HomeMy WebLinkAbout314817 08/15/2017 CITY OF CARMEL, INDIANA VENDOR: 362497
ONE CIVIC SQUARE DEPARTMENT OF HOMELAND SECURITQHECK AMOUNT: $......**25.00*
CARMEL, INDIANA 46032 BOILER AND PRESS.VALVE SAFETY DIV CHECK NUMBER: 314817
+ 302 W WASHINGTON ST,RM 246 CHECK DATE: 08/15/17
INDIANAPOLIS IN 46204-2739
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4350100 651680 25.00 BUILDING REPAIRS & MA
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INVOICE FOR INSPECTION / CERTIFICATE FEES
State Form 356(R4 19-93)
Approved by the State Board of Accounts-1991
Division of Fire and Building Safety
3"< 1.Mail checks payable to DEPARTMENT OF HOMELAND SECURITY You can pay all your payments online at IDHS web site
2. Mail 2nd copy 8 check to DEPARTMENT OF HOMELAND SECURITY https://oas.dhs.in.gov/dfbs/idhsFeesFines/start.do
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 LATEST PLEASE
CARMEL CITY OF
288872 INVOICE PAY THIS
THREE CIVIL SQUARE DATE AMOUNTI
Owner Id CARMEL, IN 46032
07/24/2017
640037 V
Owner number User Name&Location of vessel POLICE DEPT Fee
651680 3 CIVIC SQUARE
$ 25.00
CARMEL IN 46032
Serial number Description of vessel Manufacturer Date Last Inspected
ZK3857844 SERVICE WATER HEATER LOCHINVAR 06/19/2017
National Board No. Inspection agency Name of inspector (This fee is
TRAVELERS REEVES JOSEPH prescribed by
675 IAC 12-3-13)
Inspection Date Inspector Name Inspection Type Due
06/19/2017 REEVES JOSEPH RE-INSPECTION-Other-288872,07/24/201 $ 25.00
PLEASE NOTE THIS SHEET CONTAINS 2 DUPLICATED INVOICE, PLEASE CUT SHEET ON
LINE AND RETURN BOTTOM COPY WITH PAYMENT
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