155786 01/23/2008 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: $291.30
INDIANAPOLIS IN 46201 CHECK NUMBER: 155786
CHECK DATE: 1/23/2008
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4239011 47811 154.50 SPECIAL DEPT SUPPLIES
1120 4350900 47811 136.80 OTHER CONT SERVICES
i
e
JDJACOB-DIETZ,
INC. Invoice
P R O T E C T I O N 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 1/11/2008 47811
Bill To: Ship To:
Carmel Fire Department Carmel Fire Department
2 Civic Square 2 Civic Square
Carmel, IN 46032 Carmel, IN 46032
P.O. No. Work Order Terms Due Date Rep Project
Gary/ Bob 1/11/2008 Carmel Fire Departm...
Quantity Description Rate Amount
1 20# ABC recharge 24.25 24.25
1 OR29 Neck o -ring 1.15 1.15
1 Amerex stem 4.00 4.00
3 New 10# ABC Fire Extinguisher 51.50 154.50
3 Vehicle bracket with rubber strap 35.80. 107.40
Subtotal $291.30
Sales Tax (0.0 $0.00
Total $291.30
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 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))
Y
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
VOUQ,'•HER 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
Soo. -ov �3e.�,o materials or services itemized thereon for
which charge is made were ordered and
received except
Signature
Cost distribution ledger classification if
Title
claim paid motor vehicle highway fund