HomeMy WebLinkAbout170367 04/01/2009 r CITY OF CARMEL, INDIANA VENDOR: 362497 Page 1 of 1
ONE CIVIC SQUARE DEPARTMENT OF HOMELAND SECURITY
CARMEL, INDIANA 46032 BOILER AND PRESS. VALVE SAFETY DIV CHECK AMOUNT: $25.00
s• 302 W WASHINGTON ST, RM 246 CHECK NUMBER: 170357
M INDIANAPOLIS IN 46204 -2739
CHECK DATE: 4/1/2009
DEPARTMENT ACCOUNT PO N UMBER INVO NU MBER AMOUNT DESCRIPTION
651 50.23990 031009 25.00 OTHER EXPENSES
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retain top portion for your records
s.° *ga INVOICE FOR IN IPECTI CERTIFICATE FEES
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State Form 356 (R4 9 -93)
Approved by the State Board of Accounts 1991
Division of Fire and Building Safety
1. Mail checks payable to DEPARTMENT OF HOMELAND SECURITY
INSTRUCTIONS: 2. Mail 2nd copy check to DEPARTMENT OF HOMELAND SECURITY
Boiler and Pressure Vessel Safety Division
y 302 W WASHINGTON ST., RM 246
INDIANAPOLIS IN 46204 -2739
Telephone: (317) 232 -1921
LATEST
INVOICE
INDIANA CARMEL CITY OF DATE PLEASE
NUMBER PAY THIS
ATTN ADMINISTRATOR AMOUNTI
290011 1 CIVIC SQ 03/10/2009
CARMEL, IN 46032
User Name Location of vessel WASTE WATER TREATMENT PLT Fee
Owner number
9609 HAZEL DELL PKWY T INDIANAPOLIS IN 46280 25.00
Serial number Description of vessel Manufacturer Date Last Inspected
FIRE TUBE FIRE BOX BOILER BURNHAM 02/20/2009
National Board No. Inspection agency Name of inspector (This fee is
28519 TRAVELERS LAW FORREST J prescribed by
IC 22- 12 -6 -10)
Prescribed by State Board of Accounts City Form No. 201 (Rev 1995) I
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice or bill to be properly itemized must show, kind of service, where t.
performed, dates of service rendered, by whom, rates per day, number of units,
price per unit, etc.
Payee
362497
DEPARTMENT OF HOMELAND SECURITY Purchase Order No.
BOILER AND PRESSURE VESSEL SAFETY DI\ Terms
302 W WASHINGTON ST RM 246 Due Date 3/24/2009
INDIANAPOLIS, IN 46204
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
3/24/2009 031009 $25.00
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hereby certify that the attached invoice(s), or bill(s) is (are) true and
orrect and I have audited same in accordance with IC 5- 11- 10 -1.6
Date Officer
V�UCHER 095338 WARRANT ALLOWED
3r52497 IN SUM OF
DEPARTMENT OF HOMELAND SECUF
BOILER AND PRESSURE VESSEL SAF
302 W WASHINGTON ST RM 246
INDIANAPOLIS, IN 46204
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
031009 01- 7362 -05 $25.00
Voucher Total $25.00
Cost distribution ledger classification if
claim paid under vehicle highway fund