HomeMy WebLinkAbout233276 06/04/14 4! F"q,� CITY OF CARMEL, INDIANA VENDOR: 00351351
ONE CIVIC SQUARE JACOB-DIETZ, INC CHECK AMOUNT: S"`"""108.00'
*9, �_� CARMEL, INDIANA 46032 130 S EWING ST CHECK NUMBER: 233276
M,�TON�• INDIANAPOLIS IN 46201 CHECK DATE: 06/04/14
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 8889 108.00 OTHER EXPENSES
JDJACOB-DIET-Z, INC. Invoice
FIRE
PROTECTION SPECIALISTS
130 South Ewing St. Date Invoice#
Indianapolis,IN 46201
317-631-2304 Fax 317-631-3117 5/15/2014 8889
Bill To: Ship To:
Carmel Utilities City of Carmel HHW
760 3rd Avenue SW 901 Rangeline Road
Carmel, IN 46032 Carmel, IN 46032
P.O.No. Work Order# Terms Due Date Rep Project
25546 5/15/2014 REG Carmel Utilities
Quantity Description Rate Amount
1 Semi-annual inspection of dry chemical Fire Protection system for 90.00 90.00
HHW trailer
2 Quick Response Fusible Link 212 degree 9.00 18.00
Subtotal $108.00
Sales Tax(0.0%) $0.00
If not paid by due date,late charges will be assessed at the rate of 1.5%per month. Total $108.00
I
Prescribed by State Board of Accounts
Form No.301-S(Rev.1997) ACCOUNTS PAYABLE VOUCHER
TO
ADDRESS
Invoice Date Invoice Number Item Amount
I 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
Mo. Day Yr. Signature Title
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.
'r/ C*-f 01-x- �Mo• .c-��-9' r��
Mo. Day Yr. Officer Title
Voucher No. Warrant No.
ACCOUNTS PAYABLE DETAILED ACCOUNTS
MUNICIPAL WASTEWATER UTILITY ACCT.
CARMEL, INDIANA
Favor Of
po
Total Amount of Voucher $ ¢
Deductions
0$ DO
(9 D$ l$ 06
Amount of Warrant $ D.5� 0C)
Month of L,Yr
Acct.
VOUCHER RECORD No.
Collection System
Pumping
Treatment&Disposal
Customer Accounts
Administrative&General
Reclaimed Water Treatment
Reclaimed Water Distribution
Total
Allowed
Board Members
Filed
BOYCE FORMS•SYSTEMS 1-800-382-8702 325