224809 10/08/2013 CITY OF CARMEL, INDIANA VENDOR: 00351470 Page 1 of 1
ONE CIVIC SQUARE BURGESS MECHANICAL CHECK AMOUNT: $2,715.00
ie t CARMEL, INDIANA 46032 12220 SOUTHEASTERN AVE
y;roN`o INDIANAPOLIS IN 46259 CHECK NUMBER: 224809
CHECK DATE: 10/8/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 26518 2, 715 . 00 OTHER EXPENSES
Burgess Mechanical Corp.
Burgess Mechanical Corporation Invoice
12220 Southeastern Ave.
Indianapolis,IN 46259 Date Invoice No.
Phone: 317-862-4395 10/01/2013 26518
Fax:317-862-6774,AK
317-862-6774 Terms Due Date
(317)862-4395 Net 30 10/31/2013
jb @burgessmechanical.com
Bill To
City of Carmel Utilities
9609 Hazel Dell Parkway
Indianapolis,IN 46280
Amount Due Enclosed
$2,715.00
Please detach top portion and return with your pa;vnent
Date Activity Quantity Rate Amount
09/24/2013 Re installed boiler sections on hot water boiler. Connected inlet and outlet 24 75.00 1,800.00
water lines.Installed burner and gas train. Will let silicone cure and return
the next day to leak check and test fire boiler.
09/24/2013 Truck/Fuel Charge 2 80.00 160.00
09/25/2013 Filled boiler with water and pressure tested with 50 pounds of water 8 75.00 600.00
pressure for approximately 1 hour and verified no leaks. Connected
control wiring backup.Test fired burner and checked combustion with
Analyzer. Boiler is running clean and efficient. Drained water from boiler
and system.Boiler is ready to put online.
09/25/2013 Analyzer 1 75.00 75.00
10/25/2013 Truck/Fuel Charge 1 80.00 80.00
Delinquent accounts are subject to reasonable legal and collection fees. Total $2,715.00
VOUCHER # 136524 WARRANT # ALLOWED
00351470 IN SUM OF $
BURGESS MECHANICAL
12220 SOUTHEASTERN AVE
INDIANAPOLIS, IN 46259
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO# INV# ACCT# AMOUNT Audit Trail Code
26518 01-7362-06 $2,715.00
f
i
4
Voucher Total $2,715.00
Cost distribution ledger classification if
claim paid under 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 of service rendered, by whom, rates per day, number of units,
price per unit, etc.
Payee
00351470
BURGESS MECHANICAL Purchase Order No.
12220 SOUTHEASTERN AVE Terms
INDIANAPOLIS, IN 46259 Due Date 10/3/2013
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
10/3/2013 26518 $2,715.00
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
/o IV l/3 1(,Y - ----�-
Date Officer