174959 07/22/2009 CITY OF CARMEL, INDIANA VENDOR: 00351351 Page 1 of 1
ONE CIVIC SQUARE JA E MICHIGAN ST
-DIET INC CHECK AMOUNT: $1,503.05
CARMEL, INDIANA 46032 INDIANAPOLIS IN 46201 CHECK NUMBER: 174959
CHECK DATE: 7/22/2009
DEPARTME ACCO PO NUM INVOICE NUMBER AMOUNT DESCRIPTION y
2201 4239020 49723 551.45 FIRE PREVENTION SUPPL
1120 4350900 49765 865.45 OTHER CONT SERVICES
1205 4351501 49770 86.15 EQUIPMENT MAINT CONTR
-IS
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 6/30/2009 49770
Bill To: Ship To:
City of Carmel Carmel City Building
One Civic Square
Carmel, W 46032
P.O. No. Work Order Terms Due Date Rep Project
6/30/2009 Carmel City Building
Quantity Description Rate Amount
19 Fire Extinguisher annual inspection 3.00 57.00
1 10# ABC 6 year maintenance 13.00 13.00
1 OR27 Neck o -ring 1.15 1.15
1 Amerex stem 5.00 5.00
1 Truck charge 10.00 10.00
Subtotal $86.15
Sales Tax (0.0 $0.00
Total
$86.15-
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
J acob Dietz, Inc. Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
Ni3ofog 49770 Fire ExtingUisher annual inspection
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.
07720/
ALLOWED 20
:dcob- Dietz, In
IN SUM OF
2708 East Michigan Street
Indianapolis, IN 46201
$86.15
ON ACCOUNT OF APPROPRIATION FOR
GENERAL FUND
1205 Administration
Board Members
PO# or
DEPT. INVOICE NO. ACCT #/TITLE AMOUNT I hereby certify that the attached invoice(s), or
bill(s) is (are) true and correct and that the
1205 49770 15 materials or services itemized thereon for
which charge is made were ordered and
received except
20
r
l sign e
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
V
JACOB DIETZ, INC. Invoice
FIRE PROTECTION SPECIALISTS
2708 East Michigan Street Date Invoice
Indianapolis, IN 46201
317- 631 -2304 Fax 317 -631 -3117 1 6/29/2009 49723
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
6/29/2009 Streets Department
Quantity Description Rate Amount
62 Fire Extinguisher annual inspection 3.00 186.00
12 10# ABC 6 year maintenance 13.00 156.00
5 5# ABC hydrotest 13.65 68.25
1 5# ABC 6 year maintenance 10.00 10.00
18 OR27 Neck o -ring 1.15 20.70
5 Badger stem 5.50 27.50
13 Amerex stem 5.00 65.00
16 Hazardous Material Communication Label 0.50 8.00
1 Truck charge 10.00 10.00
Subtotal $551.45
Sales Tax (0.0 $0.00
Total $551.45
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))
06/29/09 49723 $551.45
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. WAR NO.
ALLOWED 20
Jacob Dietz Inc
IN SUM OF
2708 E. Michigan St.
Indianapolis, IN 46201
$55 1.4 5
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT
Board Members
2201 49723 42 390.20 $551.45 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
n
Friday JuI�r�12009
E r'
Street Commissioner
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
Jul 08 09 11:20a Jacob- Dietz,lnc 3176313117 p.2
J1JJAcoB-DiETz, 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 61302009 49765
Bill To: Ship To:
Carmel Fire Department
2 Civic Square
Carmel, IN 46032
P.O. No. Work Order Terms Due Date Rep Project
7/8/2009 Carmel Fire Devartm...
Quantity Description Rate Amount
105 Fire Extinguisher annual inspection 3.00 315.00
4 10# ABC 6 year maintenance 13.00 52.00
4 104 ABC hydrotest 16.65 66.60
6 Liter K test recharge 73.00
2 2 -112 Gallon Water hydrotest 15.15 30.30
2 20# ABC recharge 40.50 81.00
2 204 ABC 6 year maintenance 20.00 40.00
2 204 ABC hydrotest 23.65 47.30
1 59 ABC recharge 15.50 1 5.50
9 OR27 Neck o -ring 1.15 10.35
4 Badger stem 5.50 22.00
4 Amerex stem 5.00 20.00
9 OR29 Neck o -ring 1.15 10.35
1 340037K Neck o -ring 1.75 1.75
6 Amerex stem 5.25 31.50
1 Valve Stem for K 11.40 11.40
2 .Badger Stem 6.00 12.00
1 Kidde Valve Stem 4.00 4.00
1 Kidde stem 4.00 4.00
Subtotal
Sales Tax (0.0
Total
Page 1
Jul 08 09 11:20a Jacob- Dietz,lnc 3176313117 p.3
r I P E
JACOBDIETZ, INC. Invoice
P R O T E C T 1 0 N S P E C I A L I S T S
2708 East Michigan Street Date Invoice
Indianapolis, IN 48201
317- 631 -2304 Fax 317- 631 -3117 6/30/2009 49765
Bill To: Ship To:
Carmel Fire Department
2 Civic Square
Carmel, IN 46032
P.O. No. Work Order# Terms Due Date Rep Project
7/8/2009 Carmel Fire Deparnm...
Quantity Description Rate Amount
2 100 psi gauge (water) 4.50 9.00
2 Air Valve for water ext. 2.20 4.40
8 Hazardous Material Communication Label 0.50 4.00
Subtotal $865.45
Sales Tax (0.0 $0.00
Total $865.45
Page 2
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))
49765 $865.45
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. ,WAR NO.
ALLOWED 20
Jacob Dietz
IN SUM OF
2708 East Michigan Street
Indianapolis, IN 46201
$865.45
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members
1120 49765 43- 509.00 $865.45 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
2 0 2009
Fire Chief
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund