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192728 12/10/2010 CITY OF CARMEL, INDIANA VENDOR: 00350650 Page 1 of 1 ONE CIVIC SQUARE WILLIAMS COMFORT AIR INC CARMEL, INDIANA 46032 PO BOX 3937 CHECK AMOUNT: $691.25 CARMEL IN 46082 CHECK NUMBER: 192728 CHECK DATE: 12/10/2010 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1125 4350100 170642 185.25 BUILDING REPAIRS MA 1125 4350100 170647 506.00 BUILDING REPAIRS MA M �TZI FR`5) f heating N cooling N plumbing more 414-4- Invoice 170647 Invoice Date: 11/16/10 Re: Service Performed At CARMEL CLAY PARK'S ADMINISTRATION O CARMEL CLAY PARK'S ADMINISTRATION O OR CURRENT RESIDENT FFICE 1411 E 116TH ST 1411 E 116TH ST CARMEL IN 46032 CARMEL IN 46032 Site 115222 -001 Acct 115222 BATCH W.G: DaLe `all Slip P.O. Salesman Terms Contract 11/17/10 153172 net DESCRIPTION Replace transition collector box $506.00 1 1172229 TRANSITION ASSY Purchase Description P.O.# Pore G.L.# 2010 bud budg Line Descr I Purchaser Date BY.- OLe Oe Approval Date AS AGREED 506.00 TOTAL 506.00 Serving Central Indiana Since 1966 address 1077 3rd Avenue, SW, Carmel, Indiana 46032 toll free (877) 599 -HEAT (4328) Central Indiana (317) 844.3944 fax(317)848 —h,ae WilliamsComfortAir.eom we6sae MrPlumberindy.eom p THIS IS YOUR INVOICE C7O 4 7 Williams Comfort Air 077 3rd Avenue SW, Carmel, IN 460 r Local: 317 4 x=84 S 52 4543 A� Q ATTN SUPERVISOR INTERNAL USE ONLY E- Maif:-servlc @WWilliamsComfortAir. T MBER HVAC License H000246t' •i TECH NAME C] RSA O „RE ST,L FSp 877- 59.9 -HE (4328) C) CBA C) CT HFE heatm9 "co619 NphMW9 &more CALL SLIP NUMBER CT',R WS CIA d CTA WC 11RJ1 I K Customer Name: EQUIPMENT IDENTIFICATION CONDmoN 1 -5 (s =BEST) Calt, Note: t Y�ta ��l r Address: Ma Model Serial Age Cond. ❑Heating, CSA' Exp. Date Visit*No f: City: w+.,o r a/ State: IN Zip: o 1 Cooling, CT _C of H/W /C H/W /C 2 Source Oty. Materials Used 1 Email: 3 Agreement for Service: I, the undersigned, am an authorized representative of the 4 premises at which the work below is being done. I authorize the performance of the work 5 NCV y 010 ��r 3 as noted on this INVOICE and /or the SUMMARY OF FINDINGS. I acknowledge that the estimated price does not include unforeseen parts or labor which may be needed after the s work begins. My written authorization will be obtained before beginning any additional INDOOR AIR QUALITY work. I have read this contract, and agree to be bound by all the terms contained herein. Air Handler Cabinet 0 OK U Dust 0 Growth 0 Dirt 0 VOC's Blower Wheel U OK O Dust 0 Growth 0 Dirt 0 VOC's Signature S Housing Evaporator Coil Cl OK O Dust O Growth 0 Dirt O VOC's Ducts and Vents (S) Cl OK O Dust 0 Growth O Dirt 0 VOC's 0— T411 an d Vents-(R), OK 0 Dust O Growth 0 Dirt C) VOC's, v erall Rating (5 BEST) O 1 0 2 3 0 4 0 5 o AIRfree avings Agreement: Purchase program has been explained. lip Description Y 4A o Current participant 11 V r F Agree to purchase Decline participation Budget Nne escr Customer's Initials a e S7 0. o. �n1CNpC 0 pmvnl See SUMMARY OF FINDINGS UGIII 0 0 0 -J for additional information. CAIRfree SAVINGS AGREEMENT ❑NEW ❑RENEWAL PAYMENT OPTIONS is U mcm o o AIR CHARGE CREDIT CARD A/R CASH CHECK r Gr�O�G I Card Exp. Date:- I have discussed the. CAI Rfree Savings Print valid. Code t Agreement with the customer. I have given a copy of the contract to the customer. All work Signatur Date TODAY'S CHARGES I have done is in compliance with Williams My signature above ackno ledges that I agree to the sum total of the charges and payment `��Qp DUE AND PAYABLE Comfort Air standards of excellence in method. Seller retains ownership of all material listed until payment is made in full. Terms workmanship and in compliance with include 1.5% monthly service charge if not paid in 30 days. In the event of non payment of the f building codes when applicable. specified Total', a lien against my property may be pursued and I will be responsible for practical All work has been satisfactorily completed. Customer's Initials Technician's Signature attorney fees, collection costs, and interest. Seller is not responsible for insured losses. CUSTOMER COPY THIS IS YOUR INVOICE Williams Comfort -,4 17 0 6 4 2 1077 nu W-Ea 46032 Local. ax: ATE O ATTN SUPERVISOR �INTERNAL USE ONLY E -Mail: service @WilliamsComfortAir.com TeeH -NtOBE gar HVAC License H0002400 TECH NAME RSA E STL O FSO i 877- 599 -HEAT (4328) CBA CCB CT U HFE 6 ftCQbllg "coofi Ig NPhanbmg&mure CALL SLIP NUMBER F) QTR 'CI WS CIA Y CTA DC. CIR I �y I Customer Name: �'i EQl�1PMENT IDENTIFICATION CONDmON1 -5 (5 =BEST) Call Note: Ajo ,a Address: Model Serial Age Cond. C3 Heating CSA Exp. Date. Visit No City: State: IN Zip: 1 Cooling QT H/W /C H/W /C 2 Source Qty. Materials Used t. 3 1 Email: 0, s s /1 Purchase nli 2 Agreement for Service: I, thd' undersigned, am an authorized representative of the 4 Des A premises at which the work below is being done. I authorize the performance of the work 5 P.O! P or F 3. I .as noted on this INVOICE and /or the SUMMARY OF FINDINGS. I acknowledge that the G.L. estimated price does not includepnforeseen parts or labor; which may be needed after the s Bridget =p� INDOOR AIR QUALITY work begins: My written authorization be obtained Before beginning any additional 7. Lin Descr work. I have ead this c �a•agree to be bound by all the terms contained hereih. Air Handler cabinet OK O Dust O Growth O Dirt VOC's Purchaser a e Blower Wheel O OK a Dust O Growth Dirt EI VOC's Signature I I D Housing ti v Approval Evaporator Coil OK Dust Growth O Dirt O.VOC's Ducts and Vents (S) Cl OK O Dust O Growth Dirt 'O VOC's .9! 4° Ducts and Vents (R). OK O Dust O Growth O Dirt .Q VOC's D o o e IAO Overall Rating (5 BEST) 01 Q2 03 04_P5 a CAIRfree Savings Agreement: _n I oa This program has,been explained. Current participant Agree to purchase Decline participation Customer's Initials V e. er our p reventative O See SUMMARY OF FINDINGS I e REEMENT Ell NEW. RENEWAL e will receive a for additional information. discount off our pricing fo PAYMENT OPTIONS r15; D o cr3C�oJ t. preferre cust AIR CHARGE CREDIT CARD YR CASH CHECK. Card Exp. Date: e I have discussed the CAIRfree Savings Print Valid. Code Agreement with the customer. I have given a i copy of the contract to the customer. All work Signature s Date 1 TODAY S CHARGES I have done is in compliance with Williams Comfort Air standards of excellence in My signature above acknowledges that I agree to the sum total of the charges and payment ®��p DUE AND PAYABLE Q method. Seller retains ownership of aterial listed until payment is made in full. Terms C! workmanship and in compliance with include 1.5 monthly service charge if not paid in 30 days. In the event of non payment of the i building codes, when applicable. specified T6W', a lien against my properly may be pursued and I will, be responsible for practical All work has been satisfactorily completed. Customer's Initials daj attorney fees, collection costs, an interest. Seller is not responsible for insured losses. CU STOMER COPY Technician's Signature ACCOUNTS PAYABLE VOUCHER CITY OF CARMEL An invoice of 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. Williams Comfort Air Terms 1077 3rd Avenue SW Carmel, IN 46032 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) PO Amount 11/16/10 170647 HVAC Repairs AO 27952 506.00 11116/10 170642 HVAC Repairs AO 27952 185.25 Total 691.25 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 Voucher No. Warrant No. Williams Comfort Air Allowed 20 1077 3rd Avenue SW Carmel, IN 46032 In Sum of 691.25 ON ACCOUNT OF APPROPRIATION FOR 101 General Fund PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members Dept 1125 170647 4350100 506.00 1 hereby certify that the attached invoice(s), or 1125 170642 4350100 185.25 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 9 -Dec 2010 Signature 691.25 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund