191655 11/10/2010 CITY OF CARMEL, INDIANA VENDOR: 360650 Page 1 of 1
ONE CIVIC SQUARE GRACE REFRIGERATION CHECK AMOUNT: $353.62
s, CARMEL, INDIANA 46032 PO BOX 606
ZIONSVILLE IN 46077 -0606 CHECK NUMBER: 191655
CHECK DATE: 11/10/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4350000 21236 353.62 EQUIPMENT REPAIRS M
GRACE REFRIGERATION Invoice
317 769 3691
P 0 BOX 606 Date Invoice
ZIONSVILLE IN 46077 -0606
10/19/2010 21236
Bill To Ship To
CARMEL FD 444
5032 E. 131 ST ST.
CARMEL, IN 46033
P.O. No. Terms Equip, Name Model Serial Install Date
Due on receipt SCOTSMAN CO330MA -IA 09061320014975 11 -12 -2009
Item Qty Description Rate Amount
REGULAR PM SERVICE ON ICE MACHINE FOR
OCTOBER 2010
I -2000 1 EVERPURE 1-2000.5 MICRON WATER FILTER 69.42 69.42
K -20 I K -20 COURSE WA'T'ER FILTER 11.85 11.85
ICE MACH CLE... 12 OZ. ICE MACHINE CLEANER 2.05 24.60
SERVICE CALL 1 INITIAL SERVICF CALL, JOE W.. INCLUDES FIRST 149.00 149.00
HOUR, TRUCK. GAS, INSURANCE
JW 1.25 JOE W. S.T. 79.00 98.75
Pay online at
https:// paymentnetxvork .intuit.cGm/stm2p7q
Subtotal $353.62
Sales Tax (7.0 $0.00
Building Our Business On TRUST
Total $353.62
Payrnerlts /C red its $0.00
Balance Due $353.62
E -mail
gracerefrig tds.net
VOUCHER NO. WARRANT NO.
ALLOWED 20
Grace 4vdtmrr1 es e
IN SUM OF
(�o
$353.62 -0
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO# Dept. INVOICE NO. ACCT #!TITLE AMOUNT
Board Members
1120 21236 43 500.00 $353.62 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 gq
NOV 9 /7
r
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 property 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))
21236 Sta. 44 Ice $353.62
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