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Home My WebLink About220685 06/04/2013 CITY OF CARMEL, INDIANA VENDOR: 362779 Page 1 of 1 ONE CIVIC SQUARE LEACH&RUSSELL _. CHECK AMOUNT: $1,697.29 CARMEL, INDIANA 46032 9151 FORD CIRCLE FISHERS IN 46038 CHECK NUMBER: 220685 CHECK DATE: 6/412013 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1208 4350900 26743 27937 1, 697 .29 ENERGY CENTER CONTRAC T Leach & Russell a Mechanical Contractors, Inc. n 9151 Ford Circle Invoice Fishers, Indiana 46038 = Phone: (317) 841-7877 H M E C 12� .: R U S A N I C A L S E L L Fax: (317) 841-7460 Invoice Number: 27937 o Carmel Redevelopment Commission Invoice Date: 05/13/2013 30 W. Main Street, Suite 220 Our Job Number: 136008 ED Carmel, IN 46032 Job Name: Carmel Energy Center Your Purchase Order Number: Labor and materials needed for plumbing service in above location. Rebuilt the wall hydrant and added an isolation valve. Cleared the trench drain as well. Tested the backflow devices, made necessary repairs, retested and certified. (See copy of work order and test results attached) TOTAL AMOUNT DUE $1,697.29 D Q o JUN 03 2013 By Terms: Due Upon Receipt WORK ORDER 005351 TO: rr�.21 /'rt° e LEACH RUSSELL .. ._. MECHANICAL CONTRACTORS, INC. 9151 Ford Circle Attention: Fishers, Indiana 46038-3000 Phone (317) 841-7877 Fax (317) 841-7460 .. .. ....tSTED�. .. �y �L/�+ Date: ,l/ /`T Extra ct Order Ta en —6/ 0 cy ®'Time&Material ......... .. =Warranty 6'^ Customer bCom Complete..... � .......... .too Order No.: Job Incomplete /J L�te.......f ,........,.Z `.� ` `S. .,....�. .. ..y._.�.,7/QyFr Phone Model Number. ...... Number Our Job C ✓ V SerialNumber: Number: . �. ............ �. .. Y /., OTHER CHARGES AMOUNT r� Truck Cha s � . c ...... e...� �......,�� a.�11. ..,,.,,,.. ... ...... .. ..rge (� t7FP QTY MATERIALS AMOUNT t� c . .._.mil .. Cc,.0 z s, � ., ......... L.t�......_G 'c �. . .. t .............. ........ .. 1I... TOTAL OTHER CHARGES /. ....... ,.. Z.,...... .. ._ -... /....0._ ...,..7.. .... DATE LABOR ST 1.5 -DT AMOUNT l 0... ° ., ...�' .� ..................W..r� .G' ......::. art.Y .......................... I .i............. ............... ... ..... ............................................ .. ./ .. ./ t ._(e go .,. . TOTAL MATERIAL 2 2 TOTAL LABOR ISM' U TOTAL MATERIAL, OTHER& LABOR Zq Work Ordered By: TAX Signature: TOTAL y 17 2 ere y ac no age a sa is ac ory comp a ion o e a ove escnbecTwork an — agree to render payment upon receipt of invoice. LeachA Russell Mechanical Contractors, Inc. 9151 Ford Circle Back-Flow Fishers, Indiana 46038 Preventer Test Phone: (317) 841-7877 R U S S E L L M F C H A N I C A L Fax: (317) 841-7460 S et ce Address: Owner's Address: Serial rnber- rw t..: k?— 1 Man fa urer- 3rav- t�ve- 0.1 /k L IV E, Model:'i` 75Xl, f Z_ Size: 1 vy, S e�eOurnber: Loc t* n ........... Reduced Pressure Principal Assembly ? ........ RP SVB CD C) Double Check Valve DC DCDA o C> PVB RPDA cD Check Valve #1 Check Valve #2 Relief Valve PVB/SVB Held at 7( PSID Held at PSID Opened at PSID Air Inlet Closed Tight � Closed Tight Opened at PSID Leaked ❑ Leaked Did Not Open ❑ ❑ Cleaned ❑ Cleaned ❑ Cleaned Check Valve: ❑ Replaced ❑ Replaced ❑ Replaced Held at PSID Leaked ❑ Cleaned Replaced M 0- 0 Q) CU _0 a) > "Fu -U) Held at PSID Held at PSID Opened at PSID Air Inlets PSID C a) [Z F- Closed Tight ❑ Closed Tight ❑ Check Valve PSID Comments: 'FU Date 034.3 Time j 3 Certified Tester No. F17-1 Passed Test By (Signature) Printed Name c ❑ Failed Date Time Certified Tester No. w Test By (Signature) Printed Name 76 Date Time Certified Tester No. ❑ Passed C iz Test By (Signature) Printed Name ❑ Failed Water Authority: Acknowledged By: Account Number: Leach & Russell Mechanical Contractors, Inc. 9151 Ford Circle Back-Flow ' Fishers, Indiana 46038 �eS� Phone: (317) 841-7877 ��e�e��e�° u s s f < < M F C H A N I C A L Fax: (317) 841-7460 M S ice Address: f Owner's Address: Sal Nu e Cam, a Manufacture: 1 Model Size: j/ S ice Nur: ,2e a L 9go tioni -Reduced Pressure Principal Assembly � RP SVB o -� Double Check Valve DC DCDA o C) PVB RPDA o Check Valve #1 Check Valve #2 Relief Valve PVB/SVB N Held at 7 PSID Held at PSID Opened atS, 2- PSID Air Inlet Closed Tight Closed Tight Opened at PSID Leaked ❑ Leaked _ ❑ Did Not Open ❑ ❑ Cleaned ❑ Cleaned ❑ Cleaned Check Valve: ❑ Replaced ❑ Replaced ❑ Replaced Held at PSID Leaked ❑ Cleaned U a ❑ Replaced 0_ 0 a� rn a� a� C7 Held at PSID Held at PSID Opened at PSID Air Inlets PSID TL F- Closed Tight El Closed Tight El Check Valve PSID Comments: Date ax/ o3,ze/_3 Time Z- cI Certified Tester No. _ assed c I- Test By (Signature) - Printed Name Zc ff)gaaS 1 - ❑ Failed cc Date Time Certified Tester No. a i Test By (Signature) Printed Name m N Date Time Certified Tester No. ❑ Passed C a) Test By (Signature) Printed Name ❑ Failed Water Authority: �1 t T, Acknowledged By: Account Number: Leach & Russell Mechanical Contractors, Inc. 9151 Ford Circle Back-Flow Fishers, Indiana 46038 Preventer Test R U S S E L L Phone: (317) 841-7877 C H A N I C A L Fax: (317) 841-7460 S Address: Owner's Address: Se7_rial N U -v_ 7 Ma '27 Z7 7-A-kfive, 4 L,/ 'fl 71�? c"Ct _Zkv Mode,,-,,, Size: Z r,; b . > Loon:on:,r Reduced Pressure Principal Assembly RP SVB .......... Double Check Valve DC DCDA C) C:> PVB RPDA o Check Valve #1 Check Valve #2 Relief Valve PVB/SVB Held at PSID Held at PSID Opened at PSID Air Inlet Closed Tight ❑ Closed Tight Opened at PSID Leaked Leaked ❑ Did Not Open ❑ F-1 Cleaned ❑ Cleaned ❑ Cleaned Check Valve: F-1 Replaced ❑ Replaced ❑ Replaced Held at PSID Leaked ❑ Cleaned ❑ Replaced M 0. 0 Q) U) _0 76 Held at 7 1 7 PSID Held at PSID Opened at PSID Air Inlets PSID a) Closed Tight Closed Tight Check Valve PSID Comments: _Z1, 7- Da 0-7, Zo Time 1/ 7- Certified Tester No. 7-11S_5 El Passed a) Date /25p Test By (Signature) Printed Name ailed Date WL3 Time Certified Tester No. CL 0 w Test By (Signature) Printed Name eov-5-1 "Fu Date O Zo Time Z Certified Tester No. t four assed ii H Test By (Signature) Printed Name 4, ❑ Failed Water Authority: it, Acknowledged By: Account Number: VOUCHER NO. WARRANT NO. Leach & Russell Mechanical Contractors, Inc ALLOWED 20 IN SUM OF $ 9151 Ford Circle Fishers, IN 46038 $1,697.29 ON ACCOUNT OF APPROPRIATION FOR Building Operations Account PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members 26743 I 27937 I -509.00 I $1,697.29 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 Monday, June 03, 201 Director, 4minstration 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)) 05/13/13 27937 Energy Center $1,697.29 I 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