237155 9/16/2014 a`! CITY OF CARMEL, INDIANA VENDOR: 00351351
® ONE CIVIC SQUARE JACOB-DIETZ, INC CHECK AMOUNT: $*****1,789.30*
�_ � CARMEL, INDIANA 46032 130 S EWING ST CHECK NUMBER: 237155
9M�<fori�°' INDIANAPOLIS IN 46201 CHECK DATE: 09/16/14 '
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4350900 59626 1,789.30 OTHER CONT SERVICES
JDJACOB-nETZ, INC. Invoice
F I R E PROTECTION SPEC I A L I S T S
130 South Ewing St Date Invoice#
Indianapolis,IN 46201
317-631-2304 Fax 317-631-3117 7/31/2014 59626
Bill To: Ship To:
Carmel Fire Department Carmel Fire department
2 Civic Square One Civic Square
Carmel IN 46032 Carmel IN 46032
P.O.No. Work Order# Terms Due Date Rep Project
31768 7/31/2014 RDJ Carmel Fire Departm...
Quantity Description Rate Amount
143 Fire Extinguisher annual inspection 3.00 429.00
2 20#ABC 6 year maintenance 20.00 40.00
6 5#ABC 6 year maintenance 10.00 60.00
1 5#ABC recharge 15.50 15.50
1 2-1/2 Gallon water recharge 8.10_ 8.10
4 2-1/2 Gallon Water hydrotest 19.00 76.00
6 10#ABC 6 year maintenance 13.00 78.00
1 20#CO2 test&recharge 31.00 31.00
2 209 ABC hydrotest 23.65 47.30
1 10#ABC hydrotest 17.65 17.65
1 5#BC 6 year maintenance 10.00 10.00
6 6 Liter K test&recharge(Amerex) 90.00 540.00
2 209 ABC recharge 40.50 81.00
1 15#CO2 recharge 16.00 16.00
10 OR27 Neck o-ring 1.30 13.00
- 15 OR29 Neck o=ring - -- -- - ---- - - 1:30-- 19:50--- ----
1 340036K Neck o-ring 2.00, 2.00
1 CO2 Neck o-ring 2.50 2.50
4 OR37 Neck o-ring 1.30 5.20
8 Amerex stem 6.00 48.00
Subtotal
Sales Tax(0.0%)
If not paid by due date,late charges will be assessed at the rate of 1.5%per month. Total
Page 1
JDjACOB,DETZ, INC. Invoice
PROTECTI ON SPECIALISTS
130 South Ewing St. Date Invoice#
Indianapolis,IN 46201 .
317-631-2304 Fax 317-631-3117 7/31/2014 59626
Bill To: Ship To:
Carmel Fire Department Carmel Fire department
2 Civic Square One Civic Square
Carmel IN 46032 Carmel 11446032
P.O.No. Work Order# Terms Due Date Rep Project
31768 7/31/2014 RDJ Carmel Fire Departm...
Quantity Description Rate Amount
4 Amerex stem 6.00 24.00
3 Badger Stem 7.00 21.00
5 Valve Stem for K 13.40 67.00
6 Badger stem 7.00 42.00
9 CO2 hose continuity test 1.50_ 13.50
1 Amerex safety disc 12.75 12.75
3 5#hose band 2.50 7.50
1 Amerex CO2 stem 12.50 12.50
4 Buckeye stem 9.50 38.00
9 Hazardous Material Communication Label 0.70 6.30
1 Kidde pro-line stem 5.00 5.00
Pay online at:
https://ipn.intuit.com/r42r65nr
Subtotal $1,789.30
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 $1,789.30
Page 2
VOUCHER NO. WARRANT NO.
ALLOWED 20
Jacob Dietz
IN SUM OF$
130 S. Ewing Street
Indianapolis, IN 46201
I
$1,789.30
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO#/Dept. INVOICE NO. ACCT#rrITLE AMOUNT Board Members
1120 59626 43-509.00 $1,789.30 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 SEP 5 201
i s
Fire Chief
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
i
°Prescribed by State Board of Accounts City Form No.201 (Rev.1995)
I ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
i
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
I
Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s)or bill(s))
59626 $1,789.30
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