205973 01/31/2012 CITY OF CARMEL, INDIANA VENDOR: 365081 Page 1 of 1
I; ONE CIVIC SQUARE QUALITY ROOFING SERVICES INC CHECK AMOUNT: $810.00
CARMEL, INDIANA 46032 7920 GEORGETOWN ROAD SUITE 400
w� ylor �o. INDIANAPOLIS IN 46268 CHECK NUMBER: 205973
CHECK DATE: 1/31/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1094 4350100 19496 810.00 BUILDING REPAIRS MA
1
r
Remit to:
F _QU ALITY Qualit Roofin services, Inc. Invoice
Services Group 7920 Georgetown Road
Roofing -Building Maintenance •Const uction Suite 400
Indianapolis, IN 46268 Date Invoice
1212912011 19496
Job Site:
Bill To
Carmel Clay Parks Recreation Monon Community Center
Administrative Office H 95 Central Park Dr W
1411 E. 116th Street Carmel, IN
Carmel, IN 46032
P.O. Number Terms Rep Ship Via F.O.B. Project
2% 10, NET 30 Days GB 12/29/2011 M -11 -20119
Quantity Item Code Description Price Each Amount
4001 See attached work order 810.00 810.00
Purchase
Descript ROCF L1:AK RUAIRS
P.O. 30 320 P 00
l OqU 43% 1 00
Line'
Bud P� u�d irlr 13 f M_ $M ain
Line Descr
Purchaser Date
Approval Date
RIECEIVF
JAN 0 6 2012
BY:
Total $810:00
uality Work Order /Sales Invoice Job# M ,j
7920 Georgetown Road Incom lete Customer r,,r �1, I I �,i fG rr: i,��<� (r a h
�oof i ng suite 400 p
IrK ianaaolis, IN 46268 Address
ervices Office: 317 334 0601 F Complete
Fax: 317 3344605
Worksite /Building Name /''IrZ40'.
PO# Address IL yrr j4 'or r,�l. M n
Date �/Z I
Service Tech Z3'Cr,4,r_A K ✓%LI Worksite Contact Name
Contact Phone#
ROOF Drawing Authorization Needed- A
g Ok J Repaired x Code Description
1 Location of Rep orted Leak #1 d
J--'•- J_ -'•-J-- 2 Location of Reported Leak #2
3 Location of Reported Leak #3
4 Location of Reported Leak #4 F
A Wall Flashing Base Flashin
:';,Y.
B Field Membrane
C CounterFlashin
D Previous Patchin
E HVAC Unit Fan Unit Vent Unit
F Flue Pie Soil Stack Pitch Pan
s G Skylight/ High Hat
..f_ ti.. _y.. .y
H Expansion Joint Area Divider
I Gravel Stop/ Copin
J Terrmination Bar Roof Edge
K Roof Hatch
L Drain Scupper Gutter
M Debris on Roof
F
N Dormer Raised Roof Area
Description of Work
V.. f.... 1-. S«:. «4.- 1- ..L- 1.a..i- x..1...1. t. J..4 ",.1.- «3. S
JA Z u f 00- e I
r
t IC: %a C,iti f ki �i
21 d
rnor: T moan I Date 1 rnis n ours
Notes to Customer 9
M aterials se
Item Type Qty Item T ype OLy
7
i
Invoice
Materials
Labor
Customer Signature otal
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice of 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.
365081 Quality Roofing Services, Inc. Terms
7920 Georgetown Road, Suite 400
Indianapolis, IN 46268
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
12/29/11 19496 Roof leak repairs 30330 810.00
Total 810.00
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. Warrant No.
365081 Quality Roofing Services, Inc. Allowed 20
7920 Georgetown Road, Suite 400
Indianapolis, IN 46268
In Sum of
810.00
ON ACCOUNT OF APPROPRIATION FOR
109 Monon Center
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1094 19496 4350100 810.00 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
26 -Jan 2012
Wvz
Signature
810.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund