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213979 10/23/2012 CITY OF CARMEL, INDIANA VENDOR: 356465 Page 1 of 1 ONE CIVIC SQUARE JIM RUSSELL PLUMBING&HEATING CARMEL, INDIANA 46032 PO Box 846 CHECK AMOUNT: $422.32 ZIONSVILLE IN 46077 CHECK NUMBER: 213979 CHECK DATE: 10/23/2012 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1120 4350100 216421 136 . 92 BUILDING REPAIRS & MA 1120 4350100 216430 285 .40 BUILDING REPAIRS & MA Date Invoice O11�5%41;2N� 216430 R. PLUMBING,HEATING&AIR CONDITIONING,L.L.C. Page 1 BOX 846 •ZIONSVILLE, IN 46077 PH ,(3171 873-5773 FAX: (317( 873-2816 yGICENSE#CP10200006 Billed To: Carmel Fire Dept. Station Job: SERVICE 2 Civic Sq. Customer Phone: 508-5777 Carmel, In. 46032 Description of Work: Day Work Re: Station#42 1. Replaced closet sloan valve. Old valve was cracked in brass casting, 2. Tightened toilet at the floor. Total 285.40 PAYMENT DUE UPON RECEIPT. Customer Copy — ` Invoice FM216421 LLLUMBING,HEATING&AIR CONDITIONING,L.L.C. Page 1 OX 846 -ZIONSVILLE, IN 46077 171 873-5773 FAX: (3171 873-2816 Billed To: Carmel Fire Dept. Station Job: SERVICE 2 Civic Sq. Customer Phone: 508-5777 Carmel, In. 46032 Description of Work: Dal Work -- ---' Re: Station 43 this was sent to wrong address. 1. Sloan valve in water closet running continously. Replaced vaccum breaker and diaphram and O-ring. Total 1136.92 PAYMENT DUE UPON RECEIPT. Customer Copy VOUCHER NO. WARRANT NO. ALLOWED 20 Jim Russell Plumbing, Heating &Air Conditioni IN SUM OF $ P.O. Box 846 Zionsville, IN 46077 $422.32 ON ACCOUNT OF APPROPRIATION FOR Carmel Fire Department PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members 1120 216421 43-501.00 $136.92 1 hereby certify that the attached invoice(s), or 1120 216430 43-501.00 $285.40 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 OCT 2 2 2012 Y V � 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)) 216421 $136.92 216430 $285.40 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