193146 12/22/2010 CITY OF CARMEL, INDIANA VENDOR: 00351351 Page 1 of 1
ONE CIVIC SQUARE JACOB- DIETZ, INC
0 CHECK AMOUNT: $85.00
CARMEL, INDIANA 46032 2708 E MICHIGAN ST
INDIANAPOLIS IN 46201 CHECK NUMBER: 193146
CHECK DATE: 12/22/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1205 4351501 52629 85.00 EQUIPMENT MAINT CONTR
E�z, INC. 2° 5 Inv ®ice
J JACOB
PROTECTION SPECIALISTS
2708 East Michigan Street Date Invoice
Indianapolis, IN 46201
317- 631 -2304 Fax 317 631 -3117 12/7/2010 52624
Bill To: Ship To:
City of Carmel Carmel City Building
One Civic Square
Carmel, IN 46032
P.O. No. Work Order `Perms Due Date Rep Project.
25207 12/7 /2010 Carmel City Building
Quantity Description Rate Amount
25 Fire Extinguisher annual inspection 3.00 75.00
1 Truck charge 10.00 10.00
Pay online at
https:Hipn.intuit.com /g4368dt
UL 20 2010
By
Subtotal $85.00
Sales Tax (0.0 $0.
Total $85.00
VOUCHER NO, WARRANT NO.
ALLOWED 20
Jacob Deitz, Inc.
IN SUM OF
2708 East Michigan Street
Indianapolis, IN 46201
$85.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel Administration
PO# Dept. INVOICE NO. I ACCT #/TITLE AMOUNT Board Members
1205 I 52629 j 43- 515.01 I $85.00 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
Monday, December 20, 2010
Director, Administratio
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
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))
12/07/10 52629 $85.00
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