243746 03/31/15 ;,y u!.FAgyf CITY OF CARMEL, INDIANA VENDOR: 00351351
r ONE CIVIC SQUARE JACOB-DIETZ, INC CHECK AMOUNT: S"""`164.75•
CARMEL, INDIANA 46032 130 S EWING ST CHECK NUMBER: 243746
INDIANAPOLIS IN 46201 CHECK DATE: 03/31/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4350900 60638 121.60 OTHER CONT SERVICES
1120 4350900 60754 43.15 OTHER CONT SERVICES
JDJACOB-rXETZ, INC. Invoice
F I R E PROTECTION SPECIALISTS
130 South Ewing St Date Invoice#
Indianapolis,IN 46201
317-631-2304 Fax 317-631-3117 2/26/2015 60638
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
32525 2/26/2015 RDJ Carmel Fire Departm...
Quantity Description Rate Amount
2 20#ABC recharge 40.50 81.00
2 OR29 Neck o-ring 1.30 2.60
2 Amerex stem 9.00 18.00
2 LTN1044 DOT Label 0.65 1.30
1 Hazardous Material Communication Label 0.70 0.70
1 Truck charge 18.00 18.00
Subtotal $121.60
Sales Tax $0.00
If not paid by due date,late charges will be assessed at the rate of 1.5%per month. Total $121.60
INC. Invoice
JDJACOB-DETZ,
PROTECTION SPECIALISTS
130 South Ewing St. Date Invoice#
Indianapolis,IN 46201
317-631-2304 Fax 317-631-3117 2/28/2015 60754
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
32526 2/28/2015 RDJ Carmel Fire Departm...
Quantity Description Rate Amount
1 10#ABC 6 year maintenance 13.00 13.00
1 OR37 Neck o-ring 1.30 1.30
1 Buckeye stem 9.50 9.50
1 Hazardous Material Communication Label 0.70 0.70
1 UN1044 DOT Label 0.65 0.65
1 Truck charge 18.00 18.00
Subtotal $43.15
Sales Tax $0.00
If not paid by due date,late charges will be assessed at the rate of 1.5%per month. Total $43.15
VOUCHER NO. WARRANT NO.
ALLOWED 20 �
Jacob Dietz
IN SUM OF $ �
130 S. Ewing Street
Indianapolis, IN 46201
$164.75
I
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1120 60638 43-509.00 $121.60 1 hereby certify that the attached invoice(s), or
1120 60754 43-509.00 $43.15 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
MAR 3 0 2015
I
■ �I
b' 6
Fire Chief
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
Ii
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))
60638 $121.60
60754 $43.15
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
120
Clerk-Treasurer