HomeMy WebLinkAbout205496 01/17/2012 CITY OF CARMEL, INDIANA VENDOR: 229400 Page 1 of 1
ONE CIVIC SQUARE INDIANA DEPT OF HOMELAND SECURIT�'
CARMEL, INDIANA 46032 DIV OF ELEVATOR SAFETY- FISCAL OFFI HECK AMOUNT: $120.00
302 W WASHINGTON ST, RM E221 CHECK NUMBER: 205496
INDIANAPOLIS IN 46204
CHECK DATE: 1/17/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1091 4358300 120.00 73424112272011
CARMEL /CLAY BOARD OF PARKS RECREATION 1411 E 116TH ST Pat Schlemmer CARMEL IN 46032
1.If Code An annual test report is due before a 2 is issued.
2.If Code A 5 year Test report is due befor a permit is issued.
3.Over due fees must be paid be fore a permit is issued.
If elevator(s) are not in service please request an "ELEVATOR OUT OF SERVICE
AFFIRMATION" form.
State No Due Over Due Location Address
111703 $120.00 0.00 1235 CENTRAL PARK DR EAST, CARMEL IN 40632
Purchase p EL r-
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Description (,LnQu,� 11.4-r/
P.O.# PorF 0 e 7
G.L. ()9/- 358 300 sy
Burlvet p o UC nnCC C 2 8 2011
I_irie bescr F Exl `f 0
Purchaser Date
Approval Date 2 z I Ll a
Reference Number Invoice Date Please submit ENTIRE document with payment
734241 12272011 -1 12/27/2011 Unit(s) 1 Total Due upon receipt
of 1 120.00 of 120.00
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
12/27/11 734241122720111 Annual elevator permit 120.00
Total 120.00
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
120.00 4
ON ACCOUNT OF APPROPRIATION FOR
109 Monon Center
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1091 734241122720111 4358300 120.00 1 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
11 -Jan 2012
�Jr'fi
Signature
120.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund