HomeMy WebLinkAbout222351 07/30/2013 CITY OF CARMEL, INDIANA VENDOR: 366507 Page 1 of 1
ONE CIVIC SQUARE CIRCUIT SQUARE TV-VIDEO
CARMEL, INDIANA 46032 9613 N.COLLEGE AVE CHECK AMOUNT: $464.85
INDIANAPOLIS IN 46280 CHECK NUMBER: 222351
CHECK DATE: 7/30/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1096 4350000 14548 154 . 95 EQUIPMENT REPAIRS & M
1096 4350000 14549 154 . 95 EQUIPMENT REPAIRS & M
1096 4350000 14550 154 . 95 EQUIPMENT REPAIRS & M
t
CIRCUIT SQUARE TV-VIDEO
9613 N College Ave
Indianapolis, IN 46280
(317) 844-4000
® DATE /
NAME
ADDRESS . . 14548
-
PHONE DATE PROMISED
,jvlAK MODEL NO. /��2 SERIAL N 43 SERIAL DATE OF ORIGINAL INSTALLATION
TnROUBLE REPORTED GG 7 /�1/
❑ ESTIMATE ❑ CASH
❑ WARRANTY ❑ CHARGE
❑ CONTRACT ❑ C.O.D.
CITY. DESCRIPTION AMOUNT
VIE
I
I
�y
cif Al RS
1 1 2013
`W6f'bty:90 days on new parts TOTAL
30 days labor on new part SERVE TIME ❑ SHOP HOME Q TECHNICAL
�/��F�'�!(�//`!( � ��/��. L 3 ❑ CI _ ❑ Cu e'91=FFiC�ALL /�y�9
i
TECHNICIAN
SIGNATURE
=TOTAL
Signatu Bove constitutes acceptance of above work as being -
satisf ctory-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)
J7 . . -
CIRCUIT SQUARE TV-VIDEO
9613 N College Ave
Indianapolis, IN 46280
(317) 844-000
v DATE
NAME
ADDRESS 14 V"T,9
PHONE DATE PROMISED T VVVV'T
- "y- aZb
MAKE MODEL NO. SERIAL NO. DATE OF ORIGINAL INSTALLATION
�1t%`�FSt�� GG Ttro z r TiLO/G9
TROUBLE REPORTED
n ❑ ESTIMATE ❑ CASH
/f,G�1/�` ❑ WARRANTY ❑ CHARGE
J//� (J//J ❑ CONTRACT ❑ C.O.D.
QTY. DESCRIPTION AMOUNT
1-V '411 R5 JUL 1 1 2013
a C'9 L 5 F
'v1MENTS /!
4arranty:90 days on new pars TOTAL MASER '
30 days labor on new parts SERVICE TIME ❑ SHOP ❑ O E lei
P'V(0()L&
TECHNICIAN D/�// �f
SIGNATURE � '5" 'r
TOTAL 7
Signal .,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)
CIRCUIT SQUARE TV-VIDEO
w 9613 N College Ave
Indianapolis, IN 46280
(317) 8"4=
DATE
CCADRESS 14550
PHONE DATE PROMISED
MAKE , M EL O+ / SER� ./. �/ DATE OF ORIGINAL INSTALLATION
JvG
TROUBLE REPORTED
�f ��� 7/ ❑ ESTIMATE ❑ CASH
//�//i ��iC/`^��/�V Y � ❑ WARRANTY ❑ CHARGE
W/ ❑ CONTRACT ❑ C.O.D.
QTY. DESCRIPTION AMOUNT
_ ��l yf' -ICJ•�oCO/��o .. _
v4 d g�
�ITtJGSS BIKE T\/ RGC'Al R5 - r=
jUL 112013
V MENTS TOTAL fvtGi #FfrCS"� �� J-'�J
arranty:so days on new pans TECHNICAL
34 days la or on new part SERVICE TIME ❑ SHOP ❑ HOME G
MM OR
TECHNICIAN DA`9CWE-/Tb5 T Q
i
SIGNATURE ..
TOTAL
Signat 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
7/11/13 14548 Fitness bike TV repair 29945 $ 154.95
7/11/13 14549 Fitness bike TV repair 29945 $ 154.95
7/11113 14550 Fitness bike TV repair 29945 $ 154.95 -
Total $ 464.85
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.
366507 Circuit Square TV-Video Allowed 20
9613 N. College Ave.
Indianapolis, IN 46280
In Sum of$
$ 464.85
ON ACCOUNT OF APPROPRIATION FOR
109 - Monon Center
PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members
Dept#
1096-21 14548 4350000 $ 154.95 1 hereby certify that the attached invoice(s), or
1096-21 14549 4350000 $ 154.95 bill(s) is(are)true and correct and that the
1096-21 14550 4350000 $ 154.95 materials or services itemized thereon for
which charge is made were ordered and
received except
25-Jul 2013
Signature
$ 464.85 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund