HomeMy WebLinkAbout248469 08/12/15 CITY OF CARMEL, INDIANA VENDOR: 369736
ONE CIVIC SQUARE OHIO DEPT OF PUBLIC SAFETY CHECK AMOUNT: $*******414.16*
CARMEL, INDIANA 46032 ATTN:REVENUE MANAGEMENT CHECK NUMBER: 248469
' Cr6N.c�.a PO BOX 16521 CHECK DATE: 08/12/15
COLUMBUS OH 43216-6521
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4350900 RAD16-0013 414.16 OTHER CONT SERVICES
John R.Kasich,Governor
OHIO DEPARTMENT John Born,Director
OF PUBLIC SAFETY Bureau of Motor Vehicles
SAFETY • SERVICE • PROTECTION Emergency Management Agency
Emergency Medical Services Division 1970 West Broad Street
Office of Criminal Justice Services P.O. Box 182081
Ohio Homeland Security Columbus,Ohio 43218-2081
Ohio State Highway Patrol (614)466-3383
www.publicsafety.ohio.gov
CARMEL FIRE DEPT. State of Ohio Federal Tax Identification No.
ACCOUNTS PAYABLE 31-1334820
2 CIVIC SQUARE
CARMEL, IN 46032 INVOICE
Date: JUL 22 2015
Invoice No: RAD16-0013
espy tion Quanttt nit, rtce:: mount::::;
CAL. RAD DETECT EQUIPMENT. $414. 16
REFERENCE WORK ORDER RADCAL
1599.
Payments/Credits:
Inquiries should be directed to: Total Due:
$414. 16
EMERGENCY MANAGEMENT AGENCY Remittance Due 30 Days from Date of Invoice
ROB STONE (614)889-7175
John R_Kasich,Governor
OHIO DEPARTMENT John Born,Director
OF PUBLIC SAFETY
SAFETY SERVICE F_ PROTECTION Bureau of Motor Vehicles SimaMerick
Emergency Management Agency Executive Dnector
• Emergency Medical Services
• Office of Criminal Justice Services A Emergency Management Agency
• Ohio Homeland Security 2855 West Dublin-Granville Road
• Ohio Investigative Unit Columbus,Ohio 43235-2206
• Ohio State Highway Patrol (614)889-7150
www.ema.ohio.gov
WORK ®
WO# RadCal 1599 WO Date Prepared by: Rob Stone
Ref. Inv.# July 16, 2015
Purchase Order RAD16-0013 Reviewed by: B. Stockum
— -- - (If Applicable) Service Date Review date: 7117115
June 1, 2015
Billing Address Shipping Address
Carmel Fire Department Items picked up by Carmel Fire staff.
2 Civic Square
Carmel, IN 46032
POC: Accounts Payable POC: Rad Equipment Coordinator
TEL: 317-571-2600 TEL: 317-407-3597
Unit Price Amount
Service Description S/N Quantity Cost Dollars and Cents
Cal. Ludlum 2241-2 + 1 channel 217802 1 $56.72 $56.72
Cal. extra channel 217802 1 $14.00 $14.00
Cal. Ludlum 2241-3 + 1 channel 267141 1 $56.72 1 $56.72
Cal. extra channel 1 267141 1 3 $14.00 $42.00
Replacement GM Tube for probe 267141 1 $174.00 $174.00
Cal. Ludlum 14C + 1 probe 179669 1 $56.72 $56.72
Cal. extra probe 179669 1 $14.00 $14.00
- --- - -- --- -- — — - - — --$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
Subtotal $414.16
Shipping $0.00
Total $414.16
For Questions and/or comments concerning your calibration contact OEMA Radiological Instrumentation Calibration Lab Supervisor:
Rob Stone at 614-799-6620; FAX 614-688-3362;E-mail rdstone@dps.state.oh.us
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))
RAD-16-0013 Repair Radiological Detector $414.16
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
Clerk-Treasurer
VOUCHER NO. WARRANT NO.
ALLOWED 20
Ohio Department of Public Safety
Attn: Revenue Management IN SUM OF $
PO Box 16521
Columbus, OH 43216-6521
$414.16
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO#/Dept. INVOICE NO. ACCT#!TITLE AMOUNT Board Members
1120 RAD-16-0013 43-509.00 $414.16 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
AUG 1 0 2015
NOV C•'
Fire Chief
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund