250297 10/07/15r
CITY OF CARMEL, INDIANA VENDOR: 00351351
® ONE CIVIC SQUARE JACOB-DIETZ, INC CHECK AMOUNT: $*****1,609.10*
CARMEL, INDIANA 46032 130 S EWING ST CHECK NUMBER: 250297
q.roN INDIANAPOLIS IN 46201 CHECK DATE: 10/07/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4350900 61312 133.20 OTHER CONT SERVICES
1120 4350900 61518 1,475.90 OTHER CONT SERVICES
JDJACOB-EXETZ,
INC. Invoice _
P R O T E C T I O N SPEC I ALISTS
130 South Ewing St. Date Invoice#
Indianapolis,IN 46201
317-631-2304 Fax 317-631-3117 7/31/2015 61518
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
33153,33156,33155,33316... 7/31/2015 JWR Carmel Fire Departm...
Quantity Description Rate Amount
152 Fire Extinguisher annual inspection 3.00 456.00
1 204 CO2 test&recharge 31.00 31.00
1 20# CO2 recharge 19.00 19.00
1 15#CO2 test&recharge 28.00 28.00
1 21/2 Gallon Wet Chemical Test and Recharge 155.00 155.00
1 2-1/2 Gallon Water hydrotest 19.00 19.00
1 20#ABC hydrotest 23.65 23.65
1 20#ABC test&recharge 59.15 59.15
2 20#ABC recharge 35.50 71.00
4 10#ABC hydrotest 17.65 70.60
4 10#ABC 6 year maintenance 13.00 52.00
3 10#ABC recharge 25.50 76.50
1 5# ABC hydrotest 13.65 13.65
1 59 ABC recharge 15.50 15.50
10 OR27 Neck o-ring 1.30 13.00
6 OR29 Neck o-ring 1.30 7.80
1 340037K Neck o-ring 2.25 2.25
1 OR37 Neck o-ring 1.30 1.30
1 Buckeye stem 9.50 9.50
7 Badger stem 8.50 59.50
Subtotal
Sales Tax
If not paid by due date,late charges will be assessed at the rate of 1.5%per month. Total
Page 1
JPJACOB,DETZ, INC. Inv®ice
PROTECTION SPECIALISTS
130 South Ewing St. Date Invoice#
Indianapolis,IN 46201
317-631-2304 Fax 317-631-3117 7/31/2015 61518
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
33153,33156,33 155,333 16... 7/31/2015 JWR Carmel Fire Departm...
Quantity Description Rate Amount
2 Amerex stem 8.00 16.00
5 Amerex stem 9.00 45.00
2 Kidde stem 8.00 16.00
2 340036K Neck o-ring 2.00 4.00
1 Valve Stem for K 13.40 13.40
10 Hazardous Material Communication Label 0.70 7.00
18 UN1044 DOT Label 0.65 11.70
2 CO2 DOT label 0.95 1.90
1 Badger handle 6.00 6.00
3 195 PSI dry chemical gauge 7.50 22.50
1 100 psi gauge(water) 9.50 9.50
3 Ainerex CO2 stem 12.50 37.50
3 Amerex safety disc 12.75 38.25
3 CO2 Neck o-ring 2.50 7.50
1 10#hose band 4.25 4.25
2 20#hose band 5.25 10.50
1 20#ABC Hose 9.75 9.75
7 Pull Pin 1.75 12.25
13 CO2 hose continuity test 1.50 19.50
Subtotal $1,475.90
Sales Tax $0.00
If not paid by due date,late charges will be assessed at the rate of 1.5%per month. Total $1,475.90
Page 2
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))
61518 $1,475.90
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
VOUCHER NO. WARRANT NO.
ALLOWED 20
Jacob Dietz
IN SUM OF $
130 S. Ewing Street
Indianapolis, IN 46201
$1,475.90
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1120 61518 43-509.00 $1,475.90 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
OCT - 5 2095
Fire Chief
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
JACOB DIETZ, INC. Invoice
FIRE PROTECTION SPECIALISTS
130 South Ewing St. Date Invoice#
Indianapolis,IN 46201
6/30/2015 61312
317-631-2304 Fax 317-631-3117
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
33086 Net 30 7/30/2015 J WR Carmel Fire Departm...
Quantity Description Rate Amount
2 New 5#ABC Fire Extinguisher w/vehicle brkt 57.60 115.20
1 Truck charge 18.00 18.00
Subtotal $133.20
Sales Tax $0.00
If not paid by due date, late charges will be assessed at the rate of 1.5%per month. Total $133.20
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))
61312 $133.20
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
Jacob Dietz
IN SUM OF $
130 S. Ewing Street
Indianapolis, IN 46201
$133.20
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1120 61312 43-509.00 $133.20 I 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
OCT - 5 2015
V
Fire Chief
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund