180152 12/08/2009 CITY OF CARMEL, INDIANA VENDOR: 00351351 Page 1 of 1
ONE CIVIC SQUARE JACOB- DIETZ, INC CHECK AMOUNT: $217.35
CARMEL, INDIANA 46032 2706 E MICHIGAN Sr
INDIANAPOLIS IN 46201 CHECK NUMBER: 180152
CHECK DATE: 12/8/2009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2201 4239020 50584 217.35 FIRE PREVENTION SUPPL
JACOB-DETZ, INC. Invoice
F I R E 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 11/24/2009 50584
Bill To: Ship To:
City of Carmel Streets Department
One Civic Square 3400 West 131 st Street
Carmel, IN 46032 Westfield, IN 46074
P.O. No. Work Order Terms Due Date Rep Project
Fire Demo 22022 11/24/2009 Streets Department
Quantity Description Rate Amount
7 10# ABC recharge 25.50 178.50
1 5# ABC recharge 15.50 15.50
1 OR27 Neck o -ring 1.15 1.15
20 Pull Pin 0.50 10.00
20 Bullseye flag seal white 0.11 2.20
1 Truck charge 10.00 10.00
Subtotal $217.35
Sales Tax (0.0 $0.00
Total $217.35
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))
11/24/09 50584 $217.35
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. WARR NO.
ALLOWED 20
Jacob Dietz Inc
IN SUM OF
2708 E. Michigan St.
Indianapolis, IN 46201
$217.35
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO# Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Members
2201 50584 42- 390.20 $217.35 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
Friday, December 04, 2009
Street Commissioner
-street
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund