL OK., JOB CMPLTD, SAVED TCKT [SDLINK52469B.PNG] (VIA SDM)
Parts Used
1 W1330T10126 element haliant 12 t [SD -11/2] 96.20 96.20
Record of Times at Location Payments Received Parts Total
SD 10119 TUE 17:44 17:55 00:11 96.20
SD 11/2 TUE 10:46 11 :20 00:34 Service Call
85.00
Labor
T echnician's Signature Customer Signature
Sales Tax
Steve D Invoice Total
184.20
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Duncan Appliance Service
317- 344 420, www.duncanappliance.com
1 1404 Central Drive East, Carmel, IN 46032
Carme /Carmel fire #4 10/23110, 02459
3610 VV 106th St Ice Machine, U -line
Carmel, IN 46032 U L N- B 115WH -00, 01 3633 -05 -0002
Replaced inlet valve and peeling icemaker, unit tests ok.
1 402 icemaker 179.00
1 2552A water valve 43.00
by Tony 0 Parts Total 222.00
Labor 88.00
Other
Sales Tax
Total Ticket 310.00
1 have reviewed thisform and approve its contents. Acting for myself (or as agent far the listed party)
I agree to make timely payment of all sums owed (and, if I fail in that, to pay all associated collection costs, Total Monies Received: $0.00
including attorneys fees, plus interest at the rate 1.5 percent per month). Balance due $310.00
VOUCHER NO. WARRANT NO.
ALLOWED 20
Dur,.can Appliance Service
IN SUM OF
11404 Central Drive East
Carmel, IN 46032
$4
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO# Dept. INVOICE NO. ACCT #!TITLE AMOUNT Board Members
1120 02459 43- 500.00 $310.00 1 hereby certify that the attached invoice(s), or
1120 02469 43- 500.00 $184.20 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
a
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))
02459 42 Ice Maker $310.00
02469 44 Stove $184.20
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