HomeMy WebLinkAbout195397 03/16/2011 CITY OF CARMEL, INDIANA VENDOR: 229400 Page 1 of 1
ONE CIVIC SQUARE DEPARTMENT OF HOMELAND SECURITI&ECK AMOUNT: $25.00
CARMEL, INDIANA 46032 BOILER AND PRESSURE VESSEL DIVISIO
302 W WASHINGTON ST RM 246 CHECK NUMBER: 195397
INDIANAPOLIS IN 46204 -2739
CHECK DATE: 3116/2011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 25.00 WATER TRMT PLANT
INVOICE FOR INSPECTION CERTIFICATE FEES
State Form 356 (R4 9 -93)
Approved by the State Board of Accounts 1991
Division of Fire and Building Safety
1. Mail checks payable to DEPARTMENT OF HOMELAND SECURITY
INSTRUCTIONS: 2. Mail 2nd copy &check to DEPARTMEN f OF HOMELAND SECURITY
Boiler and Pressure Vessel Safety Division
302 W WASHINGTON l RM 246
INDIANAPOLIS IN 4 6704 -2739
Telephone: (317) 232-;9 1
LATEST
CARMEL CITY OF INVOICE
INDIANA DATE PLEASE
ATTN ADMINISTRATOR
,NUMBER PAY THIS
C/O LISA KEMPA AMOUNT!
290011 1 760 3RD AVE SW SUITE 110 X02/25/2011
CARMEL, IN 46032
Owner number
I User Name Location of vessel WASTE WATER TREATMENT PLT Fee
9609 HAZEL DELL PKWY
p
INDIANAPOLIS IN _45280 T
FIRE TUBE FIRE BOX BOILER- 25.00
Serial number
-_._...t
u Manufacturer Date Last Ins ected
Description of vessel i P
BURNHAM 1 02/10/2011
National Board No. Inspection agency Name of inspector (This fee is
2$519 TRAVELERS CALHOUN JOSEPH S prescribed by
J 675 IAC 12 -3 -13)
VOUCHER 107232 WARRANT ALLOWED
362497 IN SUM OF
DEPARTMENT OF HOMELAND SECUF
BOILER AND PRESSURE VESSEL SAF
302 W WASHINGTON ST RM 246
INDIANAPOLIS, IN 46204
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
290011 01- 7362 -05 $25.00
Voucher Total $25.00
Cost distribution ledger classification if
claim paid under 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 of service rendered, by whom, rates per day, number of units,
price per unit, etc.
Payee
362497
DEPARTMENT OF HOMELAND SECURITY Purchase Order No.
BOILER AND PRESSURE VESSEL SAFETY DI\ Terms
302 W WASHINGTON ST RM 246 Due Date 3/7/2011
INDIANAPOLIS, IN 46204
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
3/7/2011 290011 $25.00
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
Date Officer