215396 12/11/2012 f CITY OF CARMEL, INDIANA VENDOR: 255850 Page 1 of 1
ONE CIVIC SQUARE QUALITY REPAIR SERVICE, INC
CARMEL, INDIANA 46032 411 KNIGHT DRIVE CHECK AMOUNT: $470.00
GREENWOOD IN 46142 CHECK NUMBER: 215396
CHECK DATE: 12/1112012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 20533 470 . 00 CONT SVS-OTHER
'.yuality Repair Service, Inc. Invoice
411 Knight Drive Date Invoice#
Greenwood, IN 46142 11/27/2012 20533
Phone# 317-881-0205
Fax# 317-881-0294
Bill To
CITY OF CARMEL
-760'3'rd AVE. S.W. # 1 10
CARMEL, IN 46032
P.O. No. Terms Due Date Rep Project
S13394 Net 30 12/27/2012 TAS 20533
Description Amount
ONE(1)MTIC3 CONTROLLER REPAIR SIN: C036043 450.00
ONE(1)MTIC3 CONTROLLER REPAIR S/N: F1220083 (NO CHARGE) 0.00
FREIGHT 20.00
Subtotal $470.00
1.5 % FEE PER MONTH ON UNPAID INVOICES
Sales Tax (7.0%) .
Total $470.00
Balance Due
Web Site
www.qua]ityrepairserviceinc.com
VOUCHER # 126282 WARRANT # ALLOWED
255850 IN SUM OF $
QUALITY REPAIR SERVICE
411 Knight Drive
GREENWOOD, IN 46142
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO# INV# ACCT# AMOUNT Audit Trail Code
20533 01-7360-04 $470.00
r
Voucher Total $470.00
Cost distribution ledger classification if
claim paid under 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 of service rendered, by whom, rates per day, number of units,
price per unit, etc.
Payee
255850
QUALITY REPAIR SERVICE Purchase Order No.
411 Knight Drive Terms
GREENWOOD, IN 46142 Due Date 12/6/2012
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
12/6/2012 20533 $470.00
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
Date Officer