175757 08/06/2009 CITY OF CARMEL, INDIANA VENDOR: 00351351 Page 1 of 1
ONE CIVIC SQUARE JACOB- DIETZ, INC CHECK AMOUNT: $1,126.70
CARMEL, INDIANA 46032 INDIANAPOLIS MICH 46201
CHECK NUMBER: 175757
CHECK DATE: 816/2009
DE PARTMENT ACCOU PO NUMBER INVOICE NUM BER AMOUN DESCRIPTION
651 5023990 49797 38.40 OTHER EXPENSES
601 5023990 49798 234.50 OTHER EXPENSES
601 5023990 49799 208.20 OTHER EXPENSES
651 5023990 49800 488.25 OTHER EXPENSES
651 5023990 49801 157.35 OTHER EXPENSES
Z7
j"JAcoB-DiETz, INC. Invoice
F I RE 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 49798
Bill To: Ship To:
Water Distribution Water Distribution
760 3rd Avenue SW 760 3rd Avenue SW
Carmel, IN 46032 Carmel, IN 46032
P.O. No. Work Order Terms Due Date Rep Project
6/30/2009 Water Distribution
Quantity Description Rate Amount
28 Fire Extinguisher annual inspection 3.00 84.00
2 5# ABC 6 year maintenance 10.00 20.00
5 2 -1/2# ABC 6 year maintenance 7.25 36.25
1 2-1/2# ABC hydrotest 8.00 8.00
1 IS# CO2 test recharge 25.00 25.00
8 OR27 Neck o -ring 1.15 9.20
7 Amerex stem 5.00 35.00
1 Badger stem 5.50 5.50
1 CO2 Neck o -ring 1.15 1.15
1 Amerex safety disc 9.75 9.75
1 CO2 DOT label 0.65 0.65
Subtotal $234.50
Sales Tax (0.0 $0.00
Total $234.50
jD JAcoB-DiETz, INC. Invoice
,'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 49799
Bill To: Ship To:
Carmel Waterworks Carmel Waterworks
760 3rd Avenue SW 760 3rd Avenue SW
Carmel, M 46032 Carmel, IN 46032
P.O. No. Work Order Terms Due Date Rep Project
6/30/2009 Carmel Waterworks
Quantity Description Rate Amount
41 Fire Extinguisher annual inspection 3.00 123.00
1 2 -1/2# ABC 6 year maintenance 7.25 7.25
2 15# CO2 test recharge 25.00 50.00
1 OR27 Neck o -ring 1.15 1.15
1 Amerex stem 5.00 5.00
2 CO2 Neck o -ring 1.15 2.30
2 Amerex safety disc 9.75 19.50
Subtotal $208.20
Sales Tax (0.0 $0.00
Total $208.20
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.
0
Payee
351351
JACOB- DIETZ, INC. Purchase Order No.
2708 E. Michigan St. Terms
Indianapolis, IN 46201 Due Date 7/29/2009
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
7/29/2009 49798 $234.50
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
Date Officer
VOUCHER 092533 WARRANT ALLOWED
3 51351 IN SUM OF
JACOB- DIETZ, INC.
2708 E. Michigan St. N
Indianapolis, IN 46201 2
��R AD
Carmel Water Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
49798 01- 6360 -06 5234.50
yC of gy p, aag ZD
I I Voucher Total L j -7 50
1
Cost distribution ledger classification if
claim paid under vehicle highway fund
J!JJAcoB-DiETz, INC. Invoice
F I RE 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 49800
Bill To: Ship To:
Carmel Waste Water Carmel Waste Water
760 3rd Avenue SW 760 3rd Avenue SW
Carmel, IN 46032 Carmel, IN 46032
P.O. No. Work Order Terms Due Date Rep Project
6/30/2009 Carmel Waste Water
Quantity Description Rate Amount
72 Fire Extinguisher annual inspection 3.00 216.00
1 5# ABC 6 year maintenance 10.00 10.00
3 2-1/2# ABC 6 year maintenance 7.25 21.75
4 OR27 Neck o -ring 1.15 4.60
1 Badger stem 5.50 5.50
3 Amerex stem 5.00 15.00
1 New 10# ABC Fire Extinguisher 79.60 79.60
1 New 20# ABC Fire Extinguisher 135.80 135.80
2 Condemned Rusted 0.00 0.00
Subtotal $488.25
Sales Tax (0.0 $0.00
Total $488.25
d J JJJAC0B-nETZ, INC. Invoice
F I R E PROTECTION 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 49801
Bill To: Ship To:
City of Carmel House Hold Waste
760 3rd Avenue SW 901 Rangeline Road
Carmel, IN 46032 Carmel, In 46032
P.O. No. Work Order Terms Due Date Rep Project
6/30/2009 House Hold Waste
Quantity Description Rate Amount
31 Fire Extinguisher annual inspection 3.00 93.00
1 10# ABC hydrotest 16.65 16.65
1 54 ABC 6 year maintenance 10.00 10.00
1 2 -1/29 ABC 6 year maintenance 7.25 7.25
3 OR27 Neck o -ring 1.15 3.45
I Badger stem 5.50 5.50
2 Amerex stem 5.00 10.00
1 Fire extinguisher nozzle 4.00 4.00
1 195 psi dry chemical gauge 7.50 7.50
Subtotal $157.35
Sales Tax (0.0 $0.00
Total $157.35
r
INC. Invoice
J"JAcoB-DiETz,
P R O T E C T I ON 5 P E C i A L IS T 5
2708 East Michigan Street Date Invoice
Indianapolis, IN 46201
317- 631 -2304 Fax 317 -631 -31.17 6/30/2009 49797
Bill To: Ship To:
Carmel Utilities City of Carmel HHW
760 3rd Avenue SW 901 Rangeline Road
Carmel, IN 46032 Carmel, IN 46032
P.O. No. Work Order Terms Due Date Rep Project
6130/2009 Carmel Utilities
Quantity Description Rate Amount
7 Fire Extinguisher annual inspection 3.00 21.00
1 2 -1/2# ABC 6 year maintenance 7.25 7.25
1 OR27 Neck o -ring 1.1.5 1.15
1 Amerex stem 5.00 5.00
1 Fire extinguisher nozzle 4.00 4.00
Subtotal $38.40
Sales Tax (0.0 $0.00
Total $38.40
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 7/27/2009
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
7/27/2009 49797 $38.40
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 096079 WARRANT ALLOWED
351351 IN SUM OF
4,
JACOB- DIETZ, INC.
2708 E. Michigan St
Indianapolis, IN 46201
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
49797 01- 720H -08 $10.15
49797 01- 736H -08 $28.25
yggol o1 :Xoii•U8 30.45
pi.'36 iLow 126. q0
11 o
1 q$o
01.7
Voucher Total
Cost distribution ledger classification if
claim paid under vehicle highway fund