HomeMy WebLinkAbout219295 04/24/2013 CITY OF CARMEL, INDIANA VENDOR: 362497 Page 1 of 1
ONE CIVIC SQUARE DEPARTMENT OF HOMELAND SECURITY
CARMEL, INDIANA 46032 BOILER AND PRESS.VALVE SAFETY DIV CHECK AMOUNT: $75.00
302 W WASHINGTON ST,RM 246 CHECK NUMBER: 219295
INDIANAPOLIS IN 46204-2739
CHECK DATE: 4/24/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 290011 25 . 00 OTHER EXPENSES
651 5023990 308699 25 . 00 OTHER EXPENSES
651 5023990 317065 25 . 00 OTHER EXPENSES
r-" INVOICE FOR INSPECTION / CERTIFICATE FEES
& io State Form 356(R4/9-93)
wj ja Approved by the State Board of Accounts-1991
i'
Division of Fire and Building Safety
1.Mail checks payable to DEPARTMENT OF HOMELAND SECURITY You can pay all your payments online at IDHS web site
2. Mail 2nd copy&check to DEPARTMENT OF HOMELAND SECURITY https://myoracle.in.gov/dfbs/idhsFeesFines/start.do
INSTRUCTIONS: Boiler and Pressure Vessel Safety Division with Visa/Master Card/Discover cards.Use Owner Id on
302 W WASHINGTON ST.,RM 246 this letter or Indiana State Number on the invoice to pull
INDIANAPOLIS IN 46204-2739 up information when paying the dues online.
Telephone:(317)232-1921
IiIIN NA STATE
i NUMBER CARMEL CITY OF LATEST PLEASE
308699 INVOICE PAY THIS
C/O LISA KEMPA DATE AMOUNT!
I
Owner Id 760 3RD AVE SW SUITE 110
03/25/2013
I
651680 CARMEL, IN 46032 \/
Owner number User Name&Location of vessel Fee
I CARMEL WASTE WTR UTILITIES
9609 HAZEL DELL PKWY
$ 25.00
CARMEL IN 46280
Serial number I Description of vessel Manufacturer Date Last Inspected
i FT Boiler I HURST 02/27/2013
National Board No. Inspection agency Name of inspector (This fee is
14935 TRAVELERS CALHOUN JOSEPH S prescribed by
675 IAC 12-3-13)
Inspection Date Inspector Name Inspection Type Due
02/27/2013 CALHOUN JOSEPH S RE-INSPECTION-B-308699,03/25/2013 $ 25.00
PLEASE NOTE THIS SHEET CONTAINS 2 DUPLICATED INVOICE, PLEASE CUT SHEET ON
LINE AND RETURN BOTTOM COPY WITH PAYMENT
retain top portion for your records ------ -
I ; �' RTIFI
Mal
jT-"- � INVOICE FOR INSPECTION / CERTIFICATE FEES
State Form 356(R4/9-93)
v i; Approved by the State Board of Accounts-1991
�L Division of Fire and Building Safety
1.Mail checks payable to DEPARTMENT OF HOMELAND SECURITY You can pay all your payments online at IDHS web site
2. Mail 2nd copy&check to DEPARTMENT OF HOMELAND SECURITY https:/I myoracle.in.gov/dfbs/idhsFeesFines/start.do
INSTRUCTIONS: Boiler and Pressure Vessel Safety Division with Visa/Master Card/Discover cards.Use Owner Id on
302 W WASHINGTON ST.,RM 246 this letter or Indiana State Number on the invoice to pull
INDIANAPOLIS IN 46204-2739 up information when paying the dues online.
Telephone:(317)232-1921
INDIANA STATE
NUMBER CARMEL CITY OF LATEST PLEASE
290011 INVOICE PAY THIS
C/O LISA KEMPA DATE AMOUNT!
Owner Id 760 3RD AVE SW SUITE 110
651680 CARMEL, IN 46032 03/25/2013
—--- ---- ------ -------- --- --- --
------------------------- --
Owner number User Name&Location of vessel WASTE WATER TREATMENT PLT Fee
9609 HAZEL DELL PKWY $ 25.00
INDIANAPOLIS IN 46280
Serial number Description of vessel Manufacturer Date Last Inspected
j FT Boiler BURNHAM 02/27/2013
National Board No. Inspection agency Name of inspector (This fee is
28519 TRAVELERS CALHOUN JOSEPH S prescribed by
675 IAC 12-3-13)
Inspection Date Inspector Name Inspection Type Due
02/27/2013 CALHOUN JOSEPH S RE-INSPECTION-B-290011,03/25/2013 $ 25.00
PLEASE NOTE THIS SHEET CONTAINS 2 DUPLICATED INVOICE, PLEASE CUT SHEET ON
LINE AND RETURN BOTTOM COPY WITH PAYMENT
nd retain top portion for y�records ----^p
I
INVOICE FOR INSPECTION / CERTIFICATE FEES
o To State Form 356(R4/9-93)
Approved by the State Board of Accounts-1991
�t Division of Fire and Building Safety
Haig' 1.Mail checks payable to DEPARTMENT OF HOMELAND SECURITY
You can pay all your payments online at IDHS web site
2. Mail 2nd copy&check to DEPARTMENT OF HOMELAND SECURITY https://myoracle.in.gov/dfbs/idhsFeesFines/start.do
INSTRUCTIONS: Boiler and Pressure Vessel Safety Division with Visa/Master Card/Discover cards.Use Owner Id on
302 W WASHINGTON ST.,RM 246 this letter or Indiana State Number on the invoice to pull
INDIANAPOLIS IN 46204-2739 up information when paying the dues online.
Telephone:(317)232-1921
� INDIANA STATE
--------------------------------
NUMBER LATEST PLEASE
INVOICE PAY THIS i
317065 CARMEL WASTE WATER PLANT DATE AMOUNT!
Owner Id 9609 HAZEL DELL
787451 INDIANAPOLIS, IN 46280 03/25/2013
Owner number User Name&Location of vessel CARMEL WASTE WATER PLANT Fee
9609 HAZEL DELL $ 25.00
CARMEL IN 46032
r erial number Description of vessel Manufacturer Date Last Inspected
726L05555 ALUMINUM BOILER HARSCO P&K 02/27/2013
National Board No. Inspection agency Name of inspector �. (This fee is
TRAVELERS CALHOUN JOSEPH S prescribed by
675 IAC 12-3-13)
Inspection Date Inspector Name Inspection Type Due
02/27/2013 CALHOUN JOSEPH S RE-INSPECTION--317065,03/25/2013 S 25.00
PLEASE NOTE THIS SHEET CONTAINS 2 DUPLICATED INVOICE, PLEASE CUT SHEET ON
LINE AND RETURN BOTTOM COPY WITH PAYMENT
h—P and retain top portion for your records
= CERTIFICAT � '�`L`
;r., i