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Home My WebLink About246047 06/04/15 CITY OF CARMEL, INDIANA VENDOR: 229400 ONE CIVIC SQUARE DEPARTMENT OF HOMELAND SECURITI?HECK AMOUNT: $"" "**1 13.00" CARMEL, INDIANA 46032 BOILER AND PRESSURE VESSEL DIVISION CHECK NUMBER: 246047 302 W WASHINGTON ST RM 246 CHECK DATE: 06/04/15 INDIANAPOLIS IN 46204-2739 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1093 4239099 333410 35.00 OTHER MISCELLANOUS 1093 4239099 333411 35.00 OTHER MISCELLANOUS 1093 4239099 333412 43.00 OTHER MISCELLANOUS &�Fa INVOICE FOR INSPECTION / CERTIFICATE FEES MAY 2015 rfi` a State Form 356(R4/9-93) W it Approved by the State Board of Accounts-1991 N Division of Fire and Building Safety _ 'V ` ` You can pay all your payments online at IDH-web site- rare 1.Mail checks payable to DEPARTMENT OF HOMELAND SECURITY 2. Mail 2nd copy&check to DEPARTMENT OF HOMELAND SECURITY https://myoracle.in.gov/dfbsrtdhsFeesFineslstarLdo INSTRUCTIONS: Boiler and Pressure Vessel Safety Division with Visa/Master Card/Discover cards.Use Owner Id on 302 W WASHINGTON ST.,RM 246 this letter or Indiana State Number on the invoice to pull INDIANAPOLIS IN 46204-2739 up information when paying the dues online. Telephone:(317)232-1921 INDIANA STATE NUMBER CARMEL CLAY PARKS & RECREATION LATEST PLEASE 333412 INVOICE PAY THIS 1411 E 116TH ST DATE AMOUNTI Owner Id CARMEL, IN 46032-3455 05/09/2015 759531 ` 7 Owner number User Name&Location of vessel THE MONON CTR Fee 1235 CENTRAL PARK DR E $ 43.00 CARMEL IN 46032 - — — -Serial nunber - Description of vessel Manufacturer Date Last Inspected - - 262708 W T Boiler LOCHINVAR 04/29/2015 National Board No. Inspection agency Name of inspector (This fee is STATE OF INDIANA PARKEY LARRY E prescribed by 675 IAC 12-3-13) Inspection Date Inspector Name Inspection Type Due 04/29/2015 PARKEY LARRY E FIRST INSPECTION-BOILER-333412,05/ $ 43.00 PLEASE NOTE THIS SHEET CONTAINS 2 DUPLICATED INVOICE, PLEASE CUT SHEET ON LINE AND RETURN BOTTOM COPY WITH PAYMENT ��$=A MAY 18 2015 INVOICE FOR INSPECTION /' CERTIFICATE FEES e State Form 356(R4/9-93) Approved by the State Board of Accounts-1991 a Division of Fire and Building Safety ---= 1.Mail checks payable to DEPARTMENT OF HOMELAND SECURITY You can pay all your payments online at]DHS web site 2. Mail 2nd copy&check to DEPARTMENT OF HOMELAND SECURITY https:/lmyoracle.in.govldfbsfidhsFeesF!nes/starLdo INSTRUCTIONS. Boiler and Pressure Vessel Safety Division with Visa/Master Card/Discover cards.Use Owner [don 302 W WASHINGTON ST.,RM 246 this letter or Indiana State Number on the invoice to pull INDIANAPOLIS IN 46204-2739 up information when paying the dues online. Telephone:(317)232-1921 INDIANA STATE NUMBER CARMEL CLAY PARKS & RECREATION LATEST PLEASE 333411 INVOICE PAY THIS 1411 E 116TH ST DATE AMOUNT] Owner Id CARMEL, IN 46032-3455 05/09/2015 759531 7 Owner number User Name&Location of vessel MONON COMMUNITY CTR Fee 1235 CENTRAL PARK DR E $ 35.00 CARMEL IN 46032 Serial number Description of vessel Manufacturer Date Last Inspected 69369 W T Boiler LOCHINVAR 04/29/2015 National Board No. Inspection agency Name of inspector (This fee is STATE OF INDIANA PARKEY LARRY E prescribed by 675 IAC 12-3-13) Inspection Date Inspector Name Inspection Type Due 04/29/2015 PARKEY LARRY E FIRST INSPECTION-SWH-333411,05/09/: $ 35.00 PLEASE NOTE THIS SHEET CONTAINS 2 DUPLICATED INVOICE, PLEASE CUT SHEET ON LINE AND RETURN BOTTOM COPY WITH PAYMENT INVOICE FOR INSPECTION / CERTIFICATE FEES MAY 18 2015 a State Form 356(R4/9-93) 'z Approved by the State Board of Accounts-1991 BY. Division of Fire and Building Safety 1.Mail checks payable to DEPARTMENT OF HOMELAND SECURITY You can pay all your payments online at IDHS web site 2. Mail 2nd copy&check to DEPARTMENT OF HOMELAND SECURITY https://myoracle.in.govldfbsrdhsFeesFines/starLdo INSTRUCTIONS: Boiler and Pressure Vessel Safety Division with Visa/Master Card/Discover cards.Use Owner [don 302 W WASHINGTON ST.,RM 246 this letter or Indiana State Number on the invoice to pull INDIANAPOLIS IN 46204-2739 up information when paying the dues online. Telephone:(317)232-1921 INDIANA STATE NUMBER CARMEL CLAY PARKS & RECREATION LATEST PLEASE 333410 INVOICE PAY THIS 1411 E 116TH ST DATE AMOUNTI Owner Id CARMEL, IN 46032-3455 U 05/09/2015 759531 Owner number User Name&Location of vessel MONON COMMUNITY CTR Fee 1235 CENTRAL PARK DR E $ 35.00 CARMEL IN 46032 Serial number Description of vessel Manufacturer Date Last Inspected - -- 67976 W T Boiler LOCHINVAR 04/29/2015 National Board No. Inspection agency Name of inspector (This fee is STATE"OF INDIANA PARKEY LARRY E prescribed by 675 IAC 12-3-13) Inspection Date Inspector Name Inspection Type Due 04/29/2015 PARKEY LARRY E FIRST INSPECTION-SWH-333410,05/09/: $ 35.00 PLEASE NOTE THIS SHEET CONTAINS 2 DUPLICATED INVOICE, PLEASE CUT SHEET ON f LINE AND RETURN BOTTOM COPY WITH PAYMENT 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 Department Purchase Order No. 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 5/9/15 333412 Boiler inspections 2015 xx2147 $ 43.00 5/9/15 333410 . Boiler inspections 2015 xx2147 $ 35.00 519/15 333411 Boiler inspections 2015 -- _ _,__ xx2147 $ 35.00 Total $ 113.00 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 20_ C rk-Treasurer Voucher No. Warrant No. Indiana Department 229400 of Homeland Security Allowed 20 Fiscal Department 302 W Washington St., Rm E221 Indianapolis, IN 46204 In Sum of$ $ 113.00 ON ACCOUNT OF APPROPRIATION FOR 109 -Monon Center I PO#or INVOICE NO. ACCT#rrITLE AMOUNT Board Members Dept# 1093 333412 4239099 $ 43.001, 1 hereby certify that the attached invoice(s), or 1093 333410 4239099 $ 35.00! bill(s)is(are)true and correct and that the 1093 333411 4239099 $ 35.00 materials or services itemized thereon for which charge is made were ordered and received except i J' May 28,2015 I . Signature $ 113.00 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund i i;