172393 05/13/2009 CITY OF CARMEL, INDIANA VENDOR: 00351351 Page 1 of 1
ONE CIVIC SQUARE JACOB- DIETZ, INC CHECK AMOUNT: $390.00
CARMEL, INDIANA 46032 2708 E MICHIGAN ST
off _o INDIANAPOLIS IN 46201 CHECK NUMBER: 172393
CHECK DATE: 5/13/2009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4350900 7686 300.00 OTHER CONT SERVICES
651 5023990 7867 90.00 OTHER EXPENSES
P w
JACOB,nETZ, INC.
Invoice
I I R L P I i U I L C I I O N S P L C I A L I S I S
2708 East Michigan Street Date Invoice
Indianapolis, IN 46201
4/27/2009 7687
31.7 -631 -2304 Fax 317 -631 -3117
Bill To: Ship To:
Carmel Utilities City of Carmel HEW
760 3rd Avenue SW 901 Rangeline Road
Carmel, IN 46032 Carmel, IN 46032
P.O. No. Work Order Terms Due Date Rep Project
4/27/2009 Carmel Utilities
Quantity Description Rate Amount
1 Semi- annual inspection of dry chemical Fire Protection system for HHW 90.00 90.00
Trailer
Subtotal $90.00
Sates Tax (O.O $0.00
Total $90.00
4
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 of service rendered, by whom, rates per day, number of units,
price per unit, etc.
Payee
351351
JACOB- DIETZ, INC. Purchase Order No.
2708 E. Michigan St Terms
Indianapolis, IN 46201 Due Date 5/6/2009 p
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
5/6/2009 7687 $90.00
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
VOUCHER 095594 WARRANT ALLOWED
351351 IN SUM OF
'JACOB- DIETZ, INC.
2708 E. Michigan St
Indianapolis, IN 46201
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
j�
Board members
PO INV ACCT AMOUNT Audit Trail Code
7687 01- 736H -08 $90.00
Voucher Total $90.00
Cost distribution ledger classification if
claim paid under vehicle highway fund
J DJAcoB-DiETz, INC: Invoice
EIHL- PHU 1 1w I IUN SPLC IALIS 1 S
2708 East Michigan Street Date Invoice
Indianapolis, IN 46201
4/27/2009 7686
317- 631 -2304 Fax 31.7 -631 -3117
Bill To: Ship To:
City of Carmel Fire Department
One Civic Square
Carmel, IN 46032
P.O. No. Work Order Terms Due Date Rep Project
4/27/2009
Quantity Description Rate Amount
1 Serni- annual inspection of kitchen hood fire system for station 41 58.00 58.00
2 Fusible links 8.50 17.00
1 Semi annual inspection of kitchen hood fire system for station 45 58.00 58.00
1 Semi annual inspection of kitchen hood fire system for station 46 58.00 58.00
3 Fusible links .8.50 25.50
1 Semi annual inspection of kitchen hood fire system for station 42 58.00 58.00
3 Fusible links 8.50 25.50
Subtotal $300.00
Sales Tax (0,0 $0.00
Total $300.00
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))
7686 $300.00
a
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 N
ALLOWED 20
Jacob Dietz
IN SUM OF
2708 East Michigan Street
Indianapolis, IN 46201
$300.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO# Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Members
1120 7686 43- 509.00 $300.00 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
MAY 112009
Fire Chief
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund