205929 01/31/2012 CITY OF CARMEL, INDIANA VENDOR: 364570 Page 1 of 1
ONE CIVIC SQUARE MECHANICAL CONTRACTING SERVICE CHECK AMOUNT: $672.50
CARMEL, INDIANA 46032 15371 STONEY CREEK WAY
NOBLESVILLE IN 46060 CHECK NUMBER: 205929
CHECK DATE: 1/31/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
601 5023990 8192 672.50 OTHER EXPENSES
MCS, INC. 114VOICE
15371 STONY CREEK WAY
NOBLESVILLE, IN 46060 Invoice Number: 8192
Invoice Date: Dec 31, 2011
Page: 1
Voice: 317- 773 -7370
Fax: 317 773 -7340
Bill To N Ship
�.:v 1 ,Y.. a. r
CARMEL WATER COMPANY JOB 11300 003498
3450W. 131ST ST l� SERVICE CALL
WESTFIELD, IN 46074
CustomerlD a �CustorrerPO x: Pa ment�Terms����
���a��mm.. €rc... us >ts. a� �ry�.�a.r'ra .KdC 3 w,,.b s,
CARM Net 30 Days
�rShipte DueaDate
1/30/12
I es Service 672.50
Subtotal 672.50
Sales Tax
Total Invoice Amount 672.50
Check /Credit Memo No: Payment /Credit Applied
TOTAL
1.
EM Mechanical Contracting Services, Inc. Phone: (317) 773 -7370 003498 SERVICE REPO
15371 Stony Creek Way Noblesville, In 46060 Fax: (317) 773 -7340
Name: Qty- Description Purchase Order Number Amount
Address:
Cit `j niState: ii p:
Contact:
Phone No.:
Date:
Equip:
�t
Model No.:
Serial No.:
Year: Total Material Is
WE ARE PERFORMING THE FOLLOWING ITEMS: Plumbing Service Performed:
Service Call I )A, /1'_'
Preventive Maintenance
Warranty
No Heating Call i
No Cooling Call i
Equipment Check List R Code Environmental Check List
Com ressor. Volta a Ph. E Refrigerant Type:
Condensor Coil: Clean: Dirty F 1 Recovered: Yes No Qty, 0
Refrigerant: Type Leek Charge R 2 Recycled: Yes No Qty.
Fan Motor: Voltage Ph. I 3 Reclaimed: Yes No Qty.
Evaporator Coil: Clean Dirty G 4 Returned: Yes No_ Qty.
Condensate: Clean Dirty E 5 Non Usable: Yes No Qty.
Air Filters: Clean Dirty R 6 Disposal: Yes No_ Qty.
Heating Assembly: Clean Dirty A Notes:
Electrical: Relay Contactor P.S. N
Thermostat Replace Relocate T
L HRS /HR REGULAR T Time Left Last Job
A HRS l� /HR REGULAR R Time Arrived On Job
B HRS /HR REGULAR A Time Departed From Job
p ZHRS /HR REGULAR V 2nd Arrival
R HRS /HR OVERTIME E 2nd Departure
HRS /HR OVERTIME L Truck Char e
C M serial All parts noted above are warranted as per
H 2 Truck Char e O`er manufacturers specifications.
A 3 Lbor 0
All labor noted above relative to the
R 4- Sales Tax equipment serviced as noted is guaranteed
G
E for a period of 30 days.
I Amount Due Terms: Net Due Upon Receipt
Service M�� Customer: Date:
Signature: Printed:
BILLING COPY
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 of service rendered, by whom, rates per day, number of units,
price per unit, etc.
Payee
364570
MECHANICAL CONTRACTING SERVICES Purchase Order No.
15371 STONY CREEK WAY Terms
NOBLESVILLE, IN 46060 Due Date 12/30/2011
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
12/30/201' 8192 $672.50
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
/L 7// 1, Cc,..�-�'l
Date Officer
VOUCHER 113476 WARRANT ALLOWED
364570 IN SUM OF
MECHANICAL CONTRACTING SERVIC
15371 STONY CREEK WAY WATER
NOBLESVILLE, IN 46060 OPERATIONS
Carmel Water Utility
ON ACCOUNT OF APP OPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
8192 01- 6360 -06 $672.50
Voucher Total $672.50
Cost distribution ledger classification if
claim paid under vehicle highway fund