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213430 10/09/2012 CITY OF CARMEL, INDIANA VENDOR: 00351921 Page 1 of 1 ONE CIVIC SQUARE DUNCAN APPLIANCE SERVICE ` CARMEL, INDIANA 46032 11404 CENTRAL DRIVE EAST CHECK AMOUNT: $131.96 CARMEL IN 46032 CHECK NUMBER: 213430 CHECK DATE: 10/9/2012 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1120 4350000 08703 131 . 96 EQUIPMENT REPAIRS & M Duncan Appliance Service 317-844-0420, www.duncanappliance.corn 91404 Central Drive East , Carmel, IN 46032 Carme/Carmel fire #4 9/25/12, # 08703 2 Civic Sq Refrigerator, Whirlpool Carmel, IN 46032 GX5FHDXVQ02, K03938399 Installed new drain tube grommetts and tested unit. Thawed frost and ice from freezer to allow proper door closing. Tested units, all ok. 2 VV10309238 grommet 18.95 by Steve D Parts Total 18.95 Labor 25.00 S.Call 88.00 Sales Tax ��,_��.-a--3- �� Total Ticket 339 I ha reviewed this form and approve its contents. Acting for myself(or as agent for the listed party) I agree to make timely payment of all sums owed(and, if I fail in that.to pay all associated collection costs. Total Monies Received: $0.00 including attorneVs fees. plus interest at the rate 1.5 percent per month). Balance due = $133.29 )rescribed 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 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)) 08703 $131.96 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 VOUCHER NO. WARRANT NO. ALLOWED 20 Duncan Appliance Service IN SUM OF $ 11404 Central Drive East Carmel, IN 46032 $131.96 ON ACCOUNT OF APPROPRIATION FOR Carmel Fire Department PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members 1120 I 08703 I 43-500.00 I $131.96 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 PICT ° 8 2012 Fire Chief Title Cost distribution ledger classification if claim paid motor vehicle highway fund