161906 07/23/2008 CITY OF CARMEL, INDIANA VENDOR: 00351351 Page 1 of 1
ONE CIVIC SQUARE JACOB- DIETZ, INC
CARMEL, INDIANA 46032 2708 E MICHIGAN ST CHECK AMOUNT: $60.00
INDIANAPOLIS IN 46201 CHECK NUMBER: 161906
CHECK DATE: 7/23/2008
DE PARTMENT ACCOUNT PO NUMBER I NUMBER AMOUNT DESCRIPTION
1205 4351501 48345 60.00 EQUIPMENT MAINT CONTR
D jAcoB-DiETz, INC. Invoice
F I R E PROTECTION S P E C I A L I S T S
2708 East Michigan Street Date Invoice
Indianapolis, IN 46201
317- 631 -2304 Fax 317- 631 -3117 6/30/2008 48345
Bill To: Ship To:
City of Carmel Carmel City Building
One Civic Square
Carmel, W 46032
P.O. No. Work Order Terms Due Date Rep Project
6/30/2008 Carmel City Building
Quantity Description Rate Amount
20 Fire Extinguisher annual inspection 2.75 55.00
1 Truck charge 5.00 5.00
Subtotal $60.00
Sales Tax (0.0 $0.00.
TOM 60.00
Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No. 201 (Rev. 1995)
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
Jacob Dietz, Inc. Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
48345 Re Extinguisher annual inspection 0.00
Total
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.
07/21 /08
ALLOWED 20
Jacob Dietz, Inc. IN SUM OF
2708 East Michigan Street
Indianapolis, IN 46201
$60.00
ON ACCOUNT OF APPROPRIATION FOR
GENERAL FUND
1205 Administration
Board Members
DEPT or INVOICE NO. ACCT #!TITLE AMOUNT I hereby certify that the attached invoice(s), or
bill(s) is (are) true and correct and that the
19n 48346— 616 0 Faterials or services itemized thereon for
which charge is made were ordered and
received except
20
ignature
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund