238137 10/15/14 �j"' "*F�
�.,® CITY OF CARMEL, INDIANA VENDOR: 00351351
y ONE CIVIC SQUARE JACOB-DIETZ, INC CHECK AMOUNT: $*******181.50*
s�. ;�,, CARMEL, INDIANA 46032 130 S EWING ST CHECK NUMBER: 238137
9M,(TUN�. INDIANAPOLIS IN 46201 CHECK DATE: 10/15/14
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4350900 59819 181.50 OTHER CONT SERVICES
JDJACOB-DIETZ, INC. Invoice
FIRE PROTECTI O N SPEC IALISTS
130 South Ewing St Date Invoice#
Indianapolis,IN 46201
317-631-2304 Fax 317-631-3117 8/31/2014 59819
Bill To: Ship To:
Carmel Fire Department
2 Civic Square
Carmel IN 46032
P.O.No. Work Order# Terms Due Date Rep Project
30789 8/31/2014 Carmel Fire Departm...
Quantity Description Rate Amount .
1 209 ABC recharge 40.50 40.50
1 OR29 Neck o-ring 1.30 1.30
1 Amerex stem 9.00 9.00
1 Hazardous Material Communication Label 0.70 0.70
8 Rubber Straps 14.00 112.00
1 Truck charge 18.00 18.00
Pay online at:
https://ipn.intuit.com/n346vvbj
Subtotal $181.50
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 $181.50
VOUCHER NO. WARRANT NO.
ALLOWED 20
Jacob Dietz
IN SUM OF $
130 S. Ewing Street
Indianapolis, IN 46201
$181.50
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO#/Dept. INVOICE NO. ACCT#lrlTLE AMOUNT Board Members
1120 59819 43-509.00 $181.50 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
OCT 13 2014
Fire Chief
Title
I �
Cost distribution ledger classification if
claim paid motor vehicle highway fund
i
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))
59819 $181.50
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