158900 04/30/2008 CITY OF CARMEL, INDIANA VENDOR: 360650 Page 1 of 1
ONE CIVIC SQUARE GRACE REFRIGERATION
l€ CHECK AMOUNT: $198.42
CARMEL, INDIANA 46032 Po BOX 606
ZIONSVILLE IN 46077-0606 CHECK NUMBER: 158900
CHECK DATE: 4/30/2008
DEPARTMENT ACCOUNT PO NUMBER INVOICE NU MBER AMOUNT DESCRIPTION
1120 4350000 18573 198.42 EQUIPMENT REPAIRS M
�V
GRACE ,REFRIGERATION I nvo i ce
3177693691
P O BOX 606 Date Invoice
ZIONSVILLE IN 46077 -0606 4i2/2008 18573
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
SERVICED ICE MACHINE AND INSTALLED NEW
WATER FILTER
MAT 1 1 -2000 MICRO WATER FILTER 69.42 69.42
SERVICE CALL I INITIAL SERVICE CALL REQUEST 129.00 129.00
Su btotal -$198.42
Sales Tax (7.0 $0.00
Total $198.42
Payments /Credits $0.00
Balance Due $198.42
GRACE REFRIGERATION, INC. a M) Drs
P.O. Box 606
ZIONSVILLE, IN 46077 18573
(317) 769 -3691
PHONE DATE OF ORDER
Y -v 8
ORDER TAKEN BY CUSTOMER'S ORDER NUMBER
TO c ❑DAY WORK CONTRACT EXTRA
JOB NAME /NUMBER
p i apt U( �E
JOB LOCATION
JOB PHONE STARTING DATE
TERMS:
OTY. MATERIAL PRICE AMOUNT DESCRIPTION OF WORK
Equip. Name sc
Model Co ca -1
Serial 6)0 313 Zoz Z1
ation Date
OTHER CHARGES
TOTAL OTHER
LABOR HRS. RATE AMOUNT
J
Payment due within 10 days of receipt of Invoi
L ate payments will e charged o per mont
Customer agrees to pay all cost incurred in collection. TOTAL LABOR
DATE COMPLETED TOTAL MATERIALS TOTAL MATERIALS
TOTAL OTHER
Work ordered by D Char e
TAX
Signature
I hereby acknow above described work. TOTAL
VOUCHER NO. WARRANT NO.
ALLOWED 20
Grace Refrigeration
IN SUM OF
P.O Box 606
Zionsville, IN 46077
$198.42
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO# Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Members
1120 18573 43- 500.00 $198.42 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
r
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))
04/02/08 18573 Repair Sta. 45 Ice Maker $198.42
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