210862 07/17/2012 CITY OF CARMEL, INDIANA VENDOR: 360650 Page 1 of 1
0 ONE CIVIC SQUARE GRACE REFRIGERATION
CARMEL, INDIANA 46032 PO Box 606 CHECK AMOUNT: $190.17
ZIONSVILLE IN 46077-0606 CHECK NUMBER: 210862
CHECK DATE: 7/17/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4350000 23363 190 . 17 EQUIPMENT REPAIRS & M
D � ®� Invoice
ull', WE 1w Date Invoice#
PO Box 606 Zionsville.IN 46077 317-769-3691 Fax 317-769.-3330 7/6/2012 23363
www.GraceReirt8eration.com
Bill To Ship To
CARMEL FD 444
5032 E. 131 ST ST.
CARMEL.IN 46033
P.O. No. Terms Equip. Name Model# Serial# Install Date
Due on rece... SCOTSMAN C0330MA-IA 09061320014975 11-12-2009
Item Qty Description Rate Amount
DELIVERED AND INSTALLED NEW WATER
FILTERS ON ICE MACHINE.
K-20 1 K-20 COURSE WATER FILTER 11.85 11.85
I-2000 1 EVERPURE 1-2000.5 MICRON WATER FILTER 74.57 74.57
SB 1 STEVE BLACKWELL S.T. 83.00 83.00
CT 0.25 CALEB TAYLOR S.T. 83.00 20.75
Sales Tax (7.0%)
Pay online at: https://ipn.intuit.com/bzbb7cbs
Total $0.00
_Grace.Refrigeration Sells and Leases the most popular $190.17
ice machine on the planet, Scotsman Ice Machines.
For a quote call 317-769-3691 Payments/Credits $0.00
Balance Due
`'®scotsm $190.17
E-mail
Building Our Business On TRUST steve@gracerefrigeration.com
VOUCHER NO. WARRANT NO.
ALLOWED 20
Grace Refrigeration
IN SUM OF $
P.O. Box 606
Zionsville, IN 46077
$190.17
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1120 I 23363 I 43-500.00 I $190.17 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
UL 16 2012
-1 Y
e
Fire Chief
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))
23363 Sta. 44 $190.17
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