171901 04/29/2009 CITY OF CARMEL, INDIANA VENDOR: 00351351 Page 1 of 1
F ONE CIVIC SQUARE JACOB- DIETZ, INC CHECK AMOUNT: $208.50
CARMEL, INDIANA 46032 2708 E MICHIGAN ST
'Lees �o. INDIANAPOLIS IN 46201 CHECK NUMBER: 171901
CHECK DATE: 4/2912009
DEPARTMENT ACCOUNT PO NUMBE INVOICE NUMBER AMOUNT DESCRIPTION
1120 4350900 49309 46.65 OTHER CONT SERVICES
1110 4239099 49311 161.85 OTHER MISCELLANOUS
I
JACOBnETZ, INC. Invoice
FIRE PROTECTION SPECIALISTS
2708 East Michigan Street Date Invoice
Indianapolis, IN 46201
317 -631 -2304 Fax 317- 631 -3117 3/31/2009 49311
Bill To: Ship To:
Carmel Police Department Carmel Police Department
3 Civic Square 3 Civic Square
Carmel, IN 46032 Carmel, IN 46032
P.O. No. Work Order Terms Due Date Rep Project
3/31/2009 Carmel Police Depar...
Quantity Description Rate Amount
3 5# ABC recharge 15.50 46.50
3 54 ABC test recharge 25.15 75.45
6 OR27 Neck o -ring 1.15 6.90
4 Badger stem 5.50 22.00
2 Kidde stem 4.00 8.00
6 Pull Pin 0.50 3.00
Yellow is JDI copy please sign. Subtotal $161.85
White is delivery copy for Customer.
Sales Tax (0.0 $0.00
Total $161.85
Prescribed by State Board of Accounts City Form No. 201 (Rev. 1995)
ACCOUNTS PAYABLE VOUCHER
r "j
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
.Jacob- Dietz, Inc. Purchase Order No.
2708 East MIchigan Street Terms
Indianapolis, IN 46201 Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
3 49111 e t r extinguisher service 161.85
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
VOUCHER NO. WARRANT NO.
ALLOWED 20
J acbb- Dietz, Inc. IN SUM OF
2708 East Michigan Street
Indianapolis, IN 46201
161.85
ON ACCOUNT OF APPROPRIATION FOR
police general fund
Board Members
PO# or INVOICE NO. ACCT #/TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
1110 49311 390 -99 161.85 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
April 21 20 09
Signature
Chief of Police
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund
F J D ACOB DIETZ, INC. Invoice
I R E P R O T E C T 1 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 3/31/2009 49309
Bill To: Ship To:
Cannel Fire Department
2 Civic Square
Carmel, IN 46032
P.O. No. Work Order Terms Due Date Rep Project
3/31/2009 Carmel Fire Departm...
Quantity Description Rate Amount
1 20# ABC recharge 40.50 40.50
1 Amerex stem 5.00 5.00
1 OR27 Neck o -ring 1.15 1.15
Yellow is JDI copy please sign.
White is delivery copy for Customer. Subtotal $46.65
Sales Tax (0.0 $0.00
Total $46.65
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))
49309 Recharge Extinguishers $46.65
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. WARRA NO.
ALLOWED 20
Jacoh Dietz
IN SUM OF
2708 East Michigan Street
Indianapolis, IN 46201
$46.65
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members
1120 49309 43- 509.00 $46.65 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
APR 2 7 200
t f
r- ff
1 V
Fire Chief
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund