HomeMy WebLinkAbout240324 12/16/14 CITY OF CARMEL, INDIANA VENDOR: 229400
ONE CIVIC SQUARE INDIANA DEPT OF HOMELAND SECURI AHECK AMOUNT: $......*240.00*
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CARMEL, INDIANA 46032 DIV OF ELEVATOR SAFETY-FISCAL OFFIC CHECK NUMBER: 240324
302 W WASHINGTON ST,RM E221 CHECK DATE: 12/16/14
INDIANAPOLIS IN 46204
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1093 4350900 12012014-1 240.00 734241120120141
ELEVATOR OPERATING CERTIFICATE INVOICE
ARMEL/CLAY BOARD OF PARKS & RECREATION 1411 E 116TH ST Pat Schlemmer 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.Over 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
111704 * $120.00 $ 0.00 1235 CENTAL PARK DR EAST, CARMEL IN 46032
111978 * $120.00 $ 0.00 1235 CENTRAL PARK DR EAST, CARMEL IN 46032
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DEC Q x'2014
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Reference Number Invoice Date Please submit ENTIRE document with payment
734241-12012014 -1 12/01/2014 Unit(s) 2 Total Due upon receipt
of 2 $ 240.00 of $ 240.00
Owner Id 734241
Ref.Num. :734241-12012014 -1 $240 of $ 240.00 Invoice Date 12/01/2014
If Paying by check, include a check made payable to the Department of Homeland security. You can pay all your
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Division of Fire and Building Safety Elevators
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$ 00-40
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1 • • ` RECREATION
Official1411 E 116TH ST
Pat Schlemmer
CARMEL IN 46032
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ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice of 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
229400 (Indiana) Purchase Order No.
Department of Homeland Security Terms
Fiscal Department
302 W Washington St., Rm E221
Indianapolis, IN 46204
Invoice Invoice Description
Date Number (or note attached invoice(s)or bill(s)) PO# Amount
12/1/14 734241120120141 Elevator permits ml 484a $ 240.00
Total $ 240.00
1 hereby certify that the attached invoice(s),or bill(s)is(are)true and correct and I have audited same in accordance
with I C 5-11-10-1.6
20_
Clerk-Treasurer
Voucher No. Warrant No.
(Indiana) i
229400 Department of Homeland Security i Allowed 20
Fiscal Department I,
9
-- _ _ -- - as rnon_ ., m
Indianapolis, IN 46204 li In Sum of$
$ 240.00
i
ON ACCOUNT OF APPROPRIATION FOR
109 -Monon Center
PO#or INVOICE NO. ACCT#/TITL AMOUNT Board Members
Dept#
i
1093 734241120120141 4350900 $ 240.00 ; 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
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I
11-Dec 2014
Signature
$ 240.00 I Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund
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