216697 01/29/2013 CITY OF CARMEL, INDIANA VENDOR: 360856 Page 1 of 1
`. ONE CIVIC SQUARE FITNESS FIXX SERVICE INC
` CARMEL, INDIANA 46032 10085 ALLISONVILLE ROAD SUITE 205 CHECK AMOUNT: $118.75
FISHERS IN 46038
CHECK NUMBER: 216697
CHECK DATE: 1/29/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1096 4350000 11136 118 . 75 EQUIPMENT REPAIRS & M
V FITNESS Fixx Invoice
r `.. 10085 Allisonville Rd Suite 205 _ -
7JAN'rO rte=" Date Invoice No Fishers, IN 46038 �(317) 435-3646 12/31/12 11136
2 2013
Bill To. ? Ship To
Carmel Clay Parks and Recreation Monon Center
1411 E. 116th Street 1235 Central Park Drive East
Carmel, IN 46032 Carmel, IN 46032
P.0 Number Terms ` Due Date
29170 Net 30 01/30/13
Qua
` ,: Description .: ;: ntity Rate _ Amount
Cybex Torso Seat Frame(Customer provided) 0.00 0.00
General Labor charge for 2 technician with PM discount applied 1 85.00 85.00
Trip Charge(Round Trip) P.M. Discount 0.75 45.00 33.75
Purchase V
Description
F
P.O.#
G.L.#
Budget
Line Descr
Purchaser Date
Approval Date
Total � $1 i 8 75;
Technician: e k to & V\
YFITNESS F I X X Service Ticket/PO#:
fl 'ff
Payment Method:
10085 Allisonville Road,Ste 205 _Warranty ,20To Be Billed
Fishers,IN 46038 _Contract _Cash
P-317.435.3646 F-317.579.0653 _Prepaid _Check
W-www.fitnessfixx.com/E-service @fitnessfixx.net _New Customer _Charge
Bill To: Email:
Customer: Contact: Phone:
Address: 1 2 3 e o P,r /,CI�C e State: Zip: /r�3
Manufacturer/Model: e n'tr X \j p 70� J Serial# �j,/
;k65`e`riice�T.ime _
Service Call#1
Service Call#2
'�x�,. � � ,�.s ��� ' �'�*"�;�`,.��li`�'�, � �� �'�it_ •�_�s"r.�?1=�� � �,�,���TotaLSetvic'eT me
i'
Service Required/Trouble Reported:
Actual Failure&Service Performed:v C B X
V n p p O
` v 5 e 5 C a F— S 2�� c t� e 5 ,e-cr' v ir wL s Pi
�c � ""N
- -M
ti Part- estFat Quan . �o ,
Signatures below indicate that the above work has been performed to the customer's satisfaction, Parts Total
that the parts listed were replaced,and that the equipment has been left in good working condition Service Call Fee J
(except as noted).CustgnLers agrees to pay all charges not covered by manufacturer or dealer's Technical Service @$9 &hr
warranties. Travel r75hrs. $Z/�hr 33
Service Technician: to.
Z Z ) _ + Z Sales Tax
Customer Approval: Date: p � TotalL �.
W r te-Billing,Yellow-Customer
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice of 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.
360856 Fitness Fixx Services, Inc.
Terms
10085 Allisonville Rd, Suite 205
Fishers, IN 46038
Invoice Invoice Description
Date Number
or note attached invoice(s) or bill(s)) PO# Amount
12/31/12 11136 Repair Cybex VR3 Machine
29170 $ 118.75
Total $ 118.75
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
120—
Clerk-Treasurer
I
Voucher No. Warrant No.
360856 Fitness Fixx Services, Inc. Allowed 20
10085 Allisonville Rd, Suite 205
Fishers, IN 46038
In Sum of$
$ 118.75
ON ACCOUNT OF APPROPRIATION FOR
109 - Monon Center
PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members
Dept#
1096-21 11136 4350000 $ 118.75 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
24-Jan 2013
LP�1/
Signature
$ 118.75 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund