246863 06/30/15 CITY OF CARMEL, INDIANA VENDOR: 00351351
ONE CIVIC SQUARE JACOB-DIETZ, INC CHECK AMOUNT: S"'"'`234.40'
CARMEL, INDIANA 46032 130 S EWING ST CHECK NUMBER: 246863
aM,,rpN,Eo: INDIANAPOLIS IN 46201 CHECK DATE: 06/30/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4237000 59850 130.00 REPAIR PARTS
1120 4350900 60953 104.40 OTHER CONT SERVICES
JDJACOB-DIETZ, INC. Invoice
FI RE PROTECTION S PEC IALISTS
tlui. �Y :� f !
130 South Ewing St. w;�e3� ii f � Date Invoice#
Indianapolis,IN 46201
317-631-2304 Fax 317-631-3117 3/31/2015 60953
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
32184 4/20/2015 RDJ Carmel Fire Departm...
Quantity Description- Rate Amount
1 20#ABC recharge 40.50 40.50
4 100 psi gauge(water) 7.50 30.00
1 OR29 Neck o-ring 1.30 1.30
1 Ainerex stem 8.00 8.00
1 Hazardous Material Communication Label 0.70 0.70
1 UN 1044 DOT Label 0.65' 0.65
1 20#hose band 5.25 5.25
1 Truck charge 18.00 18.00
Subtotal $104.40
Sales Tax $0.00
If not paid by due date,late charges will be assessed at the rate of 1.5%per month. Total $104.40
JDJACOB-nETZ,
INC. Invoice
P R O T E C T I O N S P E C I A L I S T S
130 South Ewing St. •j'' PAST Date Invoice#
Indianapolis, IN 46201
317-631-2304 Fax 317-631-3117 9/25/2014 59850
2—c—e-3\
Bill To: Ship To: b�
Carmel Fire Department
2 Civic Square
Carmel IN 46032
P.O.No. Work Order# Terms Due Date Rep Project
32018 9/25/2014 RDJ Carmel Fire Departm...
Quantity Description Rate Amount
8 Rubber Straps 14.00 112.00
1 Truck charge 18.00 18.00
Subtotal $130.00
Sales Tax $0.00
If not paid by due date,late charges will be assessed at the rate of 1.5%per month. Total $130.00
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))
60953 $104.40
59850 $130.00
r
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
20Clerk-Treasurer
VOUCHER NO. WARRANT NO.
ALLOWED 20
Jacob Dietz
IN SUM OF $
130 S. Ewing Street
Indianapolis, IN 46201
$234.40
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1120 60953 43-509.00 $104.40 1 hereby certify that the attached invoice(s), or
1120 59850 42-370.00 $130.00 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
JUN 2 9 2095
y
Fire Chief
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund