HomeMy WebLinkAbout170811 04/16/2009 CITY OF CARMEL, INDIANA VENDOR: 00353196 Page 1 of 1
ONE CIVIC SQUARE JIM DAVIS
i, CARMEL, INDIANA 46032 14846 VICTORY COURT CHECK AMOUNT: $100.00
CARMEL IN 46032
CHECK NUMBER: 170811
CHECK DATE: 4/16/2009
DEPARTMENT ACCOUNT PO NUMBER IN VOICE NUMBER AMOUNT DESCRIPTION
7 ''1120 4350000 101 100.00 EQUIPMENT REPAIRS M
i
3U2232049S99�
RADZ VIDEO SERVICE
1399 N. SHADELAND AVE
INW ANAPOI.IS. IN 46219 -3605
317 -3S3 -2860
Ie: s ID: "412 Ref p: 001
Clerk 11): 1
Sale
Wry hethod: hawal
o044744 14:22;19
Inv P: 001I01 Aw Code: 69648
ARPrvd:Onlint ht6g:097NI
Avs Code: p
v-Code: h
Total: 20110
Customer Coar
T
J
1
c 9 N V Q I C E Call Back: Recei Code: C.O.D.
1 4872 Car In:: Dept. Code:
Owner Of Linit
-C�
J u SAME
tL RADZ VIDEO SERVICE INC
1399 NORTH SHADELAND AVENUE
INDIANAPOLIS IN 46219
Phone: (317) 353 -2860 Accessories
Fax: (317) 359 -9408
CARMEL FIRE DEPT., JIM DAVIS
540 WEST 136TH STREET Invoice Dates Unit Information
CARMEL IN 46032 Service Date: 04/07/2009 Product: DLP TV
Schedule Date: I I Brand: RCA
Complete Date: 04/09/2009 Model:
Horne Phone: (317).571 -2625 Return Date: I I Serial:
Work Phone: (317) 590 -3426 Ext: JI I Paid Date: Purchase I 1
Comments Other Information
Technician: Dealer:
Location: Store W.O.
MIW: Contract
Billing Code: Special Auth
Call Back: Coverage: Parts: COD tabor: -COD
Labor Breakdown Complaint
LAMP OUT
S ervice Performe
PURCHASED LAMP
Qty Part Number Reference Descrip Unit Price Amount
1 270414 LAMP 209.10 209.10
v
N l?l
OUR WARRANTY IS 30 DAYS LABOR AND 90 DAYS PARTS ON THIS SPECIFIC REPAIR ONLY, Total Parts: 209.10
YOUR SIGNATURE VERIFIES RECEIPT OF THE UNIT AND THAT UNIT WAS NOT DAMAGED Total Labor:
DURING SERVICE, OUR WARRANTY IS FOR THE SPECIFIED PERIOD. IT IS THE CUSTOMER'S Total Other,
RESPONSIBILITY TO TEST UNIT DURING THIS TIME. IF ANY RELATED PROBLEMS OCCUR, Travel: Sales Tax: THE UNIT MUST BE RETURNED FOR SERVICE IMMEDIATELY. Shipping: Total: 209.10
Diagnostics: Discounts:
Mileage: Payments: 209.10
Customer's Signature: Date: Technician's Signature: Other: Balance:
Payment. Cash[ Check[ C.C.
Auth.
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 I
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))
Reimburse for Repair of TV $100.00
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
VOUCHER NO. WA RRANT NO.
ALLOWED 20
Jim_ Davis
IN SUM OF
t
$100.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members
1120 43- 500.00 $100.00 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
?non_
c'
J Q Fire Chief
V Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund