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HomeMy WebLinkAbout196716 04/26/2011 CITY OF CARMEL, INDIANA VENDOR: 359344 Page 1 of 1 ONE CIVIC SQUARE AYERS BACKFLOW CHECK SERVICE e CHECK AMOUNT: $365.00 *f CARMEL, INDIANA 46032 20 BENNETT ROAD v o� eo CARMEL IN 46032 CHECK NUMBER: 196716 CHECK DATE: 4/26/2011 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1125 4350100 629695 245.00 BUILDING REPAIRS MA 1093 4350100 629696 120.00 BUILDING REPAIRS MA i =2= x=6=9 =6 ST ATE MENT DATE" ✓j J TERMS TO ADDRESS J/ VAL. C y�o 3Z IN ACCOUNT WITH ye-i-s- Backflow_Check -Seir. 20 Bennett Rd.- N 46032 575 =0.782 270 2 36 P0 M /:030q) Z 30 a 22.3 i -7 3 2-1 3o vo z a,&) Barns J 5 i Sc�i 5�11175'nl n a d pi APR 8 011 c3 DC5812 BACKFLOW PREVENTION TEST ADDRESS CITY ZIP r f "fit. s a .r' D BUSENESS /.RESIDENCE J I o TELEPHONE MAKE MODEL SERIAL SIZE LOCATION NEXT TEST DATE BY REDUCED PRESSURE ASSEMBLY RP DOUBLE CHECK VALVE DC PVB CHECK VALVE 1 CHECK VALVE #2 RELIEF VALVE. PVB /SVB SV`B ICI' DCDA TEST Held at PSID Held at PSID Opened AIR INLET RppA at e. PSID Opened AG i at PSID AVB Closed tight Did Not Did Not Leaked Leake Quen ODen W.G4 CHECK VALVE AVB REPAIRS CLEANED T r o (r CLEANED h tE1 CLEANED Held Open REPLACED 1 REPI.ACED� REPLACED at PSID Not Leaked Open 0.�,, .n j,IAJ,3 CLEANED AIR GAP REPLACED Pipe Size Dist. FINAL PSID Y !s PS 1D Opened Air Inlet TEST Closed V at PSID PSID Check Valve L ------PSID INIT -L TEST BY: a TESTER No. I95 -0896 DATE: Phone: (317) 258 6118 Fax: (317) 566 TIME /p COMMENTS: AL Vt T'-r49 0 6�0, 5 7'"`i C x .04" Ayers Backf low Check Service 20 BENNETT ROAD CARMEL, INDIANA 46032 N BACKFLOW PREVENTION TEST ADDRESS CITY ZIP BUSINESS/RESIDENCE TELEPHONE MAKE MODEL SERIAL SIZE 0 69 ''2_ /0 1 .3Q19 2 LOCATION 2t: NEXT TEST DATE BY REDUCED PRESSURE ASSEMBLY DOUBLE CHECK VALVE DC PVB CHECK VALVE #1 CHECK VALVE #2 RELIEF VALVE PVB /SVB SVB INITIAL DCDA TEST Held at PSID Held at PSID Opened A1R INLET RPDA at PSID Opened AO at PSID AVB Closed tight_ Did Not Did Not Leaked Leake Oren Oren CHECK VALVE AVB REPAIRS CLEANED CLEANED CLEANED Held Open REPLACED REPLACED REPLACED at PSID Not, Leaked Open CLEANED AIR GAP REPLACED Pipe Size Dist. FINAL PSID PSID Opened Air Inlet TEST Closed at PSID PSID Light Check Valve PSID INITIAL TEST BY: TESTER No. I95 0896 DATE: L/_ Phone: (317) 258 -6118 Fax: (317) 566-0087 TIME /0 COMMENTS: P ,4-1. s-. rc S ,y a rya 5 7 w' f Ayers Backf low Check Service 20 BENNETT ROAD CARMEL, INDIANA 46032 BACKFLOW PREVENTION TEST ADDRESS CITY ZIP 'BUSS /RESIDENCE TELEPHONE MAKE MODEL C SERIAL SIZE LOCATION NEXT TEST DATE BY REDUCED PRESSURE ASSEMBLY RP DOUBLE CHECK VALVE DC PVB CHECK VALVE #1 CHECK VALVE #2 RELIEF VALVE PVB /SVB SVB INITIAL DCDA TEST Held at f. '7 PSID Held at PSID Opened AIR INLET RPDA at PSID Opened AG at PSID AVB Closed tight Did Not Did Not Leaked Leaked Qnen Otien CHECK VALVE AVB REPAIRS CLEANED CLEANED CLEANED Held Open REPLACED REPLACED REPLACED at PSID Not Leaked Open CLEANED AIR GAP REPLACED Pipe Size Dist. FINAL PSID PSID Opened Air Inlet TEST Closed at PSID PSID tight Check Valve PSID INITIAL TEST BY. TESTER No. 195 -0896 DATE: Phone: (317) 258 -6118 Fax: (317) 566 -0087 TIME COMMENTS: L ILL ri Tti? 0 A 1 Y1.3 0&7 Ayers Backflew Check Service 20 BENNETT ROAD CARMEL, INDIANA 46032 1 BACKFLOW PREVENTION TEST ADDRESS CITY Z11P 10 9�° C- t -1-7 7'4+41. f 'A-rZ X, D4 e 5- c W o 4 BUS /RESIDENCE TELEPHONE MAKE 8e MODEL SERIAL SIZE W/ 4,1< /4,3 f 75 X L ZY ;2JW LOCATION NEXT TEST DATE BY REDUCED PRESSURE ASSEMBLY RP DOUBLE CHECK VALVE DC PVB CHECK VALVE #1 CHECK VALVE #2 RELIEF VALVE PVB /SVB SVB INI'T'IAL DCDA TEST Held at —511— PSID Held at PSID Opened AIR INLET RppA at m, 3 PSID Opened AG at PSID AVB Closed tig 4 ht Did Not Did Not Leaked Leake Qnen Q.gen CHECK VALVE AVB REPAIRS CLEANED CLEANED CLEANED Held Open REPLACED REPLACED REPLACED at PSID Not Leaked Open CLEANED AIR GAP REPLACED Pipe Size Dist. FINAL PSID PSID Opened Air Inlet TEST Closed at PSID PSID tight Check Valve PSID INITIAL TEST BY: A TESTER No. I95 -0896 DATE:' Phone: (317) 258 -6118 Fax: (317) 566 -0087 TIME COMMENTS: r� y a 0 1) r� --��i "�ti .P�.�'► Ayers Backflow Check Service 20 BENNETT ROAD CARMEL, INDIANA 46032 a� 6 Z:9 S TAT E MENT E E T DATE 1 TERMS e� 9 v v e 1 w ll TO ADDRESS l,'�! IN ACCOUNT WITH ennett s7-5 -07 PGA .2£Y�.'t7p L V .5 j, 20 2 0 00 4 /0 010 2 P 36 PO r x .f 1J6 z o ezvo v 20 9 y' A 2 30 C7 22 p 0 0 �2 7 3 74 Z 2 Q 0 00 Z? 2' 3 o °o 0 3 z,Ol "l 35-00 P.m p...: P or F fill A' OLD I- Una, PU Appmmal 777!7 �DC58i2 BACKFLOW PREVENTION.TEST ADDRESS CITY -I-' ZIP BUUSI�NE PRESIDENCE f TELEPHONE MAKE 8e MODEL �f SERIAL SIZE Q ?/3 rr LOCATION p NEXT TEST DATE BY t J REDUCED PRESSURE ASSEMBLY RP DOUBLE CHECK VALVE DC PVB CHECK VALVE #1 CHECK VALVE #2 RELIEF VALVE PVB /SVB SVB INITIAL DCDA, TEST Held at PSID Held at PSID Opened �y AIR INLET RPDA at PSID Opened AG at PSID AVB Closed tight x Did No Did Not Leaked Leake Onen men CHECK VALVE AVB REPAIRS CLEANED CLEANED CLEANED Held Open REPLACED REPLACED REPLACED at PSID Not Leaked Open CLEANED AIR GAP REPLACED Pipe Size Dist. FINAL PSID PSID Opened Air Inlet TEST ;Olosed z W at PSID PSID tight` Check Valve PSID r INITIAL TEST BY z TESTER No. I95 0896 DATE: V �F �1 Phone: (317) 258 61 Fax: (317) 6 -0087 TIME COMMENTS: ✓L CD T7frX f Ayers Backf low Check Service 20 BENNETT ROAD CARMEL, INDIANA 46032 BACKFLOW PREVENTION TEST ADDRESS CI'T'Y ZIP I �l! 116' ny 37 r.4"e" f L. /RESIDENCE TELEPHONE MAKE MODEL 1 SERIAL SIZE rl LOQP TION NEXT TEST DATE BY REDUCED PRESSURE ASSEMBLY ItP DOUBLE CHECK VALVE DC PVB CHECK VALVE #1 CHECK VALVE #2 RELIEF VALVE PVB /SVB SVB INITIAL DCDA TEST Held at Ac PSID Held at PSID Opened AIR INLET RPDA at 2- t 0 PSID Opened AG at PSID AVB Closed tight Did Not Did Not Leaked Leake Open Qnen CHECK VALVE AVB REPAIRS CLEANED CLEANED CLEANED Held Open REPLACED REPLACED REPLACED at PSID Not Leaked Open CLEANED AIR GAP REPLACED Pipe Size Dist. FINAL PSID PSID Opened Air Inlet TEST Closed at PSID PSID tight Check Valve PSID INITIAL TEST BY: 11^ta TESTER No. I95 -0896 DATE: Phone: (317) 258 -6118 ax: (317) 566 li 0087 TIME COMMENTS: 'V AL b-1 M7`[11 00,90 A;P ?IV4> 'Y7, s p' b4 i 1E Ayers Backflow Check Service 20 BENNETT ROAD CARMEL, INDIANA 460 32 BACKFLOW PREVENTION TEST ADDRESS CITY ZIP USINESS %RESIDENCE 0 rg- TELEPHONE MAKE MODEL SERIAL SIZE LOCATION j NEXT TEST DATE BY REDUCED PRESSURE ASSEMBLY RP DOUBLE CHECK VALVE DC PVB CHECK VALVE #1 CHECK VALVE #2 RELIEF VALVE PVB /SVB SVB INITIAL DCDA TEST Held at 2/ G PSID Held at PSID Opened AIR INLET RPDA at 7 PSID Opened AG at PSID AVB Closed tigh Did Not Did Not Leaked Leake 0 en Qm CHECK VALVE AVB REPAIRS CLEANED CLEANED CLEANED Held Open REPLACED REPLACED REPLACED at PSID Not Leaked Open CLEANED AIR GAP REPLACED Pipe Size Dist. FINAL PSID PSID Opened Air Inlet TEST Closed at PSID PSID tight Check Valve PSID INITIAL TEST BY: TESTER No., I95 -0896 DATE: Y—/ y""~'°I/ Phone: (317) 258 6118 Fax: (317)566 0087 TIME 97 7 A o"`' COMMENTS: 'C$ G I�"f 1 79 "a 0 OPP 4 TY// .5 7 ef /.,?/H Ayers Sackflow Check Service 20 BENNETT ROAD CARMEL, INDIANA 46032 BACKFLOW PREVENTION TEST ADDRESS CITY ZIP t I 1 5 e" �B RESIDENCE fa �a. 5 TELEPHONE Of MAKE MODEL SERIAL SIZE �r kP/L /c 5 L z-o 9 1 /37 LOCATION NEXT TEST DATE BY REDUCED PRESSURE ASSEMBLY RP] DOUBLE CHECK VALVE DC PVB CHECK VALVE #1 CHECK VALVE #2 RELIEF VALVE PVB /SVB SVB TNITI DCDA TEST Held at PSID Held at PSID Opened e' AIR INLET RADA at P 7 PSID Opened AG Mat PSID AVB Closed tight Did Not Did Not Leaked Leake �gen Oven CHECK VALVE AVB REPAIRS CLEANED CLEANED CLEANED Held Open REPLACED REPLACED REPLACED at PSID Not Leaked Open CLEANED AIR GAP REPLACED Pipe Size Dist. FINAL PSID PSID Opened Air Inlet TEST Closed at PSID PSID tight Check Valve PSID INITIAL TEST BY: R I TESTER No. I95 0896 DA'Z'E: Phone: (317) 258 -6118 r Fax: (317) 566 -0087 TIME A COMMENTS: V A,/ I/P_ 1 5 7 1/ 00 0 W, S 7" f J Ayers Backflow Check Service 20 BENNETT ROAD CARMEL, INDIANA 46032 r BACKFLOW PREVENTION TEST ADDRESS CITY ZIP BUSIN E�SS/RESIDENCE /0 f- /3/ S TELEPHONE MAKE MODEL SERIAL SIZE LOCATION l� NEXT TEST DATE BY REDUCED PRESSURE ASSEMBLY I RP DOUBLE CHECK VALVE DC PVB CHECK VALVE #I CHECK VALVE #2 RELIEF VALVE PVB /SVB SVB INITIAL DCDA TEST Held at r 0 PSID Held at PSID Opened AIR INLET RPDA at Q PSID Opened AG at PSID AVB Closed ti ght Did Not Did Not Leaked Leake ORen open CHECK VALVE AVB REPAIRS CLEANED CLEANED CLEANED Held Open REPLACED REPLACED REPLACED at PSID Not Leaked Open CLEANED AIR GAP REPLACED Pipe Size Dist'. FINAL PSID PSID Opened Air Inlet TEST Closed at PSID PSID tight Check Valve PSID INITIAL TEST BY: TESTER No. I95 -0896 DATE: Phone: (317) 258 -6118 Fax: (317) 1 566 7 0087 TIME COMMENTS: 0 pl y r f e ll" f f Ayers Backf low Check Service 20 BENNETT ROAD CARMEL, INDIANA 46032 BACKFLOW PREVENTION TEST ADDRESS CITY ZIP rte fe�'v 2. BUS I� ESIDENCE f /E'/ r' TELEPHONE MAKE MODEL SERIAL� SIZE 7 3;(2 LOCATION NEXT TEST DATE BY YR, REDUCED PRESSURE ASSEMBLY t DOUBLE CHECK VALVE "D PVB CHECK VALVE #I CHECK VALVE #2 RELIEF VALVE PVB /SVB SVB INITIAL DCDA TEST Held at 7,( PSID Held at PSID Opened AIR INLET RPDA at q 0 PSID Opened AG at PSID AVB Closed tight J"► Did Not Did Not Leaked Leake Oven �nen CHECK VALVE AVB REPAIRS CLEANED CLEANED CLEANED Held Open REPLACED REPLACED REPLACED at PSID Not Leaked Open CLEANED AIR GAP REPLACED Pipe Size Dist. FINAL PSID PSID Opened Air Inlet TEST Closed at PSID PSID tight Check Valve PSID INITIAL TEST BY: 1 "—J/ 9 TESTER No. I95 -0896 DATE: Phone: (317) 258 -6118 Fax: (317) 5 6 0087 TIME COMMENTS: L. li l` i X 11 a/) mil" Yj S "777f 4 011 1 Ayers Backf low Check Service 20 SENNETT ROAD CARMEL, INDIANA 46032 BACKFLOW PREVENTION TEST ADDRESS CITY ZIP //d r� 37 44 2 v--I t q 3 BUt�SINE /RESIDENCE TELEPHONE 0 447ZA1 s MAKE MODEL SERIAL SIZE 2,2-235i( z Al LOCATION 3 0 u-- //6 Tw f i NEXT TEST DATE BY l.v4-S'T"4Ah&z REDUCED PRESSURE ASSEMBLY RP DOUBLE CHECK VALVE DC PVB CHECK VALVE #1 CHECK VALVE #2 RELIEF VALVE PVB /SVB SVB INITIAL DCDA TEST Held at PSID Held at PSID Opened AIR INLET RPDA at _PSID Opened AG at PSID AVB Closed tigh i Did Not Did Not Leaked Leake Dom Qgp� CHECK VALVE AVB REPAIRS CLEANED CLEANED CLEANED Held Open REPLACED REPLACED REPLACED at PSID Not Leaked Open CLEANED AIR GAP REPLACED Pipe Size Dist. FINAL PSID PSID Opened Air Inlet TEST Closed at PSID PSID tight Check Valve PSID INITIAL TEST BY: JU 12-Af TESTER No. I95 -0896 DATE: 'Y 15 I) Phone: (317) 258 6118 Fax: (317) 566 0087 TIME i 1 '`1 COMMENTS: IlAs k£ 77.9 7`` R b ©D D d Yw/ S j7r"s .PDT i Ayers Backf low Check Service 20 BENNETT ROAD CARMEL, INDIANA 46032 BACKFLOW PREVENTION TEST ADDRESS CITY ZIP BU SI IN_ESS /RESIDENCE J; w �j� TELEPHONE MAKE MODEL SERIAL SIZE e, s V '0a15 1 0 y3 90z of LOCATION NEXT TEST DATE BY REDUCED PRESSURE ASSEMBLY RP DOUBLE CHECK VALVE DC PVB CHECK VALVE #1 CHECK VALVE #2 RELIEF VALVE PVB /SVB SVB INITIAL DCDA TEST Held at 51 t� PSID Held at PSID Opened AIR INLET RPDA at a PSID Opened AG at PSID AVB Closed tight Did Not Did Not Leaked Leake ODBn Qnen CHECK VALVE AVB REPAIRS CLEANED CLEANED CLEANED Held Open REPLACED REPLACED REPLACED at PSID Not Leaked Open CLEANED AIR GAP REPLACED Pipe Size Dist. FINAL PSID PSID Opened Air Inlet TEST Closed at PSID PSID tight Check Valve PSID INITIAL TEST BY: TESTER No 195 -0896 DATE: Phone: (317) 258 -6118 Fax: (31,7, 566 -0087 TIME Aq., COMMENTS: �1 �Z 6i 7'S S GOB rl� S `T S' ®b� Ayers Backf low Check Service 20 BENNETT ROAD CARMEL, INDIANA 46032 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. 359344 Ayers Backflow Check Ser Terms 20 Bennett Rd Carmel, IN 46032 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) PO Amount 4/15/11 629696 MCC Backflow Prevention tests 120.00 4/15/11 629695 Backflow preventention tests 245.00 Total 365.00 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 1 20 Clerk- Treasurer Voucher No. Warrant No. 359344 Ayers Backflow Check Ser Allowed 20 20 Bennett Rd Carmel, IN 46032 In Sum of 365.00 ON ACCOUNT OF APPROPRIATION FOR 101 General Fund 109 Monon Center PO# or INVOICE NO. ACCT #[TITLE AMOUNT Board Members Dept 1093 629696 4350100 120.00 1 hereby certify that the attached invoice(s), or 1125 629695 4350100 245.00 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 21 -Apr 2011 Signature 365.00 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund