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Home My WebLink About166131 11/24/2008 CITY OF CARMEL, INDIANA VENDOR: 027051 Page 1 of 1 ONE CIVIC SQUARE BOILER PRESSURE VESSEL 0 CHECK AMOUNT: $547.00 CARMEL, INDIANA 46032 OFF. OF STATE BLDG COMM 302 W WASHINGTON ST RM 246 CHECK NUMBER: 166131 INDPLS IN 46204 CHECK DATE: 11/24/2008 DEPARTMEN A CCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1047 4350000 304620 65.00 EQUIPMENT REPAIRS M 1047 4350000 304621 43.00 EQUIPMENT REPAIRS M ,1047 4350000 304622 43.00 EQUIPMENT REPAIRS M '1047 4350000 304623 49.00 EQUIPMENT REPAIRS M 1047 4350000 304624 49.00 EQUIPMENT REPAIRS M 1047 4350000 304625 49.00 EQUIPMENT REPAIRS M 1047 4350000 304626 49.00 EQUIPMENT REPAIRS M 1047 4350000 304627 49.00 EQUIPMENT REPAIRS M 1047 4350000 304628 65.00 EQUIPMENT REPAIRS M 1047 4350000 304629 43.00 EQUIPMENT REPAIRS M 1047 4350000 304631 43.00 EQUIPMENT REPAIRS M INVOICE FOR INSPECTION CERTIFICATE FEES o, State Form 356 (R4 9 -93) 1 Approved by the State Board of Accounts 1991 NOV 1 8� Division of Fire and Building Safety 0n p 1. Mail checks payable to DEPARTMENT OF HOMELAND SECURITY J O 2. Mail 2nd copy check to DEPARTMENT OF HOMELAND SECURITY INSTRUCTIONS: Boiler and Pressure Vessel Safety Division 302 W WASHINGTON ST., RM 246 INDIANAPOLIS IN 46204 -2739 Telephone: (317) 232-1921 INDIANA CARMEL CLAY PARKS RECREATION LATEST PLEASE NUMBER ATTN JEREMIAH KERR I ATECE AMOUNITI 304620 1411 E 116TH ST CARMEL, IN 46032 10/31/2008 l i Owner number User Name Location of vessel THE MONON CTR Fee 1235 CENTRAL PARK DR E 65.00 CARMEL IN 46032 Serial number Description of vessel I Manufacturer Date Last Inspected W T Blr Hot Water Heating BRYAN 10/09/2008 National Board No. Inspection agency Name of inspector (This fee is 53259 STATE OF INDIANA PARKEY LARRY E prescribed by IC 22- 12 -6 -10) Inspection Date Inspector Name Inspection Type Due 10/09/2008 PARKEY LARRY E FIRST INSPECTION 304620,10/31/2008 S 65.00 Tear here and retain top portion for your records *r� INVOICE FOR INSPECTION CERTIFICATE FEES State Form 356 (R4 9 -93) Approved by the State Board of Accounts 1991 'L Division of Fire and Building Safety o,c 1. Mail checks payable to DEPARTMENT OF HOMELAND SECURITY INSTRUCTIONS: 2. Mail 2nd copy check to DEPARTMENT OF HOMELAND SECURITY Boiler and Pressure Vessel Safety Division 302 W WASHINGTON ST., RM 246 INDIANAPOLIS IN 46204 -2739 Telephone: (317) 232-1921 LATEST INVOICE INDIANA CARMEL CLAY PARKS RECREATION DATE PLEASE NUMBER PAY THIS ATTN JEREMIAH KERR AMOUNT! 304620 1411 E 116TH ST 10/31/2008 CARMEL, IN 46032 Owner number User Name Location of vessel THE MONON CTR Fee 1235 CENTRAL PARK DR E CARMEL IN 46032 65.00 Serial number Description of vessel Manufacturer Date Last Inspected W T Blr Hot Water Heating BRYAN 10/09/2008 National Board No. Inspection agency Name of inspector (This fee is 53259 STATE OF INDIANA PARKEY LARRY E prescribed by IC 22- 12 -6 -10) Purchase q II O,! I Description l W1 9 P.O.# POr NOV Y 8 2008 G.L jj `,3,5 10 v Bud Line Descr Purchaser Date Approval Date r t�E °rEOF INVOICE FOR INSPECTION CERTIFICATE FEES State Form 356 R419 -93 Approved by the State Board of Accounts 1991 NOV Division of Fire and Building Safety 1 8 2008 Te b 1. Mail checks payable to DEPARTMENT OF HOMELAND SECURITY 2. Mail 2nd copy check to DEPARTMENT OF HOMELAND SECURITY INSTRUCTIONS: Boiler and Pressure Vessel Safety Division 302 W WASHINGTON ST., RM 246 INDIANAPOLIS IN 46204 -2739 Telephone: (317) 232-1921 INDIANA CARMEL CLAY PARKS RECREATION LATEST PLEASE NUMBER CE PAY THIS ATTN JEREMIAH KERR I NVOI CE AMOUNT! 304621 1411 E 116TH ST 10/31/2008 I CARMEL, IN 46032 Owner number User Name Location of vessel THE MONON CTR Fee 1235 CENTRAL PARK DR E 43.00 CARMEL IN 46032 Serial number Description of vessel Manufacturer Date Last Inspected W T Blr Hot Water Heating LOCHINVAR 10/09/2008 National Board No Inspection agency Name of inspector (This fee is 184627 STATE OF INDIANA PARKEY LARRY E prescribed by IC 22- 12 -6 -10) Inspection Date Inspector Name Inspection Type Due 10/09/2008 PARKEY LARRY E FIRST INSPECTION 304621,10/31/2008 43.00 Tear here and retain top portion for your records INVOICE FOR INSPECTION CERTIFICATE FEES i7 j *:o 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 DEPARTMENT OF HOMELAND SECURITY Boiler and Pressure Vessel Safety Division 302 W WASHINGTON ST., RM 246 INDIANAPOLIS IN 46204 -2739 Telephone: (317) 232 -1921 LATEST INVOICE INDIANA CARMEL CLAY PARKS RECREATION DATE PLEASE NUMBER PAY THIS ATTN JEREMIAH KERR AMOUNT! 304621 1411 E 116TH ST 10/31/2008 CARMEL, IN 46032 User Name Location of vessel THE MONON CTR Fee Owner number 1235 CENTRAL PARK DR E CARMEL IN 46032 43.00 Serial number Description of vessel Manufacturer Date Last Inspected W T Blr Hot Water Heating LOCHINVAR 10/09/2008 National Board No. Inspection agency Name of inspector (This fee is 184627 STATE OF INDIANA PARKEY LARRY E prescribed by IC 22- 12 -6 -10) N.O. G.L. �,3 5oUoo NOV 1 8 2008 Budget Line DeSCr Purchaser Date Approval Date ZL `�?f �F a,FO INVOICE FOR INSPECTION CERTIFICATE FEES- State Form 356 (R4 9 -93) 'd v r a I Approved by the State Board of Accounts -1991 Division of Fire and Building Safety NOV Q �nn� 1. Mail checks payable to DEPARTMENT OF HOMELAND SECURITY U lJ 2. Mali 2nd copy check to DEPARTMENT OF HOMELAND SECURITY INSTRUCTIONS: Boiler and Pressure Vessel Safety Division 302 W WASHINGTON ST., RM 246 INDIANAPOLIS IN 46204 -2739 Telephone: (317) 232 -1921 INDIANA CARMEL CLAY PARKS RECREATION LATEST PLEASE NUMBER INVOICE PAY THIS ATTN JEREMIAH KERR DATE AMOUNT 304622 1411 E 116TH ST CARMEL, IN 46032 10/33/2008 i Owner number User Name Location of vessel THE MONON CTR Fee 1235 CENTRAL PARK DR E 43.00 CARMEL IN 46032 Serial number Description of vessel Manufacturer Date Last Inspected W T Boiler LOCHINVAR 10/09/2008 National Board No. Inspection agency Name of inspector (This fee is 182397 STATE OF INDIANA PARKEY LARRY E prescribed by IC 22- 12 -6 -10) Inspection Date Inspector Name Inspection Type Due 10/09/2008 PARKEY LARRY E FIRST INSPECTION 304622,10/31/200$ S 43.00 Tear here and retain top portion for your records s. *E INVOICE FOR INSPECTION CERTIFICATE FEES R4 9 -93 State Form 356 I�!(� Approved b y the State Board of Accounts -1991 Division of Fire and Building Safety mb 1. Mail checks payable to DEPARTMENT OF HOMELAND SECURITY INSTRUCTIONS: 2. Mail 2nd copy check to DEPARTMENT OF HOMELAND SECURITY Boiler and Pressure Vessel Safety Division 302 W WASHINGTON ST., RM 246 INDIANAPOLIS IN 46204 -2739 Telephone: (317) 232-1921 LATEST INVOICE INDIANA CARMEL CLAY PARKS RECREATION DATE PLEASE PAY THIS NUMBER AMOUNT! ATTN JEREMIAH KERR 304622 1411 E 116TH ST 10/31/2008 I i CARMEL, IN 46032 Owner number User Name Location of vessel THE MONON CTR Fee 1235 CENTRAL PARK DR E CARMEL IN 46032 43.00 Serial number Description of vessel Manufacturer Date Last Inspected W T Boiler LOCHINVAR 10/09/2008 National Board No. Inspection agency Name of inspector (This fee is 182397 STATE OF INDIANA PARKEY LARRY E prescribed by IC 22- 12 -6 -10) Pte P.O.# Porgy I G.L �35Ooo4 NOV 1 2008 f Budget I Line Descr r- Purchaser Date Approval Date INVOICE FOR INSPECTION CERTIFICATE FEES State Form 356 (R419 -93) Approved by the State Board of Accounts 1991 Division of Fire and Building Safety NOV 7 p 1, Mail checks payable to DEPARTMENT OF HOMELAND SECURITY N O V 7�nC1 2. Mai! 2nd copy check to DEPARTMENT OF HOMELAND SECURITY INSTRUCTIONS: Boiler and Pressure Vessel Safety Division 302 W WASHINGTON ST., RM 246 INDIANAPOLIS IN IN 46204 -2739 Telephone: (317) 232 -1921 INDIANA CARMEL CLAY PARKS RECREATION LATEST PLEASE NUMBER gTTN JEREMIAH KERR INVOICE PAY THIS DATE AMOUNT! 304623 1411 E 116TH ST CARMEL, IN 46032 10/31/2008 h 49.00 Owner number User Name Location of vessel THE MONON CTR Fee 1235 CENTRAL PARK DR E CARMEL IN 46032 I Serial number I Description of vessel Manufacturer Date Last Inspected 1 W T Boiler LOCHINVAR 10/09/2008 National Board No. Inspection agency Name of inspector (This fee is 184067 STATE OF INDIANA PARKEY LARRY E prescribed by I I VC 22- 12 -6 -10) Inspection Date inspector Name Inspection Type Due 10/09/2008 PARKEY LARRY E FIRST INSPECTION 304623,10/31/2008 49.00 Tear here and retain top portion for your records StE� INVOICE FOR INSPECTION CERTIFICATE FEES -g State Form 356 (R4 9 -93) GI Approved by the State Board of Accounts 1991 Division of Fire and Building Safety 1. Mali checks payable to DEPARTMENT OF HOMELAND SECURITY INSTRUCTIONS: 2. Mail 2nd copy check to DEPARTMENT OF HOMELAND SECURITY Boiler and Pressure Vessel Safety Division 302 W WASHINGTON ST., RM 246 INDIANAPOLIS IN 46204 -2739 Telephone: (317) 232 -1921 LATEST INVOICE PLEASE INDIANA CARMEL CLAY PARKS RECREATION DATE PAYTHIS NUMBER ATTN JEREMIAH KERR AMOUNT! 304623 1411 E 116TH ST 10/31/2008 CARMEL, IN 46032 Owner number User Name Location of vessel THE MONON CTR Fee 1235 CENTRAL PARK DR E CARMEL IN 46032 49.00 Serial number Description of vessel Manufacturer Date Last Inspected W T Boiler LOCHINVAR 10/09/2008 National Board No. Inspection agency Name of inspector (This fee is 184067 STATE OF INDIANA PARKEY LARRY E prescribed by IC 22 12 -6 -10) Pt1rChaW r NOV Z 8 2008 P.O. P or F 13 z 35odva Budget Line Descr Purchaser ate Approval Date L _d srnrE a r� INVOICE FOR INSPECTION CERTIFICATE FEES RRR State Form 356 (R4 19 -93) I Approved by the State Board of Accounts 1991 15 g 2 Un Division of Fire and Building Safety i 1 1 V 8 U '5 1. Mail checks payable to DEPARTMENT OF HOMELAND SECURITY 2, Mail 2nd copy check to DEPARTMENT OF HOMELAND SECURITY INSTRUCTIONS: Boiler and Pressure Vessel Safety Division 302 W WASHINGTON ST., RM 246 INDIANAPOLIS IN 46204 -2739 Telephone: (317) 232-1921 INDIANA CARMEL CLAY PARKS RECREATION LATEST PLEASE NUMBER ATTN JEREMIAH KERR INVOICE PAY THIS DATE AMOUNT! 