156668 02/21/2008 CITY OF CARMEL, INDIANA VENDOR: 00351351 Page 1 of 1
ONE CIVIC SQUARE JACOB- DIETZ, INC
,o CARMEL, INDIANA 46032 2708 E MICHIGAN ST CHECK AMOUNT: $90.30
INDIANAPOLIS IN 46201 CHECK NUMBER: 156668
CHECK DATE: 2/2112008
DEPARTMENT AC COUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4239011 47897 90.30 SPECIAL DEPT SUPPLIES
J DJACOB-nETZ, INC. Invoice
F I R E P R O T E C T I O N SPEC I A L I S T S
2708 East Michigan Street Date Invoice
Indianapolis, IN 46201
317 631 -2304 Fax 317- 631 -3117 2/11/2008 47897
Bill To: Ship To:
Carmel Fire Department New Ambulance
2 Civic Square
Carmel, IN 46032
P.O. No. Work Order Terms Due Date Rep Project
2/11/2008 Carmel Fire Departm...
Quantity Description Rate Amount
1 New 10# ABC Fire Extinguisher 51.50 51.50
1 Vehicle bracket with rubber strap 38.80 38.80
Yellow is JDI copy please sign.
White is delivery copy for Customer. Subtotal $90.30
Sales Tax (0.0 $0.00
Total $90.30
Prescr(bed 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
Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
Total ao :3a
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.
ALLOWED 20
IN SUM OF
ON ACCOUNT OF APPROPRIATION FOR
Board Members
PO# or INVOICE NO. ACCT #/TITLE AMOUNT
DEPT. I 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
20 0�
PLO k at
Cost distribution ledger classification if Title X claim paid motor vehicle highway fund