223909 09/10/2013 CITY OF CARMEL, INDIANA VENDOR: 367520 Page 1 of 1
ONE CIVIC SQUARE FACILITY SOLUTIONS GROUP CHECK AMOUNT: $1,892.60
CARMEL, INDIANA 46032 PO BOX 952143
'4«p� DALLAS TX 75395-2143 CHECK NUMBER: 223909
CHECK DATE: 9/10/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1093 4350100 286340 1, 892 . 60 BUILDING REPAIRS & MA
FAGL O "
9900 Westpoint Drive Indianapolis, IN 46256 - 214-217-0190 e n v oic e# 286340
Customer No: 747431-0002 Salesrep# 804 FSGE Service House
I Pae#
nvoice Terms g
Du Date e Date 1
Work Address: 08/28/13 09/27/13 NET 30
Monon Community Center Called In B Customer P.O.# all Date
1195 Central Park Drive West Dawn Koepper 5.61 4 08/08/13
Carmel, IN 46032 Com Completed
Work Order# Signed By P
1433251 Jim 08/22/13
Bill Address: Quote Nte Job#
Carmel Clay Parks & Recreation
1411 East 116th Street 0
Attn: Accounts Payable
Carmel, IN 46032
Service Requested
Tuesday, August 20th - 9am
REC`F'.TNTF'D
Install customer supplied lamps & ballast (s) in gymnasium —�
with us of lift (we must supply lift) . Ask for Jim at the AUG 2 9 2013
WEST desk.
Description of Work Performed BY'
Technician installed (15) lamps, (17) ballast(s) , & (3) sockets.
All material but (2) ballast (s) , were customer supplied.
All requested work 100% complete. DM
Signed off by: J Ransford on 8/22/13
Quantity Unit Price Extended
Ln Date Ty Description ----------
------------------------
-------------
--- -------- -- 4 .00 Reg Hrs 60.00 240 .00
9 08/20/13 LA Journeyman Electrician 8 .00 Reg Hrs 60.00 480.00
10 08/21/13 LA Journeyman Electrician 8 .00 Reg Hrs 60.00 480.00
11 08/22/13 LA Journeyman Electrician 1 .00 Each 500.00 500.00
2 08/20/13 Eq 26' Scissor Lift Narrow 2 .00 Each 96 .30 192.60
12 08/22/13 MA (B5963) 71A6051001D 1L 40OW MH 5TAP
Sub Total 1,892 .60
Sales Tax
0.00
Uok Invoice Total 1, 892 .60
Purchase 1'� � V Balance Due 1, 892 .60
Description sis
P.O.# 3CA14Lp P ooF
G.L.# 1 Q9"�1,00
F-Udget
Line Descr
Purchaser Date
Approval Date
Remit to: Facility Solutions Group P.O. Box 952143 - Dallas,
lication of
XSremittance.
Please note Invoice# 286340 on return payment to insure accurate app
mer agrees pay reasonable attorneys'sums which may be due.
On all sums not Customer agrees calculated e month exceeding ut lawfully allowed by
otract t s state) lffi
n in h . gation ommencestoollect payment amontsdue,Custo
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.
Facility Solutions Group Terms
P.O. Box 952143
Dallas, TX 75395-2143
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO# Amount
8/28/13 286340 Repair gym lighting & ballasts 36146 $ 1,892.60
Total $ 1,892.60
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
Voucher No. Warrant No.
Facility Solutions Group Allowed 20
P.O. Box 952143
Dallas, TX 75395-2143
In Sum of$
$ 1,892.60
ON ACCOUNT OF APPROPRIATION FOR
109 -Monon Center
PO#or
Dept# RE AMOUNT Board Members
1093 $ 1,892.60_ 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
5-Sep 2013
Signature
$ 1,892.60 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund