211035 07/17/2012 CITY OF CARMEL, INDIANA VENDOR: 00350967 Page 1 of 1
ONE CIVIC SQUARE ROTO-ROOTER SERVICES CO
CARMEL, INDIANA 46032
5672 COLLECTION CENTER DRIVE CHECK AMOUNT: $262.84
CHICAGO IL 60693 CHECK NUMBER: 211035
CHECK DATE: 7/17/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4350100 16738927 262 . 84 BUILDING REPAIRS & MA
LO Date I /d /Zi INVOICE NO. /4 -73 0� /,�,_
HOOTERe Custome /k.Er- Technician /3
PLUMBING Address
DRAIN SERVICE
1-80®- C�Cp G30p0 CjA�eC_ �� Ate:5672 c�Center ,Chicago IL 60693
C D .- savlos 9-640-eZT-0=(438-7688)o Ganwall(317)849-7030
PC#030400008
Commercial Site Inspection & Estimate (See Binding Terms On Reverse) Customer
Qty/Location/Description Labor Parts Discount Total Accept Decline
Main Sewer Line ❑ ❑ ❑
Outside Clean Out Covers ❑ ❑ ❑
Outside Vent Covers ❑ ❑ ❑
,Exterior_Water_Faucets—_„.—❑._ _ _❑ _❑_
Men's Room Urinal(s) ❑ ❑ ❑
Men's Room Toilet(s) ❑ ❑ ❑
Ladies'Room Toilet(s) ❑ ❑ ❑
Sink(s) maA-�r<, KtAhe✓� �59— S� d-07 P-0 �j ❑
Ladies'Room sink(s) _ ❑_ _ El El Triple Bay Strainers 11 ❑ ❑
Indirect Drains(Air Gaps) ❑ ❑ ❑
Floor Drain Cover ❑ ❑ ❑
Misc. Floor Drain ❑ ❑ ❑
Hand Sink Re-Washer ❑ ❑ ❑
Mop Sink Faucet _„_—___..
. .. 171 _ _. ❑_._.: ❑
Inlet Line(to Grease Trap) ❑ ❑ ❑
Outlet Line(from Grease Trap) ❑ ❑ ❑
Outgoing Line(from Building) ❑ ❑ ❑
3-Bay Indirect Line ❑ ❑ ❑
3-Bay Faucet ❑ ❑ ❑
Ice Machine Indirect Drain ❑ _ ❑ El Grease Trap ❑ —Y El ❑
Water Heater ❑ ❑ ❑
Backflow Prevention Device ❑ ❑ ❑
High Pressure Water Jetting ❑ ❑ ❑
Other ❑ _ _ _ _ ❑ ❑
Maintenance Products E�1 ,0,11 /,oie le./y _ �� : ❑
Quantity Discount Package ❑ ❑ ❑
WORK ORDER AUTHORIZATION I authorize the services indicated and agree to pay the amounts specified. I have read and agree to the terms on the
reverse side,including the limits on Roto-Rooter's responsibility specified in those terms. ] Total estimate reflects customer
(Signature) Q.�)_ (Print Name I °j` 1� J R 3 j authorization in work d i indicated above.
„ 'Tax not included in estimate.
ESTIMATE AND D SCRIAON Oft RK TO BE PERFORMED(The approximate starting date is D /Z —and the
approximate completion date is /U Neither date is guaranteed.Unexpected conditions or problems could cause delays. Labor'r
A definite completion date is not of the essence.) _ Parts $
2 1 E' /! r G ,Q iN /n Vii/
Discount $ !s7/, S
G,C !t 6 1G GV g17&e 4G Product $ 55?. yU
Other $ 3.
COMMENTS/ADJUSTMENTSIC HANG ES IN WORK: TOTAL $ eZ;.
❑Cash ❑Check ❑Credit Card
Auth#
COMPLETION I acknowledge completion of the above described work which has been done to my complete satisfaction. Store Stamp:
// J V” k3
(Signature) L �_,11 (Print,Name) �.1 1 �—Pt
U
- <y
� I�1 y/�G�C_� /�Pt.� Control No.
(Serve Technician's Signature) (Print Service Technician's Name and Number) 168- 4 8 L^3
J CUSTOMER COPY
Roto-Rooter Services Company
Terms and Conditions
The following terms apply to all work performed by Roto-Rooter Services Company or its affiliates("us")for the customer-indicated on
the front of this form("you").
1. Your Responsibilities. You agree to(a)remove any hazards,obstructions or dangerous conditions around the job site not caused by
our work,(b)limit access to the job site so that people not working on our job are not exposed to dangerous conditions relating to our job,(c)
place appropriate warnings to warn of dangerous conditions when we are not on the job site,and(d)provide us with adequate access.
2. Exceptions to Our Responsibilities. We are not responsible for(a)personal injury,property damage or other damage or loss to you
or others arising out of our work,except to the extent caused by our negligence or failure to perform the work in accordance with the contract
between us;(b)defective,damaged,or deteriorated lines,mold,lead piping,or other unexpected or undisclosed conditions,and the consequences
of such conditions,including delays,broken fixtures or lines,and lodged equipment(if we encounter such a condition,we may stop work,and
you will pay us a reasonable charge for the work performed);(c)the time required to complete our work with reasonable diligence;(d)unless
explicitly stated in writing,any damage necessary to complete our work,including damage to landscaping,walls,painting,tile or concrete or
similar items;(e)damage caused by the removal of any clean out,drain cover or cap;or(f)tasks we perform in accordance with your specific
instructions.
3.Release and Hold Harmless. You release us from(and if you are a commercial customer,you will defend and indemnify us and hold
us harmless against)all damages,claims,demands,settlements,judgments,liabilities,costs and expenses,including reasonable attorneys' fees,
allegedly arising out of(a)breach of your responsibilities under paragraph 1,or(b)matters for which we disclaim responsibility under
paragraph 2.
4. Our Guarantee. If we provide a parts or equipment guarantee,as your exclusive remedy,we will give you the benefit we receive,if
any,under the manufacturer's warranty. If we provide a service guarantee,it covers only drainage failure in the line serviced,and defective
plumbing workmanship,during the guarantee term. As your exclusive remedy under our service guarantee,we will,at our option,either do the
work again at no labor cost or refund your payment.Guarantees do not apply to problems arising out of main sewer line backup or improper,
abnormal or unanticipated use or conditions. Except as explicitly stated in writing,we are not giving any guarantees or making any warranties.
WE DISCLAIM ANY IMPLIED WARRANTIES OF MERCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE. You may
transfer a guarantee of plumbing repair or replacement to a person who purchases the property,but you may not transfer a drain cleaning or
toilet auger guarantee.Your transferee must present the warranty claim to Roto-Rooter at the time we perform our work.We do not guarantee
that our site inspection will identify all existing or potential problems.Any damages or necessary repairs arising from plumbing problems,
either identified or unidentified,are the sole responsibility of the customer.
5. Limitation of Damages.Our liability to you for any claim arising out of our work on any job(other than a claim permitted by these
terms for personal or bodily injury)will in no event exceed three times the amount you actually pay us for the work on that job.EXCEPT FOR A
CLAIM PERMITTED BY THESE TERMS FOR PERSONAL OR BODILY INJURY OR PROPERTY DAMAGE,YOU WAIVE ANY RIGHT
TO RECOVER INCIDENTAL DAMAGES,CONSEQUENTIAL DAMAGES,OR DELAY DAMAGES.
6. Payment Terms.When you provide a check as payment,you authorize us either to use information from your check to make a
one-time electronic fund transfer from your account or to process the payment as a check transaction. If you fail to pay us any amount when due,
we will charge you interest on the amount due at the rate of 1.5%per month(but not exceeding the highest rate legally permissible). You will
reimburse us for the reasonable attorneys'fees we incur in all stages of collection.
7. General. These terms are part of our contractual agreement and will prevail over any inconsistent terms in any other agreement
between us,including the terms of any purchase order,and may be modified only in a written instrument signed by both of us which specifically
refers to the provisions to be modified. If any of these terms is held invalid or unenforceable,the remaining provisions will not be affected and
will continue to apply.
HOW TO RESOLVE A PROBLEM
• Contact the manager at your Roto-Rooter office. Everything will be done to resolve your
problem at the local level.
• If your problem cannot be resolved locally,please contact Pat Swanson,Customer Service
Coordinator,in our national headquarters:
Roto-Rooter Services Company or email pswanson @rrsc.com
2500 Chemed Center
-- - 255 East Fifth Street
Cincinnati,OH 45202
VOUCHER NO. WARRANT NO.
ALLOWED 20
Roto Rooter
IN SUM OF $
5672 Collections Center Drive
Chicago, IL 60693
$262.84
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1120 I 16738927 I 43-501.00 I $262.84 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
JUL 16 2012
Illy
J0
Fire Chief
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
'rescribed by State Board of Accounts City Form No.201(Rev.1995)
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
kn invoice or bill to be properly itemized must show: kind of service,where performed, dates service rendered, by
vhom, 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))
16738927 $262.84
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