304624 1411 E 116TH ST CARMEL, IN 46032 10/31/2008 h Fee Owner number User Name Location of vessel THE MONON CTR 1235 CENTRAL PARK DR E 49.00 CARMEL IN 46032 Serial number Description of vessel Manufacturer Date Last Inspected W T Boiler T A LOCHINVAR 10/09/2008 National Board No. Inspection agency Name of inspector (This fee is 195396 STATE OF INDIANA PARKEY LARRY E IC 22-12-6-10) Inspection Date Inspector Name Inspection Type Due 10/09/2008 PARKEY LARRY E FIRST INSPECTION 304624,10/31/2008 49.00 Tear here and retain top portion for your records INVOICE FOR INSPECTION CERTIFICATE FEES tt y State Form 356 (R4 9 -93) Approved by the State Board of Accounts 1991 s ce Division of Fire and Building Safely er 1. Mail checks payable to DEPARTMENT OF HOMELAND SECURITY INSTRUCTIONS: 2. Mail 2nd copy check to DEPARTMENT OF HOMELAND SECURITY Boiler and Pressure Vessel Safety Division 302 W WASHINGTON ST., RM 246 INDIANAPOLIS IN 46204 -2739 Telephone: (317) 232 -1921 LATEST INVOICE INDIANA CARMEL CLAY PARKS RECREATION DATE P PLEASE NUMBER ATTN JEREMIAH KERR AMOUNT! 304624 1411 E 116TH ST 10/31/2008 CARMEL, IN 46032 �J Owner number User Name Location of vessel THE MONON CTR Fee 1235 CENTRAL PARK DR E CARMEL IN 46032 49.00 Serial number Description of vessel Manufacturer Date Last Inspected W T Boiler LOCHINVAR 10/09/2008 Nationai Board No. Inspection agency Name of inspector (This fee is 195396 STATE OF INDIANA PARKEY LARRY E prescribed by IC 22- 12 -6 -10) DescriptlOfl P .O.# PorF NOV 1 8 2008 G.L 35CYaOt� Budget line ZlesCr.� Purchaser Date Approval Date /y-D_I?" INVOICE FOR INSPECTION CERTIFICATE FEES State Form 356 (R419 -93) 1r Tom, Approved by the State Board of Accounts 1991 e 4L� v Division of Fire and Building Safely 1. Mail checks payable to DEPARTMENT OF HOMELAND SECURITY NOV T 008 2. Mail 2nd copy check to DEPARTMENT OF HOMELAND SECURITY INSTRUCTIONS: Boiler and Pressure Vessel Safely Division 302 W WASHINGTON ST., RM 246 INDIANAPOLIS IN 46204 -2739 Telephone: (317) 232-1921 INDIANA CARMEL CLAY PARKS RECREATION LATEST PLEASE NUMBER INVOICE PAY THIS ATTN JEREMIAH KERR DATE AMOUNT! 304625 1411 E 116TH ST CARMEL, IN 46032 10/31/2008 Owner number User Name Location of vessel THE MONON CTR Fee 1235 CENTRAL PARK DR E 49.00 CARMEL IN 46032 j Serial number Description of vessel Manufacturer Date Last Inspected W T Boiler LOCHINVAR 10/09/2008 National Board No. Inspection agency Name of inspector (This fee is 181548 STATE OF INDIANA PARKEY LARRY E prescribed by IC 22- 12 -6 -10) Inspection Date Inspector Name Inspection Type Due 10/09/2008 PARKEY LARRY E FIRST INSPECTION 304625,10/31/2008 49.00 Tear here and retain top portion for your records S F -..Fa INVOICE FOR INSPECTION CERTIFICATE FEES r State Form 356 (R4 9 -93) c a 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 DEPARTMENT OF HOMELAND SECURITY Boiler and Pressure Vessel Safety Division 302 W WASHINGTON ST., RM 246 INDIANAPOLIS IN 46204 -2739 Telephone: (317) 232 -1921 LATEST INVOICE INDIANA CARMEL CLAY PARKS RECREATION DATE PLEASE PAY THIS NUMBER AMOUNT! ATTN JEREMIAH KERR 304625 1411 E 116TH ST 10/31/2008 CARMEL, IN 46032 Owner number User Name Location of vessel THE MONON CTR Fee 1235 CENTRAL PARK DR E CARMEL IN 46032 49.00 Serial number Description of vessel Manufacturer Date Last Inspected W T Boiler LOCHINVAR 10/09/2008 National Board No. Inspection agency Name of inspector (This fee is 181548 STATE OF INDIANA PARKEY LARRY E prescribed by IC 22- 12 -6 -10) Purchase r Description P.O.# P NOV 1 2008 G.L 35oo00 Bud t f Linell�a Purchaser Data Approval Date INVOICE FOR INSPECTION CERTIFICATE FEES o o State Form 356 (R4 19 -93) Approved by the State Board of Accounts 1991 ®k Division of Fire and Building Safety 1. Mail checks payable to DEPARTMENT OF HOMELAND SECURITY •g� 2. Mail 2nd copy check to DEPARTMENT OF HOMELAND SECURITY INSTRUCTIONS: Boiler and Pressure Vessel Safety bivision r 302 W WASHINGTON ST., RM 246' INDIANAPOLIS IN 46204 -2739 Telephone: (317) 232 -1921 i NOV 1 f7 204— 1 O i INDIANA CARMEL CLAY PARKS RECREATION I jf; LATEST PLEASE NUMBER INVOICE PAY THIS ATTN JEREMIAH KERR `DATE AMOUNT! 304626 1411 E 116TH ST CARMEL, IN 46032 10/31/20081 Owner number User Name Location of vessel THE MONON CTR Fee 1235 CENTRAL PARK DR E 49.00 CARMEL IN 46032 Serial number I of vessel Manufacturer Date Last Inspected L Description Boiler LOCHINVAR 10/09/2008 National Board No. ction agency Name of inspector (This fee is 181626 E OF INDIANA PARKEY LARRY E C prescribed 22- 2 6 b Inspection Date Inspector Name Inspection Type Due 10/09/2008 PARKEY LARRY E FIRST INSPECTION 304626,10/31/2008 S 49.00 Tear here and retain top portion for your records INVOICE FOR INSPECTION CERTIFICATE FEES State Form 356 (R4 9 -93) h Approved by the State Board of Accounts 1991 Y Division of Fire and Building Safety 1. Mail checks payable to DEPARTMENT OF HOMELAND SECURITY INSTRUCTIONS: 2. Mail 2nd copy check to DEPARTMENT OF HOMELAND SECURITY Boiler and Pressure Vessel Safety Division 302 W WASHINGTON ST., RM 246 INDIANAPOLIS IN 46204 -2739 Telephone: (317) 232 -1921 LATEST INVOICE INDIANA CARMEL CLAY PARKS RECREATION DATE PLEASE NUMBER PAY THIS ATTN JEREMIAH KERR AMOUNTI 304626 1411 E 116TH ST 10/31/2008 CARMEL, IN 46032 \J Owner number User Name Location of vessel THE MONON CTR Fee 1235 CENTRAL PARK DR E CARMEL IN 46032 49.00 Serial number Description of vessel Manufacturer Date Last Inspected W T Boiler LOCHINVAR 10/09/2008 National Board No. Inspection agency Name of inspector (This fee is 181626 STATE OF INDIANA PARKEY LARRY E prescribed by IC 22- 12 -6 -10) Pumhm oesw"M a NOV 1 8 2008. P.O.0 P 01F Bu P LJne� ru Date )��Date t —v INVOICE FOR INSPECTION CERTIFICATE FEES o a State Form 356 (R419 -93) -._s —�r--� a Approved by the State Board of Accounts 1991 Division of Fire and Building Safety a y 1. Mail checks payable to DEPARTMENT OF HOMELAND SECURITY N V 1 2008 2. Mail 2nd copy check to DEPARTMENT OF HOMELAND SECURITY O INSTRUCTIONS: Boiler and Pressure Vessel Safety Division 302 W WASHINGTON ST., RM 246 T. INDIANAPOLIS IN 46204 -2739 Telephone: (317) 232 -1921 INDIANA CARMEL CLAY PARKS RECREATION LATEST PLEASE NUMBER INVOICE PAY THIS ATTN JEREMIAH KERR DATE AMOUNT! 304627 1411 E 116TH ST CARMEL, IN 46032 10/31/2008 Owner number User Name Location of vessel THE MONON CTR Fee 1235 CENTRAL PARK DR E 49.00 CARMEL IN 46032 Serial number Description of vessel Manufacturer Date Last Inspected W T Boiler LOCHINVAR 10/09/2008 National Board No. Inspection agency Name of inspector (This fee is 181533 STATE OF INDIANA PARKEY LARRY E prescribed by IC 22- 12 -6 -10) Inspection Date Inspector Name Inspection Type Due 10/09/2008 PARKEY LARRY E FIRST INSPECTION--304627,10/31/2008 49.00 Tear here and retain top portion for your records r r INVOICE FOR INSPECTION CERTIFICATE FEES IQ .n :P Slate Form 356 (R4 9 -93) Approved by the State Board of Accounts 1991 .q Division of Fire and Building Safety ois L Mail checks payable to DEPARTMENT OF HOMELAND SECURITY INSTRUCTIONS: 2. Mail 2nd copy check to DEPARTMENT OF HOMELAND SECURITY Boiler and Pressure Vessel Safety Division 302 W WASHINGTON ST., RM 246 INDIANAPOLIS IN 46204 -2739 Telephone: (317) 232 -1921 LATEST INVOICE PLEASE INDIANA CARMEL CLAY PARKS RECREATION DATE PAY THIS NUMBER ATTN JEREMIAH KERR AMOUNT! 304627 1411 E 116TH ST 10/31/2008 I CARMEL, IN 46032 User Name Location of vessel THE MONON CTR Fee Owner number 1235 CENTRAL PARK DR E CARMEL IN 46032 49.00 Serial number Description of vessel Manufacturer Date Last Inspected W T Boiler LOCHINVAR 10/09/2008 National Board No.. Inspection agency Name of inspector (This fee is 181533 STATE OF INDIANA PARKEY LARRY E prescribed by IC 22- 12 -6 -10) Purchm Dmd P.O. 0 PorF T. Budget u neDesctr �aiu ►J i'naE NOV 1 8 2008 Purchaser Date APProval Date INVOICE FOR INSPECTION CERTIFICATE FEES State Form 356 (R4 9 -93) Ad by the State Board of Accounts 1991 pp 2008 Q 1$ Approv I O t V f 1 O f Division of Fire and Building Safety e 1. Mail checks payable to DEPARTMENT OF HOMELAND SECURITY 2. Mail 2nd copy check to DEPARTMENT OF HOMELAND SECURITY INSTRUCTIONS: Boiler and Pressure Vessel Safety Division 302 W WASHINGTON ST., RM 246 INDIANAPOLIS IN 46204 -2739 Telephone: (317) 232-1921 INDIANA CARMEL CLAY PARKS RECREATION LATEST PLEASE NUMBER INVOICE PAY THIS ATTN JEREMIAH KERR DATE AMOUNTI 304628 1411 E 116TH ST CARMEL, IN 46032 10/31/2008 I I Owner number User Name Location of vessel THE MONON CTR Fee 1235 CENTRAL PARK DR E 65.00 CARMEL IN 46032 -F Serial number Description of vessel l Manufacturer Date Last Inspected W T Boiler LOCHINVAR 10/09/2008 National Board No. Inspection agency Name of inspector (This fee is 181629 STATE OF INDIANA PARKEY LARRY E prescribed by IC 22- 12 -6 -10) Inspection Date Inspector Name Inspection Typc Due 10/09/2008 PARKEY LARRY E FIRST INSPECTION 304628,10/31/2008 S 65.00 Tear here and retain top portion for your records tsr °'�o INVOICE FOR INSPECTION CERTIFICATE FEES State Form 356 (R4 9 -93) N'4n Approved by the State Board of Accounts 1991 Division of Fire and Building Safety ._(MI6 1. Mail checks payable to DEPARTMENT OF HOMELAND SECURITY INSTRUCTIONS: 2. Mail 2nd copy check to DEPARTMENT OF HOMELAND SECURITY Boiler and Pressure Vessel Safety Division 302 W WASHINGTON ST., RM 246 INDIANAPOLIS IN 46204 -2739 Telephone: (317) 232-1921 LATEST INVOICE INDIANA DATE PLEASE CARMEL CLAY PARKS RECREATION PAY THIS NUMBER ATTN JEREMIAH KERR AMOUNTI 304628 1411 E 116TH ST 10/31/2008 CARMEL, IN 46032 User Name Location of vessel THE MONON CTR Fee Owner number 1235 CENTRAL PARK DR E CARMEL IN 46032 65.00 Serial number Description of vessel Manufacturer Date Last Inspected W T Boiler LOCHINVAR 10/09/2008 National Board No. Inspection agency Name of inspector (This fee is 181629 STATE OF INDIANA PARKEY LARRY E prescribed by IC 22- 12 -6 -10) irt;haSe G,, I�pQ1G�as' C PorF q 7- `l3t �d000 7-77-L4" Ldget ine Descr GL{' ?008 I Purchaser Da�� Appro INVOICE FOR INSPECTION CERTIFICATE FEES o State Form 356 (R4 9 -93) sly t Approved by the State Board of Accounts 1991 NO Q Division of Fire and Building Safety N O 1 O 200$ a c 1, Mail checks payable to DEPARTMENT OF HOMELAND SECURITY 2. Mail 2nd copy check to DEPARTMENT OF HOMELAND SECURITY INSTRUCTIONS: Boiler and Pressure Vessel Safety Division 302 W WASHINGTON ST., RM 246 INDIANAPOLIS IN 46204 -2739 Telephone: (317) 232 -1921 INDIANA CARMEL CLAY PARKS RECREATION LATEST PLEASE NUMBER ATTN JEREMIAH KERR INVOICE AY THIS P DATE AMOUNT! 304629 1411 E 116TH ST CARMEL, IN 46032 10/31/2008 J Owner number User Name Location of vessel THE MONON CTR Fee 1235 CENTRAL PARK DR E 43.00 CARMEL IN 46032 Serial number Description of vessel Manufacturer Date Last Inspected W T Bailer LOCHINVAR 10/09/2008 National Board No. Inspection agency Name of inspector (This fee is STATE OF INDIANA PARKEY LARRY E prescribed by IC 22- 12 -6 -10) Inspection Date Inspector Name Inspection Type Due 10/09/2008 PARKEY LARRY E FIRST INSPECTION 304629,10/31/2008 S 43.00 Tear here and retain top portion for your records .S.. 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 r>,6 1. Mail checks payable to DEPARTMENT OF HOMELAND SECURITY INSTRUCTIONS: 2. Mail 2nd copy check to DEPARTMENT OF HOMELAND SECURITY Boiler and Pressure Vessel Safety Division 302 W WASHINGTON ST., RM 246 INDIANAPOLIS IN 46204 -2739 Telephone: (317) 232 -1921 LATEST INVOICE INDIANA ATTN JEREMIAH KERR AMOUNT! NA DATE PLEASE CARMEL CLAY PARKS RECREATION PAYTHIS 29 1411 E 116TH ST 16/31/2008 j CARMEL, IN 46032 VV User Name Location of vessel THE MONON CTR Fee Owner number 1235 CENTRAL PARK DR E CARMEL IN 46032 43.00 Sepal number Description of vessel Manufacturer Date Last Inspected W T Boiler LOCHINVAR 10/09/2008 National Board No. Inspection agency Name of inspector (This fee is STATE OF INDIANA PARKEY LARRY E prescribed by IC 22- 12 -6 -10) .i1. I ._r •..q` G R. G.L. 1 �3S�oo Budget NOV 9 200$ �1�u,1 D ��G?�� Line Descr k Purchaser Date Appmy Date 1 Al D INVOICE FOR INSPECTION CERTIFICATE FEES State Form 356 (R4 9 -93) -H C v Approved by the State Board of Accounts 1991 Division of Fire and Building Safety 1! Q p 1. Mail checks payable to DEPARTMENT OF HOMELAND SECURITY N 1 V 2000 2. Mail 2nd copy check to DEPARTMENT OF HOMELAND SECURITY INSTRUCTIONS: Boiler and Pressure Vessel Safety Division 302 W WASHINGTON ST., RM 246 INDIANAPOLIS IN 46204 -2739 Telephone: (317) 232 -1921 INDIANA CARMEL CLAY PARKS RECREATION LATEST PLEASE NUMBER INVOICE PAY THIS ATTN JEREMIAH KERR DATE AMOUNT! 304631 1411 E 116TH ST CARMEL, IN 46032 10/31/2008 J Owner number User Name Location of vessel THE MONON CTR Fee 1235 CENTRAL PARK DR E 43.00 CARMEL IN 46032 Serial number I Description of vessel Manufacturer Date Last Inspected W T Boiler AO SMITH 10/09/2008 National Board No. Inspection agency Name of inspector (This fee is C12490 STATE OF INDIANA PARKEY LARRY E prescribed by IC 22- 12 -6 -10) inspection Date Inspector Name Inspection Type Due 10/09/2008 PARKEY LARRY E FIRST INSPECTION 304631,10/31/2008 43.00 Tear here and retain top portion for your records INVOICE FOR INSPECTION CERTIFICATE FEES State Form 356 (R4 9 -93) Approved by the Slate 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 DEPARTMENT OF HOMELAND SECURITY Boiler and Pressure Vessel Safely Division 302 W WASHINGTON ST., RM 246 INDIANAPOLIS IN 46204 -2739 Telephone: (317) 232-1921 LATEST INVOICE INDIANA CARMEL CLAY PARKS RECREATION DATE PLEASE NUMBER PAY THIS ATTN JEREMIAH KERR AMOUNT! 304631 1411 E 116TH ST 10/31/2008 CARMEL, IN 46032 Owner number User Name Location of vessel THE MONON CTR Fee 1235 CENTRAL PARK DR E CARMEL IN 46032 43.00 Serial number Description of vessel Manufacturer Date Last Inspected W T Boiler AO SMITH 10/09/2008 National Board No. Inspection agency Name of inspector (This fee is C12490 STATE OF INDIANA PARKEY LARRY E prescribed by IC 22- 12 -6 -10) PUrchne P.o.I► PorF NOV 1 8 2008 G.LaR 7— ODdo Built r Purchaser D e Approval Date ACCOUNTS PAYABLE VOUCHER CITY OF CARMEL An invoice of 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. Department of Homeland Security Terms Boiler Pressure Vessel Safety Div 302 W Washington St., Rm 246 Indianapolis, IN 46204 -2739 Invoice Invoice Description Amount Date Number (or note attached invoices) or bill(s)) 65.00 10/31/08 304620 M.C. Boiler Inspection 43.00 10/31/08 304621 M.C. Boiler Inspection 43.00 10/31/08 304622 M.C. Boiler Inspection 49.00 10/31/08 304623 M.C. Boiler Inspection 49.00 10/31/08 304624 M.C. Boiler Inspection 49.00 10/31/08 304625 M.C. Boiler Inspection 49.00 10/31/08 304626 M.C. Boiler Inspection 49.00 10/31/08 304627 M.C. Boiler Inspection 65.00 10/31/08 304628 M.C. Boiler Inspection 43.00 10/31/08 304629 M.C. Boiler Inspection 43.00 10/31/08 304631 M.C. Boiler Inspection Total 547.00 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 20 Clerk- Treasurer Voucher No. Warrant No. Department of Homeland Security Allowed 20 Boiler Pressure Vessel Safety Div 302 W Washington St., Rm 246 Indianapolis, IN 46204 -2739 In Sum of 547.00 ON ACCOUNT OF APPROPRIATION FOR 104 Program Fund PO# or INVOICE NO. ACCT #fTITLE AMOUNT Board Members Dept 1047 304620 4350000 65.00 1 hereby certify that the attached invoice(s), or 1047 304621 4350000 43.00 bill(s) is (are) true and correct and that the 1047 304622 4350000 43.00 materials or services itemized thereon for 1047 304623 4350000 49.00 which charge is made were ordered and 1047 304624 4350000. 49.00 received except 1047 304625 4350000 49.00 1047 304626 4350000 49.00 1047 304627 4350000 49.00 1047 304628 4350000 65.00 1047 304629 4350000 43.00 18 -Nov 2008 1047 304631 4350000 43.00 Signature 547.00 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund