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Home My WebLink About199059 07/06/2011 CITY OF CARMEL, INDIANA VENDOR: 229400 Page 1 of 1 ONE CIVIC SQUARE INDIANA DEPT OF HOMELAND SECURI CARMEL, INDIANA 46032 HECK AMOUNT: $150.00 DIV OF ELEVATOR SAFETY- FISCAL OFFI 302 W WASHINGTON ST, RM E221 CHECK NUMBER: 199059 INDIANAPOLIS IN 46204 CHECK DATE: 716/2011 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1093 4350100 304625 25.00 BUILDING REPAIRS MA 1093 4350100 304626 25.00 BUILDING REPAIRS MA 1093 4350100 304627 25.00 BUILDING REPAIRS MA 1093 4350100 304628 25.00 BUILDING REPAIRS MA 1093 4350100 304629 25.00 BUILDING REPAIRS MA 1093 4350100 304631 25.00 BUILDING REPAIRS MA INVOICE FOR INSPECTION CERTIFICATE FEES State Form 356 (R4 9 -93) j� Approved by the State Board of Accounts 1991 Division of Fire and Building Safety You can pay all your payments online at IDHS web site T; 1. Mail checks payable to DEPARTMENT OF HOMELAND SECURITY https:Hmyorade .in.gov /dfbs /idhsFeesFines/ 2. Mail 2nd copy check to DEPARTMENT OF HOMELAND SECURITY start.do with Visa /Master Card /Discover INSTRUCTIONS: Boiler and Pressure Vessel Safety Division Indiana St Owner Id on this letter or 302 W WASHINGTON ST., RM 246 INDIANAPOLIS IN 46204 -2739 Indiana State Number paying the invoice to pull Telephone: (317) 232 -1921 up information when paying the dues online, INDIANA STATE NUMBER LATEST PLEASE CARMEL CLAY PARKS RECREATION PAY 304625 ATTN TERRY MYERS INVOICE AMOUN DATE AMOUNT! Owner Id 1411 E 116TH ST 06/09/2011 759531 CARMEL, IN 46032 Owner number User Name Location of vessel THE MONON CTR Fee 1235 CENTRAL PARK DR E 25.00 CARMEL IN 46032 Serial number i Description of vessel Manufacturer Date Last Inspected i W T Boiler LOCHINVAR 05/24/2011 i National Board No. Inspection agency Name of inspector (This fee is 181548 TRAVELERS CALHOUN JOSEPH S prescribed by 675 1AC 12 -3 -13) Inspection Date Inspector Name Inspection Type Due 05/24/2011 CALHOUN JOSEPH S RE-INSPECTION--304625,06/09/2011 25.00 �Yr- "rte INVOICE FOR INSPECTION CERTIFICATE FEES df `,io State Form 356 (R4 19 -93) j� Approved by the State Board of Accounts 1991 Division of Fire and Building Safety You can pay all your payments online at IDHS web site 1. Mail checks payable to DEPARTMENT OF HOMELAND SECURITY https: /myorade .in.gov /dfbs /idhsFeesFines/ 2. Mail 2nd copy check to DEPARTMENT OF HOMELAND SECURITY start.do with Visa /Master Card /Discover INSTRUCTIONS: Boiler and Pressure Vessel Safety Division Indiana St Owner Id on this letter or 302 W WASHINGTON ST., RM 246 INDIANAPOLIS IN 46204 -2739 Indiana State Number paying the invoice to pull Telephone: (317) 232 -1921 up information when paying the dues online. INDIANA STATE .I NUMBER I CARMEL CLAY PARKS RECREATION LATEST PLEASE INVOICE PAYTHIS 304626 I ATTN TERRY MYERS DATE AMOUNT Owner Id 1411 E 116TH ST I 759531 I CARMEL, IN 46032 06/09/2011 Owner number User Name Location of vessel THE MONON CTR Fee 1235 CENTRAL PARK DR E 25.00 CARMEL IN 46032 Serial number Description of vessel Manufacturer Date Last Inspected W T Boiler i LOCHINVAR 05/24/2011 National Board No. Inspection agency Name of inspector l (This fee is 181626 TRAVELERS CALHOUN JOSEPH S prescribed by 675 IAC 12 -3 -13) Inspection Date Inspector Name Inspection Type Due 05/24/2011 CALHOUN JOSEPH S RE-INSPECTION--304626,06/09/2011 25.00 INVOICE FOR INSPECTION CERTIFICATE FEES State Form 356 (R4 19 -93) W' Approved by the State Board of Accounts 1991 N Division of Fire and Building Safety You can pay all your payments online at 1. Mail checks payable to DEPARTMENT OF HOMELAND SECURITY IDHS web site dfbslidhsFeesFines/ https://myoracle.in.gov/dfbs/idhsFeesFines/ Mail 2nd copy check to DEPARTMENT OF HOMELAND SECURITY h tart.do with Visa n.gov/ Card /Discover INSTRUCTIONS: Boiler and Pressure Vessel Safety Division 302 W WASHINGTON ST., RM 246 cards.Use Owner Id on this letter or INDIANAPOLIS IN 46204 -2739 Indiana State Number on the invoice to pull Telephone: (317) 232 -1921 up information when paying the dues online. INDIANA STATE NUMBER CARMEL CLAY PARKS RECREATION LATEST PLEASE 304627 ATTN TERRY MYERS INVOICE I PAY THIS DATE AMOUNT! Owner Id 1411 E 116TH ST 759531 CARMEL, IN 46032 06/09/2011 Owner number User Name Location of vessel THE MONON CTR Fee 1235 CENTRAL PARK DR E 25.00 CARMEL IN 46032 Serial number i Description of vessel Manufacturer Date Last Inspected W T Boiler LOCHINVAR 05/24/2011 National Board No. Inspection agency Name of inspector (This fee is 181533 TRAVELERS CALHOUN JOSEPH S prescribed by 675 IAC 12 -3 -13) Inspection Date Inspector Name Inspection Type Due 05/24/2011 CALHOUN JOSEPH S RE-INSPECTION--304627,06/09/2011 25.00 "5T4T�o INVOICE FOR INSPECTION CERTIFICATE FEES State Form 356 (R4 9 -93) wf jp Approved by the State Board of Accounts 1991 Division of Fire and Building Safety You can pay all your payments online at 1. Mail checks payable to DEPARTMENT OF HOMELAND SECURITY IDHS web site 2. Mail 2nd copy check to DEPARTMENT OF HOMELAND SECURITY https:Hmyorade .in.gov /dfbs /idhsFeesFines/ INSTRUCTIONS: start.do with Visa /Master Card /Discover Boiler and Pressure Vessel Safety Division cards.Use Owner Id on this letter or INDIANAPOLIS IN 462004 -4- 27339 9 302 WASHINGTON 246 Indiana State Number on the invoice to pull Telephone: (317) 232 -1921 up information when paying the dues online. INDIANA STATE NUMBER I CARMEL CLAY PARKS RECREATION f LATEST PLEASE 304628 ATTN TERRY MYERS DATE AMOUNT! Owner Id 1411 E 116TH ST 759531 i CARMEL, IN 46032 06/09/2011 I Owner number User Name Location of vessel THE MONON CTR Fee 1235 CENTRAL PARK DR E 25.00 CARMEL IN 46032 Serial number Description of vessel P Manufacturer Date Last Inspected IW T Boiler LOCHINVAR 05/24/2011 National Board No. [TRAVELERS nspection agency Name of inspector (This fee is 181629 CALHOUN JOSEPH S prescribed by 675IAC 12 -3 -13) Inspection Date Inspector Name Inspection Type Due 05/24/2011 CALHOUN JOSEPH S RE-INSPECTION--304628,06/09/2011 S 25.00 INVOICE FOR INSPECTION CERTIFICATE FEES s ties State Form 356 (R4 19 -93) it Approved by the State Board of Accounts 1991 Division of Fire and Building Safety You can pay all your payments online at IDHS web site WIG 1. Mail checks payable to DEPARTMENT OF HOMELAND SECURITY ttpsJlmyoracle .in.gov /dfbs /idhsFeesFinesi tart.do with Visa Discover n.gov/ r 2. Mail 2nd copy check to DEPARTMENT OF HOMELAND SECURITY h Card INSTRUCTIONS: Boiler and Pressure Vessel Safety Division cards. with Owner Id on this letter or INDIANAPOLIS NAPOLIS IN WASHINGTON 04- 27339 9 246 Indiana State !Number on the invoice to pull Telephone: (317)232 2-1921 1921 ND up information when paying the dues online. INDIANA STATE NUMBER CARMEL CLAY PARKS RECREATION LATEST PLEASE INVOICE PAY THIS 304629 ATTN TERRY MYERS DATE AMOUNT! Owner Id 1411 E 116TH ST 759531 CARMEL, IN 46032 06/09/2011 Owner number User Name Location of vessel THE MONON CTR Fee 1235 CENTRAL PARK DR E 25.00 CARMEL IN 46032 Serial number Description of vessel Manufacturer Date La Inspected W T Blr Hot Water Heating LOCHINVAR 05/24/2011 National Board No. Inspection agency Name of inspector (This fee is TRAVELERS CALHOUN JOSEPH S prescribed by 675 AC. 12 -3 -13) Inspection Date Inspector Name Inspection Type Due 0512412011 CALHOUN JOSEPH S RE-INSPECTION--304629,06/09/2011 25.00 INVOICE FOR INSPECTION CERTIFICATE FEES o. S State Form 356 (R4 19 -93) w, it Approved by.the State Board of Accounts 1991 Division of Fire and Building Safety You can pay all your payments online at ns` 1, Mail checks payable to DEPARTMENT OF HOMELAND SECURITY IDHS web site 2. Mail 2nd copy check to DEPARTMENT OF HOMELAND SECURITY https:// myoracle .in.gov /dfbs /idhsFeesFines/ INSTRUCTIONS: start.do with Visa /Master Card /Discover Boiler and Pressure Vessel Safety Division cards.Use Owner Id on this letter or INDIANAPOLIS IN 462004 4 -27339 9 W WASHINGTON 246 Indiana Slate Number on the invoice to pull ND Telephone. (317) 232 -1921 up information when paying the dues online. E INDIANA STATE NUMBER CARMEL CLAY PARKS RECREATION k LATEST PLEASE 304631 ATTN TERRY MYERS INVOICE PAY THIS DATE AMOUNT! Owner Id 1411 E 116TH ST I -I 06/09/2011 f 759531 CARMEL, IN 46032 j Owner number User Name Location of vessel THE MONON CTR Fee 1235 CENTRAL PARK DR E 25.00 CARMEL IN 46032 Serial number Description of vessel Manufacturer Date Last Inspected W T Boiler AO SMITH 1 05/24/2011 National Board No. Inspection agency Name of inspector (This fee is C12490 TRAVELERS CALHOUN JOSEPH S prescribed by 675 IAC 12 -3 -13) Inspection Date Inspector Name Inspection Type Due 05/24/2011 CALHOUN JOSEPH S, RE- INSPECTION 304631,06/09/2011 25.00 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. 229400 Indiana Department of Homeland Security Terms Fiscal Department 302 W Washington St., Rm E221 Indianapolis, IN 46204 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) PO Amount 6/9/11 304625 Boiler safety inspections 25.00 6/9/11 304626 Boiler safety inspections 25.00 6/9/11 304627 Boiler safety inspections 25.00 6/9/11 304628 Boiler safety inspections 25.00 6/9/11 304629 Boiler safety inspections 25.00 6/9/11 304631 Boiler safety inspections 25.00 Total 150.00 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 Voucher No. Warrant No. 229400 Indiana Department of Homeland Security Allowed 20 Fiscal Department 302 W Washington St., Rm E221 Indianapolis, IN 46204 In Sum of 150.00 ON ACCOUNT OF APPROPRIATION FOR 109 Monon Center PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members Dept 1093 304625 4350100 25.00 1 hereby certify that the attached invoice(s), or 1093 304626 4350100 25.00 bill(s) is (are) true and correct and that the 1093 304627 4350100 25.00 materials or services itemized thereon for 1093 304628 4350100 25.00 which charge is made were ordered and 1093 304629 4350100 25.00 received except 1093 304631 4350100 25.00 28 -Jun 2011 Signature 150.00 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund