HomeMy WebLinkAbout321088 01/25/18 '4y'u,C4gf� CITY OF CARMEL, INDIANA VENDOR: 229400
{ d ! ONE CIVIC SQUARE INDIANA DEPT OF HOMELAND SECURIMECK AMOUNT: $......*120.00*
'q CARMEL, INDIANA 46032 DIV OF ELEVATOR SAFETY-FISCAL OFFIC CHECK NUMBER: 321088
9MfVoN-Go.= 302 W WASHINGTON ST,RM E221 CHECK DATE: 01/25/18
INDIANAPOLIS•IN 46204
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1093 4239099 120.00 734241010220181
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
VOUCHER NO. WARRANT NO.
An invoice of bill to be properly itemized must show;kind of service,where performed,dates service rendered,by
Vendor# 229400 Allowed 20_ whom,rates per day,number of hours,rate per hour,number of units,price per unit,etc.
Indiana Department of Homeland Security Payee
302,,W Washington St., Rm.-!E221 In Sum of$ Purchase Order#
Indlanapolls, IN-46204 229400 Indiana Department of Homeland Security Terms
20.0piseaEtiiitietit Date Due
.............
302 W Washington St.,Rm E221
ON ACCOUNT OF APPROPRIATION FOR Indianapolis,IN 46204
109-Monon Center
PO#or INVOICE NO. ACCT#!TITLE AMOUNT Invoice Description
Dept# Invoice Date Number (or note attached invoice(s)or bill(s)) PO# Amount
1093 734241010220181 4239099 $ 120.00 Board Members 1/2/18 734241010220181 Annual Elevator Permits 2018 50633 $ 120.00
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
$ 120.00 Total $ 120.00
January 19,2018
I hereby certify that the attached invoice(s),or bill(s)is(are)true and correct and I have audited same in accordance
I with IC 5-11-10-1.6
Cost distribution ledger classification ifQQjf 2f 12{�}2QJ(J
claim paid motor vehicle highway fund Signature 20_
Accounts Payable Coordinator Clerk-Treasurer
Title
ELEVATOR OPERATING CERTIFICATE-1 OICE
RMEL/CLAY-HOARD-OF PARKS & RECREATION'1411 E:.116TH.ST Pat-Schlemmer"CARMEL._IN 46032
1;If Code: * 'An'annual:test report is.due before a• permit is;issued:
2.If Code _.-# A.5 year Test report'is due.before=a'permit is issued.'
.3:0ver-due fees-must be.paid.before a 'Permit.id'issueid.
Lf elevator(s) are not in service please request an.."ELEVATOR,OUT OF SERVICE_
AFFIRMATION" form..
State-Nd.-Code _'DueOver. Due ,;Location Address.
111701 $120.00 0.00 1235 CENTRAL.PARR DR EAST, bzmlEL: IN. 40632
rg r^^�!
JAN 2D18
B :
3424 0� Pse submit ENTIRE document mith payment
Rleference Numbez<� � Invoices Date ea
1022018 01/02/2018
unit(i) 1Totalj)DueEupon reaeipp
1..
120
. . 'Qwne'r Id - 734241 - - .. .. .. - .. ..
Ref.Num::734241-01022018 -1' $120 of $ 12,0..00 Invoicepate 01/02/2018
If-Payiag by check, include a•oheck'monde payabletothe Department--of8omelandiaocurity You_tea pay all your .. -
.Payments onliae'at,IDES web site
htppe://one.dhe,iu:goyJdfba%o]..ovatoi/_start do;'-*ia Vi' /-star Card/Discover
tarda Use Owner.Id on this letter.or.State Number on the invoice to.:p41LuP-information when.�ing,tlia dues -
P
oalsae ORlcomplete the following information and return by mail Indiana Depa`r`tment'of'Homeland Security - -.
F sc`al�'partm nt;X392+W'rWashing ton 1,St `_Rm'; 2=,�1 d"7 apol:is, IN.46204 o ax_to_(31T.L3 609. Queati a? -
call'(3 7)-232°6427 o H`mai3?elevatorlavoiceQdha�ia::gov--2:25$ co-'nveaienee:fee nharged oa all'predit'card - ..
.. . . .. r -
..
Full Name'on Credit,Card ..
Billing Address; Street
City State,: Zip Code .
CC _type:Visa/Am.Express/Discover/Master Card ONLY (circle one)
Acct. Number ": .. . � Exp.Ante .(nan/yy.). _
CVY2 Number. . ' Contact.Phone.Number Signature
By signing, cardmember Agrees:to the obligations set forth-by•the,Cardmember1s
Agreement with the-is'suer:.,
Ref:Num::.734241-01022018. • =1:
:00.
$120 .. of " .Iavoice..Date .01/02/2018
'.. $ 120
1.. .
Indiana:.Departmenf of Homeland.Security
Division of Fire and Building Safety[Elevators
302 W.Washington St.,Rm:E221'.,
Indianapolis,IN-46204,. .
Address Service.Requested
'N�s h�•Y'nJ
CARMELICLAY BOARD OF PARKS&RECREATION
1816.
- 14.11-E 116TH.ST
Off .B s 2
ficial Usines
CARMEL IN 4603Pat Schlemmer