319226 11/30/2017 CITY OF CARMEL, INDIANA VENDOR: 00351351
d ONE CIVIC SQUARE JACOB-DIETZ, INC CHECK AMOUNT: $*******295.00*
4 CARMEL, INDIANA 46032 130 S EWING ST CHECK NUMBER: 319226
`M`TON_Lo;a, INDIANAPOLIS IN 46201 CHECK DATE: 11/30/17
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4350900 65751 295.00 OTHER CONT SERVICES
VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201(Rev.1995)
Vendor# 00351351 ALLOWED 20 ACCOUNTS PAYABLE VOUCHER
JACOB-DIETZ, INC IN SUM OF$ CITY OF CARMEL
130 S EWI NG ST 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.
INDIANAPOLIS, IN 46201
Payee
$295.00
Purchase Order#
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Terms
Date Due
PO# ACCT# DATE INVOICE# DESCRIPTION
DEPT# INVOICE# Fund# AMOUNT Board Members DEPT# FUND# (or note attached invoice(s)or bill(s)) AMOUNT
65751 43-509.00 $295.00 1 hereby certify that the attached invoice(s),or 11/22/17 65751 $295.00
1120 101 1120 101
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
Tuesday, November 28,2017
v4mDr - ,..
David Haboush
Fire Chief
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
120—
Cost
20Cost distribution ledger classification if claim paid motor vehicle highway fund. Clerk-Treasurer
jDkCOB,DETZ,
INC. Invoice
PROTECTION SPECIALISTS
130 South Ewing St Date Invoice#
Indianapolis,IN 46201
317-631-2304 Fax 317-631-3117 10/30/2017 65751
Bill To: Ship To:
Carmel Fire Department Fire Station#44
2 Civic Square 5032 E. Main Street
Carmel IN 4602 Carmel IN 4603
P.O.No. Work Order# Terms Due Date Rep Project
26844 10/30/2017 RDJ Fire Station 444
Quantity Description Rate Amount
1 Semi-annual inspection of FM200 fire protection system 295.00 295.00
Subtotal $295.00
Sales Tax(0.0%) $0.00
If not paid by due date,late charges will be assessed at the rate of 1.5%per month. Total $295.00