HomeMy WebLinkAbout229896 03/12/14 *F CITY OF CARMEL, INDIANA VENDOR: 362497
® ONE CIVIC SQUARE DEPARTMENT OF HOMELAND SECURIT¢HECK AMOUNT: S''"'"360.00`
?� CARMEL, INDIANA 46032 BOILER AND PRESS.VALVE SAFETY DIV CHECK NUMBER: 229896
"+',;•..__-' 302 W WASHINGTON ST,RM 246 CHECK DATE: 03/12/14
t "o" INDIANAPOLIS IN 46204-2739
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1205 4351501 767502282014 120.00 EQUIPMENT MAINT CONTR
1110 4350100 767503032014 120.00 BUILDING REPAIRS & MA
1205 4351501 767503032014 120.00 EQUIPMENT MAINT CONTR
ELEVATOR OPERATING CERTIFICATE INVOICE
CARMEL PUBLIC WORKS & SAFETY ONE CIVIC SQ CARMEL IN 46032
l.if Code = * An annual test report is due before a permit is issued.
2.If Code = # A 5 year Test report is due before-a Permit is issued.
3.0ver due fees must be paid before a permit is issued.
If elevator(s) are not in service please request an "ELEVATOR OUT OF SERVICE
AFFIRMATION" form.
State No.Code Due Over Due Location Address
45581 * $120.00 $ 0.00 3 CIVIC SQ, CARMEL IN 46032
45582 $120.00 $ 0.00 1 CIVIC SQ, CARMEL IN 46032
= ,44�4% armed To
sem, MAR 10 2014
j 9pp.
er
Reference Number Invoice Date Please submit ENTIRE document with payment
7675-03032014 - 1 03/03/2014 Unit(s) 2 Total Due upon receipt
of 2 $ 240.00 of $ 240.00
Owner Id 7675
Ref.Num. :7675-03032014 - 1 $240 of $ 240.00 Invoice Date 03/03/2014
If Paying by check, include a check made payable to the Department of Homeland security. You can pay all your
payments online at IDHS web site https://myoracle.in.gov/dfbs/idhsFeesFines/start.do with Visa/Master
Card/Discover cards. Use Owner Id on this letter or State Number on the invoice to pull up information when
paying the dues online.OR complete the following information and return by mail :Indiana Department of
Homeland Security, Fiscal Department, 302 W.Washington St., Rm : E221,Indianapolis, IN 46204 or fax to
(317)233-0401. Questions? call(317)232-6427 or E-mail:elevator-invoice@dhs.in.gov 2.25% convenience fee
charged on all credit card payments.
Full Name on Credit Card
Billing Address: Street
City State Zip Code
CC type:Visa/Am.Express/Discover/Master Card ONLY (circle one)
Acct. Number Exp.Date (mm/yy)
CVV2 Number Contact Phone Number Signature
By signing, cardmember agrees to the obligations set forth by the Cardmember's
Agreement with the issuer.
Ref.Num. :7675-03032014 - 1 $240 of $ 240.00 Invoice Date 03/03/2014
Division of • Building Safety Elevators
1.,a ►ril Lvy, _.ao' .us...v
Indianapolis, IN 1• , sl 02 1R
$ 00-406
JUM 0002003087 - /
Address Service Requested MAILED FROM ZIPCODE 4620z
19
CARMEL PUBLIC WORKS & SAFETY
ONE CIVIC D
CARMEL IN 46032
Official
' I
I
4 w 1 q.w � 1 �•• '- ('I A I: I A ,. I I w � 1 I w
v-'�' �1 �v''' 1! r,••+,'•i�ti! v.� ��! ,� Yr•� �ti! -r•-+. ti! ., v,-►,•'��7.; v'�'.
c fC. ♦ ctt • 1fC + cse ♦� csC • cfC + �>.0 ♦ crK •
we be � ya.e r yl.... yi.b yc n
, _; _1•_11 , ; . 11 , 11 , b _L•_•11 , 'b�. 11 ,.�� JI ,_ b
+! r"f a��T 4 +• at a�.�T 44
r-rr,�' .a 4 > .a
,.J]y����•.O_. -t\i- 1 ,1J �v may- ( �•.• t •- .. /fir. .fit- ",1J �J1-�v �►• 1 lei+ may- .1J 1 I�v -fir +I�v
• fL �����'!y r��'` �0.��;;���y I�J.��O"�,���y.fl ��•"�y/���y f� ���"�.�'�y /l �����>!y f�_:�����'.,
�.Oa 'b11 � X� b/1 � ', �..Oa bl1 ♦ -K-� bl1•, ,.��Oa y/1 � •,�.� bl1 , • -K'� bf1 , X�.
Vii: .m.tb �1t e►t ,m�blI ��, t �•e�.l ����1 Ir. ,alll a, t ati�l��bl �, � •a.-t ls�b urt •amtb. `� t •°►�
(.74
A - �1 1 � "`I-d A '~I.••i A Y�.el •L A 'yl .� w �1 �•,� _
/+ �ti y'►1 --'I rte,. r+a
cnC7♦ d csCv♦ -s d crty+ - �! csCv+l �!� ctrCY+ �!� civ+ _, it ,civ !�� csov♦1
ti ♦ 1
t 1.
r w�Ja-b 11 , 3 ��Jtiyll tt b > l'�e`_yll i b w�• '0rl i _b,rr�p�bll , b,.. 7'LOy✓1 t }frdyil 1"Vd
iof
j-�t= .7y �+4 �'r��a y���7y �+4 `.�'f '!`xVp�i-r� 'j y'.�+4 . r� i{ y e--.
/���1
X� /1 � �� b 11 , _.1{-� b'l1 , -.1{•.Oa b11`, ��:� b 11 � - X Oa b 11 , •-�.0a b 11 � �.�
t b 1 t- b t- b b 1 t- b b t b o pr
..� ..,
c sC h,♦ ctrC ♦ ! v • r !.- v .lam v ! v ._ 1 v 1 v
ct.0 •' �,� csC + to itS • � c-t.0 ♦ � csC •..
A,.7 w�Jnlbll 4/ A�_.yJl , �" ; ILA.�/,.,yll b ►'Vly�l , b.,._'l+�!�_•yll , b;! l'LA '0 j1 , .� ;b �.L�d '0 jl ': �.i�'p.
,J ;,: r4: fat
,�Oa bl1 , ::_.f"� b/1 ,..'1`�� b/1 � • .,.11-0!� bl1•, • ..'�-� b/1 ,_ • _n•-� bJ1 , � X 0a' bl1 , • ,X-'ya -
1 -fit:: •e►t •, b , �t ,e►,1 .. b I.J�t ,e�l� b , �t •e►l b 1 1�t .dV( b I �t .al.t b ,� �t .a.l b i �t .e►( -'.
c sC-.• ~ ]¢�♦c^"s—c'a�• l '.c se v:''•-�~l.� c fC~'�1 r~!`• ]¢(`c^'♦—C'v�.+r+• - .l ]}(�c".c`'v+' :._ ti! i t.Cv+'' 1 : c trc v
rb1j^e, tiil`,F w�.ept'0jl tw�•ep4.yl:, �.epq'0il ,F � �wdepgrii,Jc { w�. .'0il , 1�F .l�eyil'+� '►i.d'
�a,� a VP 4 ri .a 4 w aj ♦ 4. a t a 4 •- aj .a . 4 +- r,J a . 4. +• at a. 4:-r- rt a
w.o�..�J.V- r �r -�►� �r -�V- �+ �r .'1V- �+ lir_.-�►- r �•% � ' ' 1�.- 1V- r ;+�s• �i•
°
' j1' r
'!�_ �� , .-+i' J1 , .K• 11�, ,�.� bJ1� � bl1 � -bJ1 . ,x.�•] Ib 11 X�
-y7:�-� �- s p 5•,'T�-� s ,5•,'Ti... `-5•.T�-`'_ �st 5•,�i_� .ft�'S•,�'i_t ��-t> �:5•,��t
1 �: •a►{ b ,-.Jit .e►{ .. b r,..�t b,'1 Imo+ b �t; - b -�t
ELEVATOR OPERATING CERTIFICATE INVOICE
CARMEL PUBLIC WORKS & SAFETY ONE CIVIC SQ CARMEL IN 46032
1.If Code = * An annual test report is due before a permit is issued.
2.If Code = # A 5 year Test report is due before aermitwis issued.
3.Ove.r due fees must be paid before a permit is issued.
If elevator(s) are not in service please request an "ELEVATOR OUT OF SERVICE
AFFIRMATION" form.
State No.Code Due Over Due Location Address
45583 $120.00 $ 0.00 1 CIVIC SQ, CARMEL IN 46032
Submitted To
MAR 10 2014
Clerk Treasurer
Reference Number Invoice Date Please submit ENTIRE document with payment
7675-02282014 -1 02/28/2014 Unit(s) 1 Total Due upon receipt
of 1 $ 120.00 of $ 120.00
Owner Id 7675
Ref.Num. :7675-02282014 - 1 $120 of $ 120.00 Invoice Date 02/28/2014
If Paying by check, include a check made payable to the Department of Homeland security. You can pay all your
payments online at IDHS web site https://myoracle.in.gov/dfbs/idhsFeesFines/start.do with Visa/Master
Card/Discover cards. Use Owner Id on this letter or State Number on the invoice to pull up information when
paying the dues online.OR complete the following information and return by mail :Indiana Department of
Homeland Security, Fiscal Department, 302 W.Washington St., Rm : E221,Indianapolis, IN 46204 or fax to
(317)233-0401. Questions? call(317)232-6427 or E-mail:elevator-invoice®dhs.in.gov 2.25% convenience fee
charged on all credit card payments.
Full Name on Credit Card
Billing Address: Street
City State Zip Code
CC type:Visa/Am.Express/Discover/Master Card ONLY (circle one)
Acct. Number Exp.Date (mm/yy)
CVV2 Number Contact Phone Number Signature
By signing, cardmember agrees to the obligations set forth by the Cardmember's
Agreement with the issuer.
Ref.Num. :7675-02282014 - 1 $120 of $ 120.00 Invoice Date 02/28/2014
ti.�� '•41:
•
eI O
'`'��� �.•. .... .,st-Ip ,r• I I r '.+�t�y! .I• Ir. lam`!' I ,,.�,�s r"r ... lam" I� •• .r", �
-•f a' ` f A w 4 f �l A �.A '+'i ( •l A ('•l A - a. • �,.. `�f-� M. ei ry (.�-
•r'+r �xl� trr+. p ti9/ r r+•p }l.� r .r•+�.��ti1: � ra+ ♦ i• .+�. �tiq 7`' • j.i'�
i fC.. ♦ i:fC ♦ ,9 R i7fC ♦ !.f i IL fC ♦'j - .. Ic fC ♦ 4 !'• cif{Y♦[ A! li�'��..y'•° illi i fCyr�'[•�y -
'•r—e roil �K-e: roil rid til a 1 .e ro ii: cIN
qro��i s _ �-e'' ✓i- �_ e yl #
.r �r=�a''[.i ra .,a 4• �,'r,,.�' P'a 4• 37, �4.1 r.;�7-ja..a 4• u�p ' �• r;'. � . '. • �•, `ra^ 'ri-i �. „P
a a1 Y �� j > ra•' 4 V .ia
(�aie►,_�.�y.r � !..°11Yi(r,.�.�:d:' � + +' •fir.-t.-�+:� TYl�i.4'.�-� F'•�r#�•�ro-� �i;�r_ JV- �' iCv •1V-i�• r�'�.Gv�(-�'
�l >11-J' r'4T J._� >1i i� S �i w�• > 1 ,,}ji�i o,�. ,�,�> j' S4 �.,�, >1 T.O� �'-^ �����- >.i '•'..1Ji1�r�`tiL^y�- >•
�,�i ��tilih ri �>�'•�•�Tj�i,eier.rt���.} 1Gy.`�����r��l.'l F�•D�������� 1(F�� �j' /� �/��� �i r���'>`��1��I�Xf���1�'�.^,�1
YYYYYY '"� I''�' YYYYYY h l"f' �'^ ,1.>• J YYYr '�'' ,'fl �•Y •IN'• YYY
�: � �-� I •:;trl �i �:.�E� r:!���:; :irT.-.; +ter( f� T � � �� . ►:� rpt�i`?I - :� r4^�h�
1•i: Y• i...;rl • •;-•c-�,* 7. 0.3• f, Oa'• ..k el�i { •.,s.0� '•r��• F ..i-. rl • 1 !,s-0� rl.• !„•.ea rl • r ea
<< .;s. •t ,�c Vit., ,�?. ws .yr i-� ~s �1,. + ' s �l ere ` " S' •lit_,
-,. -. a �:�. -.'- -... � �. .... •- -...- '- ^--
'mrit'1
Ivy: e�►[[t�>.�M� �;:,� .e►c} ��1:� ,� eica},1�L�l �a;,�, ► eb �{°�PW
:: a.[�Cb y, .. s[�}��b. ;��R e►t,�!'`
.. 'iF.''" �`. Y'" Q Yom• S ' .L "'�Q ` Y-�•f��r-A: it+•rf, I` +,.�
'�•'� +;+� �,,�,�tiq w ,.`.�� 7 - r+.;P`�� •i,�--A7 ,.•+.,P'
�ttv t +1�: c mac •l� r,•a s!� sc` ♦•tet dlgl�. ir ��; 1�7.`.` �c�c riLet �IIC i!.c'`ra We tin fc�c"rti�e �^� iY►j�e"
, ro
� rr rl • � rw� rl • «�a ✓1-� r � r yr bi• � r..., rl • �' icy ✓1 wq• ✓1� rl.
`dP'f' _ .•Ip.l .� � 'epP' 6 r� `OpP_ �. )' � -,. }-. .dyq, • i`iy..�'�'P• ,.4�. i
+'rIL.+''t-�+"-X• ¢4•`f•G..•>��'� '4�'' ,�,,.'��• i! �,1 4>� ram �� it'd 34j� i�'��''•.,. �n'�•;'a ��� " �'S� ,
}£ ' 1V= �i b� 1�•rS�jV 4 '7# Iii'�ijx+14' y�i rV- r' �(► mss-#r�`. •y.�>��' r jr�y`�� >�'i' i�•� 'aT L> +,�(- >, r .`t ,,,� >��'.r `�' �2 lyr- >�� � �- �
*>°'•y�•• y�r t ,� r�,r�_ >�e • 'l' �` •�y-� > • Y,' r,� • Z'1.r r .� > 1 r •}- >_ 1 r �
,.. }• .�,� °'�'��;� fr � �' � fey- '�� �;`�'°� �`•�-� °�'��:t.,�
;.t s efc� .� 4 !' •. )p...� P`7E �_.]p..i r� c•+ ..[ s ef�4,n ..i, �}�+�.
rl •�l ;..••�� rorl Y�1 XTµ{Y'j.bliti �1 .:.,,•
low-
71.
�•�} .- e� r';:rl •�? :.�Oa blyi •',L4•;,•:Oa »'•>� r•-"'w-T.9
d•-, -7 .��•1T �` "' .r.:�i�fT -�t"_ •. ] `•fit'.9 �•1T • ,7 S '�•to� _7 3 " T 7
s�,�=.x�•`!W•x�i .-sir Y.`�."'.,�_[ 1 res �'+�-� _.��_
�Y: �; b �;�6�' 'm'[ . b �;�'�' '°`[ � �i��': •s.t �'�c}`�i�'�:•i 'e►'[ ,�b �;'�c'�• 'a-,1['��L•�b �.�J • r+'��rC��� �:•� 'e►•I��t
yo•-A�''�+ ?J�ti'� w .-.'�ti��' o�' �w� � ,��r+� =`�ti� rjcg�. Y•`":'�`X .-+ �C r ! � - ii•{�r�'i4t.'1✓,i`� J�� - �`�V'�'.r�.• JJ� ;,�='••7 ':�'P'.ri •J� ..,•��p^�,.rl;••�• :�P'.✓i:� �' =t-�;
!�{, > .lad`„fibr ,it a ,• g4r �L.r`a 1,r r ,j ,•,#y!i b�ry�>r :r;+•'v.�".�y;�' >fa'•: y � Y >it �.T” '>"! •�,.
tit•1I•a�.C�.,. •�l'�> + �•V•' y,,,^Y;'1F•y 'r ,�i"s.�. - •>'1 �+"�.'yy�•o. �.
,-> �1• ��y.rt >'�X1• ;��yr;3 'T'' •� T[�y'r7'�'> F � {�''wri 0117�lyrC > _F �;{!r r[i > F•y#�.l!'Mr; L .���";
":.� r✓` 'Gill
►::��r��;��• :.� rl�► 11:
`,11•'X}'Y T'Ati ie • +. P;'�-(�Y •'1'�b✓1 •,�1!�t.X'fO'S�,�'7 i"f b Yl •R•v{- oily•
V.7rO�j 'rl.•rf.,•' Y•-^.�.tN�ll •��. � �'lnl `�,l: `
• _ •11 7 � .,�` •_�s'� � n "•tt• a•, • -T T
YTI ( ti T NA
St
yrT�•� ( • !•��S'�J •l� !'t'' �T. �_ Sr,'' y-.� .�_t*L
1 •. .e►[ r •^' l • .eet 1 iWil.dL[ 1 Y 1 in b �' •'.
. c�I �,�,v��� . y�+ , �I �r aS�` lb; !�:i 's i�r`ac�sdr ' :.•a "`1 �$c �Yi .i ei l �� ��' ,�'� a►1
rc sC r♦•+, }�' tit! c t:C r �ti! t�sCe,�- t}�ti'/!r i ter'1?..' ti"IC-1rM'1'�, ti 1.��i st�r.1 fc�Cppp,��� [:[ .•'-
u—e: y�ei 'l'^ ye' v....�`'i�.yyyan_. t cue c ►j,d.
i: _r' , tire • � ��Jail • f{y�� ro11-� 3 ►vl.• � :i _ ' ♦r., r
(I�i+cif °pie•>� la r ' 1 �a�.i�"i�F 5�>�.� .�a'• 05'
o.��!,.-�w j1�, r -�t�1 i at•�v_�{��- '1",.,+`�' �.►,.o.��►'y-�A�,:11y )r/l}{i�i�MI�rs.�. �''��.)Ii .1+;!�'iPj�'+��1(�ie,,�, 1•a '�t��(i��i. "1�'�1�)ji.,1+� ��r'•t��..• •�yro�"�
{.___F'�FY:Sey,r; {^�1z• ;l� r[ {�' •i �{lyr��:- ..F �}'`ei�'�; >" 1,.-F•�t'11�w'fLtG'.Tgy'�.F 'lr�$'�f•�;•fb}'�X�; Ti`rR ''�
1^'{�..�{��-�`bil\ s� Oa'`":'t�bi1 1•� O�J�.a i/^' wi ref t'n::►;l. ���Gln �� �_ l.n• wl
rY1ty --•(�?`.=� � � � �• � eti 1 ; �.�� - 1• e',� ro 4��+T,._. , �`yi/P1.,, b1l '�1"�
�!a i1T Oa ✓1 0•i' 11 ew f1 Oa
a clrT d ,, � .s• �..,,, zr s,��..,,, �`-� s 1^t--•. ':i..s ..T'..'„ 4e_s•.w <<�-
' �• b ��• �-tl�'� • ,e..tM � •: � 1 •,. .ems <. ,��ti • .• ��5,1•. � .,. .' y,��•�� _.
'��• -�:• .,,.r �, ... . � �, '� fib. '�.� '����y,'��:. �•�t"-��,�� _ ��t.y",�y�.-, � �}y !�.:":��- �
..p.;<u- l-^•'( �A.:,�- � ,.�- A �� .�•. A y.r. ,�•� �..1• 4.A �•� y�r( F•A ,�•� y./+f-�Y.A y y
r,f (_ '••Il•ru.2e` (.' �- =-�1 t (- �w r f' •\tl•sar.
I
VOUCHER NO. WARRANT NO.
ALLOWED 20
Department of Homeland Security
IN SUM OF $
302 W. Washington, Rm E221
Indianapolis, IN 46204
$360.00
ON ACCOUNT OF APPROPRIATION FOR
Administration Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
-�
1205 7675-02282014-1 43-515.01 $120.00 I hereby certify that the attached invoice(s), or
bill(s) is (are)true and correct and that the
7675-03032014-1 .3-0/ $120.00
- materials or services itemized thereon for
1205 17675-03032014-1I 43-515.01 I $120.00 which charge is made were ordered and
received except
Monday, M�lrch 10, 2014
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))
02/28/14 7675-02282014-1 1 Civic Square $120.00
03/03/14 7675-03032014-1 3 Civic Square $120.00
03/03/14 17675-03032014-1 I 1 Civic Square I $120.00
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