241055 01/13/15 %'���� CITY OF CARMEL, INDIANA VENDOR: 00351351
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I; ONE CIVIC SQUARE JACOB-DIETZ, INC CHECK AMOUNT: $"**"**`108.00*
?4 CARMEL, INDIANA 46032 130 S EWING ST CHECK NUMBER: 241055
=9'li� ;� INDIANAPOLIS IN 46201 CHECK DATE: 01/13/15
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DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 9010 108.00 OTHER EXPENSES
JDJACOB-nETZ,
INC. Invoice
P'R"O'TECTION" SPEC I"ALI'STS
130 South Ewing St Date Invoice#
Indianapolis,IN 46201
317-631-2304 Fax 317-631-3117 11/30/2014 9010
Bill To: Ship To:
Carmel Utilities City of Carmel 1H-1W
760 3rd Avenue SW 901 Rangeline Road
Carmel, IN 46032 Carmel,IN 46032
P.O.No. Work Order# Terms Due Date Rep Project
25891 11/30/2014 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
VOUCHER # 146385 WARRANT # ALLOWED
351351 IN SUM OF $
JACOB-DIETZ, INC.
130 S. EWING STREET
Indianapolis, IN 46201
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO# INV* ACCT# AMOUNT Audit Trail Code
9010 01-720H-08 $18.00
9010 01-736H-08 $90.00
I
Voucher Total $108.00
Cost distribution ledger classification if
claim paid under 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 of service rendered, by whom, rates per day, number of units,
price per unit, etc.
Payee
351351
JACOB-DIETZ, INC. Purchase Order No.
130 S. EWING STREET Terms
Indianapolis, IN 46201 Due Date 12/29/2014
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
12/29/201, 9010 $108.00
1 hereby certify that the attached invoice(s), or bill(s) is (are) true and
correct and I have audited same in accordance with IC 5-11-10-1.6
Date Officer