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206499 02/14/2012 CITY OF CARMEL, INDIANA VENDOR: 00350650 Page 1 of 1 ONE CIVIC SQUARE WILLIAMS COMFORT AIR INC CHECK AMOUNT: $94.00 CARMEL, INDIANA 46032 1077 3RD AVE. S.W. y�.rod` CARMEL IN 46032 CHECK NUMBER: 206499 CHECK DATE: 2/14/2012 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 651 5023990 197046 94.00 OTHER EXPENSES p Williams Comfort Air THIS IS YOUR INVOICE 19704 1077 3rd Avenue SW, Carmel, IN 46032 1 Local: 317 452 4543 Fax: 317 848 8744 DATE 0 ATTN SUPERVISOR INTERNAL USE..O E Mail: service Will iamsComfortAir.com' rECHNUMBER M 0 R T I R HVAC License H0002400 TECH NAME C 877- 599 -HEAT (4328) qheadng coolie hanbm &more N N CALL SLIP NUMBER 9 p g Call Note Customer Name: �+5 1 �Payee: Job Location: 9 9 /76 Z .f wy Address: Source Qty. Materials Used City: State: 4-`Zip: �6 �a City: State: Zip: 1 H/W /C, V 3 a /o r H/W /C V H/W /C H/W /C 2 Email: Email: 3. EQUIPMENT IDENTIFICATION Make jMod 4 CONDITION 1- 5 (5 =BEST) F/ AH li S f 6- 5 o6 3 a `l 3 5 0 AC /HP O (m 5 r ©7 C 6V r q 7a Evap 6 Therm 7 Hum 8 Filter X X Med ❑Elect Pur 9 C ode Qty Status Description T P :3o I 1,, CAIRfree Savings Agreement: This program has been explained. Current participant Exp. Decline participation Customer's Initials Why participate in our CAIRfree preventative maintenance program? You will receive a discount for services 'as well as equipment dis I counts I and I have received a detailed proposal via the SUMMARY OF FINDINGS. nitials pre have/assurance that all manufacturer PAYMENT AC EPTA CE OF WORK PERFORMED C omfor t remai d ur a ti o n o p eri od CREDIT CARD A/ ❑CASH ❑CHECK ❑GIFT CARD TODAY S PAYMENT I I have discussed the CAIRfree Savings Agreement with the customer. I have given a Authorization Code Check Number copy of this invoice to the customer. I have Si S Date REMAINING BALANCE satisfactorily done all work detailed in the pro My signature above acknowledges that all work has been satisfactorily completed. I agree to the I posal in compliance with Williams Comfort Air YOUI C AIRfree SAVINGS TOdBy total charges that are now due and the payment method. WCA retains ownership of all material listed standards of excellence i workmanship and in until payment is made. in full. Terns include 1.5% monthly service charge if not paid in 30 days. If this compliance with applicable building codes. aid within 30 days, a lien a ainst m roe may be p ursued and I will be resp onsible invoice is not p y g y p property y p po e. f Technician's Signature for practical attorney fees, collection costs and interest. WCA is not responsible for insured losses. 1 z. CUSTOMER 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 350650 WILLIAMS COMFORT AIR INC Purchase Order No. P.O. BOX 3937 Terms CARMEL, IN 46082 Due Date 2/7/2012 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) Amount 2/7/2012 197046 $94.00 hereby certify that the attached invoice(s), or bill(s) is (are) true and ;orrect and I have audited same in accordance with IC 5- 11- 10 -1.6 Date Officer VOUCHER 116751 WARRANT ALLOWED 350650 IN SUM OF WILLIAMS COMFORT AIR INC P.O. BOX 3937 CARMEL, IN 46082 Carmel Wastewater Utility ON ACCOUNT OF APPROPRIATION FOR Board members PO INV ACCT AMOUNT Audit Trail Code 197046 01- 7362 -05 $94.00 Voucher Total $94.00 Cost distribution ledger classification if claim paid under vehicle highway fund