HomeMy WebLinkAbout209925 06/20/2012 o., \tif CITY OF CARMEL, INDIANA VENDOR: 365925 Page 1 of 1
ONE CIVIC SQUARE BELFOR PROPERTY RESTORATION
CARMEL, INDIANA 46032 6205 MORENCI TRAIL CHECK AMOUNT: $28,341.86
INDIANAPOLIS IN 46268 CHECK NUMBER: 209925
CHECK DATE: 6/20/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2201 4350100 15897 -1F 20,979.06 BUILDING REPAIRS MA
2201 R4350100 26257 15897 -1F 7,362.80 WASH BAY DEDUCTIBLE
Invoice 15897-IF
Date 6/1112 BELFOR t0l
Invoice PROPERTY RESTORATION
Customer: Re:
Name: City of Carmel Street Department Name: City of Carmel Street Department
Address: 3400 W. 131st Street Address: 3400 W. 131st Street
City: Carmel, IN 46074 City: Carmel, IN 46074
Attn:
DATE QTY U/M DE SCRIPTI ON Unit Price Total
FEDERAL ID 84- 1309171
REVISED 6 -14 -12
1.00 Billing for emergency services 17,637.20 17,637.20
1.00 Billing for work complete as per agreed pricing with 28,341.86 28,341.86
Travelers Insurance
1.00 Less payment (17,637.20) (17,637.20)
Sub Tota1 28,341.86
Total 28,341.86
All accounts are due upon receipt. There will be a 2% charge
per month after 15 days. All lien rights reserved.
BELFOR "USA 6205 Morenci Trail, Indianapolis, IN 46268 888.491.7941 ph: 317.297.3443 fx: 317.297,3456
24/7 emergency hotline 800.856.3333 www.batforusa.com
VOUCHER NO. WAR NO.
ALLOWED 20
Belfor Property Restoration
IN SUM OF
6205 Morenci Trail
Indianapolis, IN 46268
$28,341.86
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO# Dept. INVOICE NO. I ACCT /TITLE AMOUNT
Board Members
2201 15897 -1 F j 43- 501.00 $20,979.06 1 hereby certify that the attached invoice(s), or
26257 15897 -1 F 43- 501.00 $7,362.80
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
F I y, n' 15, 2012
Street CogmissionerV
ttl?Pt l- .f11Cll1tlC
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
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
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))
06/01/12 15897 -1 F $20,979.06
06/01112 15897 -1 F $7,362.80
1 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