206787 02/28/2012 �q4 CITY OF CARMEL, INDIANA VENDOR: 255850 Page 1 of 1
ONE CIVIC SQUARE QUALITY REPAIR SERVICE, INC
CARMEL, INDIANA 46032 CHECK AMOUNT: $3,388.00
411 KNIGHT DRIVE
GREENWOOD IN 46142 CHECK NUMBER: 206787
CHECK DATE: 2128/2012
DEPARTMENT ACCOUNT PO NUMBER INV OICE NUMBER AMOUNT DESCRIPTION
651 5023990 19949 3,388.00 OTHER EXPENSES
Quality Repair Service, Inc. Invoice
411 Knight Drive Date Invoice
Greenwood, IN 46142 2/6/2012 19949
Phone# 317- 881 -0205
Fax 317 -881 -0294
Bill To
CARMEL WWTP
760 3rd AVE. S.W. STE 110
CARMEL, IN 46280
P.O. No. Terms Due Date Rep Project
512963 Net 30 3/7/2012 TAS 19949
Description Amount
PARTS FOR VAUGHAN PUMP MODEL PE4R6CS -11.3 S/N:70265
ONE (1) V 104 -611 CUTTER NUT 56.00
ONE (1) V107 -349 CUTTER BAR PLATE 1,310.00
ONE (1) V 103 -852 UPPER CUTTER 339.00
ONE (1) V 102- 543 -108 IMPELLER 1,463.00
ONE (1) V850 -358B O -RING 25.00
TWO (2) V850 -380B O -RINGS $33.00 EACH 66.00
ONE (1) V850 -381B O -RING 33.00
ONE (1) V850 -463B O -RING 33.00
FREIGHT 63.00
Subtotal $3,388.00
1.5 FEE PER MONTH ON UNPAID INVOICES
Sales Tax (7.0
Total $3,388.00
Balance Due
Web Site
www.qualityrepairserviceinc.com
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
255850
QUALITY REPAIR SERVICE Purchase Order No.
411 Knight Drive Terms
GREENWOOD, IN 46142 Due Date 2/20/2012
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
2/20/2012 19949 $3,388.00
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
A
Date O iCer
VOUCHER 116830 WARRANT ALLOWED
255850 IN SUM OF
QUALITY REPAIR SERVICE
411 Knight Drive
GREENWOOD, IN 46142
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
19949 01- 7202 -06 $3,388.00
Voucher Total $3,388.00
Cost distribution ledger classification if
claim paid under vehicle highway fund