224146 09/10/2013 CITY OF CARMEL, INDIANA VENDOR: 00350297 Page 1 of 1
ONE CIVIC SQUARE TERMINIX PROCESSING CENTER CHECK AMOUNT: $82.00
CARMEL, INDIANA 46032 PO BOX 742592
a�La CINCINNATI OH 45274-2592 CHECK NUMBER: 224146
CHECK DATE: 9/10/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1205 4351501 11523090033 82 . 00 EQUIPMENT MAINT CONTR
INDIANAPOLIS
559 W 74TH STREET Master Commercial aster Agreement#P 5
194660140501
LJ L�LJLI INDIANAPOLIS, IN 46268 Work Order#:11523090033
COMMERCIAL (317) 328-9556
Customer Name: CITY OF CARMEL Home Phone: (317)571-2400 Service Technician: COOK,JAMES M, Date/Time In: 08/20/2013 08:17 AM
Contact Name: Work Phone: Employee Number: 19466 Date/rime Out: 0820/2013 06:46 AM
Customer#: 1024429 Cell Phone: License/Cart#: F41289 Page: 1
Sales Agrmt#: 1174211 E-mail Address: Supervisor Name: CREEK,DUSTY
Service Address: 1 CIVIC SQ Frequency: Quarterly Supv.License/Cert#: F20640
CARMEL,IN 46032 Last Svc Date: 7131/03 ServiceType: Regular
Billing Address: 1 CIVIC SQ Customer Since: 6/6/98
CARMEL,IN 46032
General Information
Work Order Summary Total Total Svc Fits Station Actions Change
Work Order# Areas Svc Fits Inspected Installed Replaced Barcode Removed
Triple Option Plus Pest Control ! 11523090033 1 3 3 Offices 0 0 0 0
1 3 3 Public Areas 0 0 0 0
Rest Rooms 0 0 0 0
0 0 0 0
Service Point Summary Pest Evidence With No Pest Summary Live Dead Evidence
Inspected Found Only Activity Activity Quantity Found Found Only
Offices 1 0 0 0 1 General Spiders 0 0 0 0
Public Areas 1 0 0 0 1 0 0 0 0
Rest Rooms 1 0 0 0 1
3 0 0 0 3
Findings and Action Plan by Service Area and Zone
INTERIOR
Pests or Evidence Found Findings/Conditions Actions Taken Recommendations
No Findings Inspected and performed preventative treatment jNone Noted
Comments
F HANK YOU FOR YOUR BUSINESS.IF THERE IS ANYTHING I CAN DO PLEASE FEEL FREE TO CONTACT ME AT 765-623-9669.JIM COOK.
OPREG-HUB 6/98 SVC.4:30PM
Material Usage
0-0-10A. Areas Ins ected Treated Pests Tarcieted Post Treatment Precautions
Active Chemical: LAMDA-CYHALOTHRIN INTERIOR-OFFICES-Offices General Spiders Do not allow unprotected persons,children,pets to
EPA Reg#: 100-1066 INTERIOR-PUBLIC AREAS-Public Areas touch/replace items/bedding,to contact/enter treated
Treatment: Spot Application(2 sq.ft.or less) INTERIOR-Rest Rooms areas til dry.
Applied Amount: 28.000 Ounce
Equipment: Comp.Air Sprayer Keep infants,children,adults,pets,and domestic
animals off treated surfaces until dry
Summary of Charges
Previous Balance: $0.00
Current Charges: $82.00
Subtotal: $82.00
Tax: $0.00
Total: $82.00
Customer Name: W MORAN Customer Signature: ` Date: 08/20/2013
Service Technician
Service Technician: JAMES M.COOK Signature: Date: 06/20/2013
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Call 1.800.TERMINIX or visit Terminix.com
VOUCHER NO. WARRANT NO.
ALLOWED 20
Terminix
IN SUM OF $
7210 Georgetown Road, Suite 500
Indianapolis, IN 46268
$82.00
ON ACCOUNT OF APPROPRIATION FOR
Administration Department
PO#/Dept. INVOICE NO. ACCT#!TITLE AMOUNT
Board Members
1205 I 11523090033 I 43-515.01 I $82.00 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
Mon ay, September 09, 2013
Director, Administration
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))
08/20/13 11523090033 $82.00
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