166221 11/24/2008 CITY OF CARMEL, INDIANA VENDOR: 360650 Page 1 of 1
ONE CIVIC SQUARE GRACE REFRIGERATION
CARMEL, INDIANA 46032 PO BOX 606
CHECK AMOUNT: $385.07
ZIONSVILLE IN 46077 -0606 CHECK NUMBER: 166221
CHECK DATE: 11/24/2008
D EPARTMENT ACCO PO NU IN VOICE NUMBER AMOUNT DESCRIPTION
1120 4350000 19192 385.07 EQUIPMENT REPAIRS M
i`
GRACE REFRIGERATION Invoice
317 769 3691
P O BOX 606 Date Invoice
ZIONSVILLE IN 46077 -0606
10/8/2008 19 192
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
REGULAR PM SERVICE ON ICE MACHINE FOR
OCTOBER 2008
MAT 16 OZS CLEANER 1.05 16.80
MAT 1 1 -2000 MICRO FILTER 69.42 69.42
MAT 1 K -20 COURSE WATER FILTER 11.85 11.85
SERVICE CALL I INITIAL SERVICE CALL REQUEST 145.00 145.00
JT 2 JIM "I'RAMMEL S.T. 71.00 142.00
Subtotal $385.07
Sales Tax (7.0 $0.00
Total $385.07
Payments /Credits $0.00
Balance Due $385.07
s
GRACE REFRIGERATION, INC. 1 c VV 0 AMMMW P.O. Box 606
ZIONSVILLE, IN 46077
1
(317) 769 -3691
PHONE DATE OF ORDER
ORDER TAKEN BY CUSTOMER'S ORDER NUMBER
TO {rr DAY WORK 01 CONTRACT EXTRA
JOB NAME /NUMBER
JOB LOCATION
JOB PHONE STARTING DATE
TERMS:
QTY. i MATERIAL PRICE AMOUNT DESCRIPTION OF WORK
z Equip. Name
Model
S erial ®'7C3 9 c�
Installation Date
L
OTHER CHARGES
Service Call
TOTAL OTHER
LABOR HRS. RATE AMOUNT
7
Payment due within 10 days of receipt of Invoice.
1 ate payment will he charged 11 4% per month
Customer agrees to pay all cost incurred in collection. TOTAL LABOR
DATE COMPLETED TOTAL MATERIALS TOTAL MATERIALS
TOTAL OTHER
Work ordered by
Truck Charge
TAX
Signature
1 hereby acknowledge_ th satisTacto i of the above described wt TOTAL
V0 NER WARRANT NO.
ALLOWED 20
'Grace Refrigeration
IN SUM OF
P.O. Box 606
Zionsville, IN 46077
$385.07
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT
Board Members
1120 19192 43- 500.00 $385.07 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
NOV 2 4 2008
t KLO
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
Prescribed by State Board of Accounts City Form, No. 201 (Rev. ?995)
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))
19192 Repair Sta. 45 Ice Maker $385.07
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