205166 01/05/2012 F CITY OF CARMEL, INDIANA VENDOR: 00351921 Page 1 of 1
ONE CIVIC SQUARE DUNCAN APPLIANCE SERVICE
CARMEL, INDIANA 46032 11404 CENTRAL DRIVE EAST CHECK AMOUNT: $187.75
CARMEL IN 46032 CHECK NUMBER: 205166
CHECK DATE: 1/5/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4350000 06339 187.75 EQUIPMENT REPAIRS M
Duncan Appliance Service
11434 Central Drive East
Carmel, IN 46032 -4510
317- 844 -0420 Voice, 888-847 -0173 Fax
Name, Address and Telephone Numbers for the Paying Party Invoice Number
i
CARMEL FIRE DEPARTMENT 06339
1
2 CIVIC SO Date Order Taken and Completed
CARMEL, IN 46032 12/27111
317 -571 -2600 12/29/11
Name, Address and Telephone Numbers for the Service Location (if different from above) Item Make and Type
CARMEL FIRE #44 44 WHIRLPOOL
5 032 E MAIN ST [19"14] WASHER
CARMEL, IN 46032 Purchase Date
I
317- 571 -2632 317- 517 -4149 317- 431 -0496
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Description of Symptoms and /or Customer's Request Model and Serial Numbers
STOPPED DRAINING, APPEARS TO HAVE IMPELLER BROKEN OFF. WFW8500SR01
HLUO336112
Service Performed
JOB IS DONE. K1 IS CHECKING THE PART PRICE So, I CAN BILL THE FIRE STATION., ORDRD 1 W101309 (PUMP), SCHDLD NEXT APPMNT FOR
12129 THU SAVED TC KT [SDL1NK16339A.PNG] (VIA SDM)I INSTALLED NEW DRAIN PUMP AND TESTED UNIT. ALL FUNCTIONS TESTED FINE., JOB
CMPLTD, SAVED TCKT [SDLINKI6339B.PNG] (VIA SDM)
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Parts Used
1 W10130913 pump [SD- 12129] 99.75 99.75
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Record of Times at Location Payments Received Parts Total
SD 12/28 WED 19:05 20:27 01:22 99.75
SD 12/29 THU 9:22 9:22 00:00 Service Call
88.00
La bor
I I
echnician's Signature Customer Signature
Sales Tax
Steve D. Invoice Total
187.75
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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))
06339 $187.75
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
VOUCH NO. WARRANT NO.
ALLOWED 20
Duncan Appliance Service
IN SUM OF
11404 Central Drive East
Carmel, IN 46032
$187.75
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members
1120 I 06339 I 43- 500.00 I $187.75 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
AN 4 201
8
Fire Chief
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund