325876 05/31/18 CITY OF CARMEL, INDIANA VENDOR: 00351351
® ONE CIVIC SQUARE JACOB-DIETZ, INC CHECK AMOUNT: $*******81 1.25*
,• CARMEL, INDIANA 46032 130 S EWING ST CHECK NUMBER: 325876
INDIANAPOLIS IN 46201 CHECK DATE: 05/31/18
DEPARTMENT ACCOUNT PO NUMBER "`INVOICE NUMBER AMOUNT DESCRIPTION
2201 4239020 67246 811.25 FIRE PREVENTION SUPPL
VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201 (Rev.1995)
Vendor# -00351351 ALLOWED 20 ACCOUNTS PAYABLE VOUCHER
JACOB-DIETZ, INC IN SUM OF$ CITY OF CARMEL
130 S EWI NG ST An invoice or bill to-be properly itemized must show:kind of sevice,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
$811.25
Purchase Order#
ON ACCOUNT OF APPROPRIATION FOR
Street Department 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
67246 42-390.20 $811.25 1 hereby certify that the attached invoice(s),or 4/30/18 67246 $811.25
2201 2201 2201 2201
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
Wednesday, May 30, 2018
Huffman, Dave
Director
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 distribution ledger classification if claim paid motor vehicle highway fund.
Clerk-Treasurer
JDJACOB-nETZ, INC. Invoice
F IRE PROTECTION SPECIALISTS
130 South Ewing St Date Invoice#
Indianapolis,IN 46201
317-631-2304 Fax 317-631-3117 4/30/2018 67246
Bill To: Ship To:
City of Carmel Streets Department
One Civic Square 3400 West 131st Street
Carmel IN 46032 Carmel IN 46074
P.O.No. Work Order# Terms Due Date Rep Project
38081 4/30/2018 MRD Streets Department
Quantity Description Rate Amount
77 Fire Extinguisher annual inspection 3.00 231.00
2 2-1/2#ABC 6 year maintenance 8.25 16.50
10 5#ABC 6 year maintenance 15.00 150.00
2 10#ABC 6 year maintenance 18.00 36.00
7 54 ABC hydrotest 16.65 116.55
1 2-1/2#ABC extinguisher condemned 0.00 0.00
1 5#ABC extinguisher condemned 0.00 0.00
16 Badger stem 8.50 136.00
1 Amerex stem 8.00 8.00
1 Kidde stem 8.00 8.00
1 340036K Neck o-ring 2.00 2.00
17 Neck o-ring - 1.30 22.10
4 5#hose band 4.50 18.00
3 195 PSI dry chemical gauge 7.50 22.50
19 UN1044 DOT Label 0.70 13.30
19 Hazardous Material.Communication Label 0.70 13.30
1 Truck charge 18.00 18.00
Subtotal $811.25
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 $811.25