216680 01/29/2013 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: $225.55
CARMEL IN 46032 CHECK NUMBER: 216680
CHECK DATE: 1/29/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4350000 09575 225 . 55 EQUIPMENT REPAIRS & M
Duncan Appliance Service
317-844-042Q 11404 Central Dr E, Carmel, IN 46032
Thank You For Your Businessf!
Carme/Carmel fire ##4 1116/18, ## 09575
10701 College Ave N Dishwasher, GE
Indianapolis, IN 46280 GLD6860N20SS, VR792729B
Replaced panel assembly with revised panel, unit tests ok now.
1 WD34X11098 escutcheon keypad as 137.55
by Tony O Parts Total 137.55
Labor
S.Call 88.00
Sales Tax 9
Total Ticket 'S`235
1 have reviewed this form and approve its contents. Acting for myself(or as agent for the listed party)
1 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 attorneys fees, plus interest at the rate 1.5 percent per month). Balance due = $235.18
Irescribed by State Board of Accounts City Form No.201 (Rev.1995)
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
\n 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))
09575 Dishwasher Repair-Sta. 45 $225.55
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
$225.55
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO#/Dept. INVOICE NO. I ACCT#/TITLE AMOUNT Board Members
1120 I 09575 I 43-500.00 I $225.55 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
Fire Chief
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund