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Home My WebLink About218416 03/25/2013 CITY OF CARMEL, INDIANA VENDOR: 366507 Page 1 of 1 ONE CIVIC SQUARE CIRCUIT SQUARE TV-VIDEO CARMEL, INDIANA 46032 CHECK AMOUNT: $328.40 9613 N.COLLEGE AVE o� INDIANAPOLIS IN 46280 CHECK NUMBER: 218416 CHECK DATE: 3/25/2013 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1096 4350000 14503 154 . 95 EQUIPMENT REPAIRS & M 1096 4350000 14504 18 . 50 EQUIPMENT REPAIRS & M 1096 4350000 14505 154 . 95 EQUIPMENT REPAIRS & M CIRCUIT SQUARE TV-VI®E f RF-CF°T� r te. 4613 N College Ave Indianapolis, IN 46280 MAR 15 2013 (317) 844-4000 DATE 7. _ �-``_-- N ADDRESS 1 4 5 0 PHONE ` j DATE PROMISED —f�aaC meltk DEL N-. W SERIA - 0 BATE OF ORIGINAL INSTALLATION ) ` C ^\J it TROUBLE REPORTED _— ,[„/ - El ESTIMATE ❑ CASH ��r' � ❑ WARRANTY ❑ CHARGE C, ❑ CONTRACT ❑ C.O.D. QTY. DESCRIPTION AMOUNT ©�r°� ILON6 21- A �C�O Dale �°/► Da'e Jffl COMMENTS WarrantT90 days on new parts TOTAL TECHNICAL 30 days labor on new parts SERV CE TIME ❑ SHOP ❑ HOME 0 M. PICK UP ❑-C RVICE as f o TECHNICIAN E. N TURE r. TOTAL / Si ure above constitutes acceptance of abo e work as being satisfactory-and that equipment has been left In good condition. .. N W E S COLOR OF HOUSE SIDE OF STREET FLOOR APT. NO. DELIVER VIA: DELIVERY INSTRUCTIONS: RECEIVED BY Before writing on this side, detach carbon, turn over and reinsert between the sheets. Promissory Notes should be made in duplicate with one copy for customer. PROMISSORY NOTE $ Date For Value Received, I, Promise to pay to the order of the sum of to be paid as follows: with interest to be paid,at the rate of per centum per annum,from date payment is due. L.S. (FOR SIGNATURE OF CUSTOMER) L.S. (ADDITIONAL SIGNATURE IF AVAILABLE) SIGNED AND SEALED IN THE PRESENCE OF: (WITNESS) CIRCUIT SQUARE -VIIDEO LIMA 5 2013 9613 N College Ave Indianapolis, IN 46280 (317) '/�\ DATE •_ �-J0 N E ADDRESS 14504 PHONE DATE PROMISED SERIAL NO � DATE OF ORIGINAL INSTALLATION B R RTED � ❑ ESTIMATE ❑ CASH ❑ WARRANTY ❑ CHARGE ❑ CONTRACT ❑ C.O.D. QTY. DESCRIPTION AMOUNT I 1 I I p - -DD /001/� I I COMMENTS TOTALLS � I TECHNICAL SERVICE SHOP [THOME O SERVICE TIME C DFe7=11 ❑ GALL TECHNICIA CJ � � ,,12 ; j S AT R (� / Q TOTAL Signat C.04--constitutes acceptance of above work as being satisfactory-and that equipment has been left in good condition. N W E S COLOR OF HOUSE SIDE OF STREET FLOOR APT. NO. DELIVER VIA: DELIVERY INSTRUCTIONS: RECEIVED BY Before writing on this side, detach carbon, turn over and reinsert between the sheets. Promissory Notes should be made in duplicate with one copy for customer. PROMISSORY NOTE $ Date For Value Received, I, Promise to pay to the order of the sum of to be paid as follows: with interest to be paid,at the rate of per centum per annum,from date payment is due. L.S. (FOR SIGNATURE OF CUSTOMER) L.S. (ADDITIONAL SIGNATURE IF AVAILABLE) SIGNED AND SEALED IN THE PRESENCE OF: (WITNESS) { °CIRCUIT SQUARE TV-V I® 9613 N College Ave Indianapolis, IN 46280 MAR 15 2013 (317) 844.4000 N /• AD SS - 14505 PHONE DATE PROMISED SERIAL NO � DATE OF ORIGINAL INSTALLATION REP T D ' 2 ❑ ESTIMATE ❑ CASH ❑ WARRANTY ❑ CHARGE ❑ CONTRACT ❑ C.O.D. TY. DESCRIPTION AMOUNT Qi r F -r- �9arr�lity:90 days on new parts TOTAL MRTTEIM TECHNICAL 30 days labor on new darts —SERVICE TIME Ll SHOP ❑ HOME �C��j�r`�i��/�"" `//�� ❑ ER ❑ S GE L TECHNICIAN D PLE1D SI TURE TOTAL iw •Signatu re,above constitutes acceptance of above work as being satisfactory-and that equipment has been left in good condition. N W E S COLOR OF HOUSE SIDE OF STREET FLOOR APT. NO. DELIVER VIA: DELIVERY INSTRUCTIONS: RECEIVED BY Before writing on this side, detach carbon,turn over and reinsert between the sheets. Promissory Notes should be made in duplicate with one copy for customer. PROMISSORY NOTE $ Date For Value Received, I, Promise to pay to the order of the sum of to be paid as follows: with interest to be paid,at the rate of per centum per annum,from date payment is due. L.S. (FOR SIGNATURE OF CUSTOMER) L.S. (ADDITIONAL SIGNATURE IF AVAILABLE) SIGNED AND SEALED IN THE PRESENCE OF: (WITNESS) 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. 366507 Circuit Square TV-Video Terms 9613 N. College Ave. Indianapolis, IN 46280 Invoice Invoice Description Date Number or note attached invoice(s) or bill(s)) PO# Amount 29467 $ 154.95 2/20/13 14503 Fitness bike TV repair 29467 $ 18.50 2/20/13 14504 Fitness bike TV repair 29467 $ 154.95 2/20/13 14505 Fitness bike TV repair Total $ 328.40 I hereby certify that the attached invoice(s), or bill(s)is(are)true and correct and I have audited same in accoi&dance with IC 5-11-10-1.6 20_ Clerk-Treasurer Voucher No. Warrant No. 366507 Circuit Square TV-Video Allowed 20 9613 N. College Ave. Indianapolis, IN 46280 In Sum of$ $ 328.40 ON ACCOUNT OF APPROPRIATION FOR 109 - Monon Center Board Members PO#or INVOICE NO. CCT#/TITLE AMOUNT Dept# 1096-21 14503 4350000 $ 154.95 1 hereby certify that the attached invoice(s), or 1096-21 14504 4350000 $ 18.50 bill(s) is (are)true and correct and that the 1096-21 14505 4350000 $ 154.95 materials or services itemized thereon for which charge is made were ordered and received except 21-Mar 2013 Signature $ 328.40 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund