HomeMy WebLinkAbout220192 05/21/2013 CITY OF CARMEL, INDIANA VENDOR: 229400 Page 1 of 1
e�s. ONE CIVIC SQUARE INDIANA DEPT OF HOMELAND SECURIT` AMOUNT: $150.00 yHECK
:o CARMEL, INDIANA 46032 DIV OF ELEVATOR SAFETY-FISCAL OFFI
302 W WASHINGTON ST,RM E221 CHECK NUMBER: 220192
INDIANAPOLIS IN 46204
CHECK DATE: 5/21/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1093 4358300 304619 25 . 00 OTHER FEES & LICENSES
1093 4358300 304620 25 . 00 OTHER FEES & LICENSES
1093 4358300 304621 25 . 00 OTHER FEES & LICENSES
1093 4358300 304622 25 . 00 OTHER FEES & LICENSES
1093 4358300 304623 25 . 00 OTHER FEES & LICENSES
1093 4358300 304624 25 . 00 OTHER FEES & LICENSES
LAP R 1 � 2013 FR ED
INVOICE FOR INSPECTION / CERTIFICATE FEES State Form 356(R4/9-93)
Approved by the State Board of Accounts-1991
Division of Fire and Building Safety
�eia 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 hops:/lmyoracle.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
CARMEL CLAY PARKS & RECREATION
304619 ATTN DAWN KOEPPER INVOICE PAY THIS
DATE AMOUNT.
Owner Id 1411 E 116TH ST
759531 CARMEL, IN 46032-3455
04/05/2013
Owner number User Name&Location of vessel MONON COIMMUNITY CTR Fee
1235 CENTRAL PARK DR E $ 25.00
CARMEL IN 46032
Serial number Description of vessel Manufacturer Date Last Inspected
W T Blr - Hot Water Heating ; BRYAN 03/13/2013
I �
INational Board No. Inspection agency Name of inspector (This fee is
53252 I TRAVELERS CALHOUN JOSEPH S prescribed by
6751AC 12-3-13)
Inspection Date Inspector Name Inspection Type Due
03/13/2013 CALHOUN JOSEPH S RE-INSPECTION--304619,04/05/2013 $ 25.00
PLEASE NOTE THIS SHEET CONTAINS 2 DUPLICATED INVOICE, PLEASE CUT SHEET ON
LINE AND RETURN BOTTOM COPY WITH PAYMENT
T.—k. n.l
_°- _._ i
INVOICE FOR INSPECTION / CERTIFICATE FEES APR 1 2013
d, `o State Form 356(R4/9-93)
W( 1. Approved by the State Board of Accounts-1991
Division of Fire and Building Safety v
You can pay all your payments online aFIIDDHS web.site--
mo 1.Mail checks payable to DEPARTMENT OF HOMELAND SECURITY ----- -------_._
2. Mail 2nd copy&check to DEPARTMENT OF HOMELAND SECURITY https://myoracle.in.gov/dfbs/ldhsFeesFines/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 i CARMEL CLAY PARKS & RECREATION LATEST PLEASE
INVOICE PAY THIS
304620 ATTN DAWN KOEPPER DATE AMOUNT!
Owner Id
1411 E 116TH ST
�
759531 CARMEL, IN 46032-3455 04/05/2013
Owner number User Name&Location of vessel Fee
i i MONON COMMUNITY CTR i
1235 CENTRAL PARK DR E $ 25.00
CARMEL IN 46032
Serial number i Description of vessel Manufacturer Date Last Inspected
i
iW Blr - Hot Water Heating BRYAN 03/13 e s/ 13
1 National Board No. I Inspection a agency Name of inspector
53259 TRAVELERS CALHOUN JOSEPH S prescribed by
675 IAC 12-3-13) J
Inspection Date Inspector Name Inspection Type Due
03/13/2013 CALHOUN JOSEPH S RE-INSPECTION--304620,04/05/2013 $ 25.00
PLEASE NOTE THIS SHEET CONTAINS 2 DUPLICATED INVOICE, PLEASE CUT SHEET ON
LINE AND RETURN BOTTOM COPY WITH PAYMENT
- ear hemp-and retpjnfan nnrtinn fny,mU
L-Y': 8 2013
INVOICE FOR INSPECTION / CERTIFICATE FEES
State Form 356(R4/9-93)Approved by the State Board of Accounts-1991
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
INDIANA STATE
NUMBER LATEST PLEASE
CARMEL CLAY PARKS & RECREATION
INVOICE PAY THIS
304621 ATTN DAWN KOEPPER
DATE AMOUNT!
Owner Id 1411 E 116TH ST
759531 CARMEL, IN 46032-3455 04/05/2013 -1\
I i
Owner number User Name&Location of vessel MONON COMMUNITY CTR Fee
1235 CENTRAL PARK DR E i
$ 25.00 i
CARMEL IN 46032
Serial number Description of vessel i Manufacturer Date Last Inspected
W T Boiler LOCHINVAR 03/13/2013
National Board No. Inspection agency (This fee is
184627 I TRAVELERS CALHOUN JOSEPH S prescribed by
Name of inspector
I 675 IAC 12-3-13)
Inspection Date Inspector Name Inspection Type Due
03/13/2013 CALHOUN JOSEPH S RE-INSPECTION--304621,04/05/2013 $ 25.00
PLEASE NOTE THIS SHEET CONTAINS 2 DUPLICATED INVOICE, PLEASE CUT SHEET ON
LINE AND RETURN BOTTOM COPY WITH PAYMENT
TPAr_hp.rp anrf retain rnn nn.tinn fnr Vn `nrds
-
Hrrq INVOICE FOR INSPECTION / CERTIFICATE FEES
LAPRI �3State Form 356(R4/9-93)
Approved by the State Board of Accounts-1991
Division of Fire and Building Safety -
:' You can pay all your payments online at IDHS web site
1.Mail checks payable to DEPARTMENT OF HOMELAND SECURITY
2. Mail 2nd copy 8 check to DEPARTMENT OF HOMELAND SECURITY https://myorac!e.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
j NUMBER CARMEL CLAY PARKS & RECREATION LATEST PLEASE
INVOICE PAY THIS
304622 ATTN DAWN KOEPPER DATE AMOUNT!
I
Owner Id 1411 E 116TH ST
CARMEL, IN 46032-3455 04/05/2013 \ j
759531 i
Owner number User Name&Location of vessel MONON COMMUNITY CTR Fee
{
i
1235 CENTRAL PARK DR E $ 25.00
CARMEL IN 46032 i
Serial number Description of vessel Manufacturer Date Last Inspected j
� W T Boiler LOCHINVAR j 03/13/2013
National Board No. Inspection agency Name of inspector (This fee is
i 182397 i TRAVELERS CALHOUN JOSEPH S prescribed by
675 IAC 12-3-13)
Inspection Date Inspector Name Inspection Type Due
03/13/2013 CALHOUN JOSEPH S RE-INSPECTION--304622,04/05/2013 $ 25.00
PLEASE NOTE THIS SHEET CONTAINS 2 DUPLICATED INVOICE, PLEASE CUT SHEET ON
LINE AND RETURN BOTTOM COPY WITH PAYMENT
- __ Tear here @nj retain ton nortinn for vni-r rPrnr is _-_ _-- - - - ---- —, ��
r4 INVOICE FOR INSPECTION / CERTIFICATE FEES Fleat'IDH 1 g
11e State Form 356(R4/9-93) 2013
� Approved by the State Board of Accounts-1991
Division of Fire and Building Safety
nT� 1.Mail checks payable to DEPARTMENT OF HOMELAND SECURITY You can pay all your payments :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 j
CARMEL CLAY PARKS & RECREATION
304623 ATTN DAWN KOEPPER INVOICE PAY THIS
I i DATE AMOUNT. 1 I
Owner Id 1411 E 116TH ST
759531 CARMEL, IN 46032-3455 04/05/2013
I
Owner number User Name&Location of vessel MONON COMMUNITY CTR Fee
1235 CENTRAL PARK DR E $ 25.00
CARMEL IN 46032
Serial number Description of vessel f Manufacturer Date Last Inspected
IW T Boiler LOCHINVAR X03/13/2013
I National Board No. I Inspection agency Name of inspector (This fee is
184067 i TRAVELERS CALHOUN JOSEPH S prescribed by
-- -- --- - ——------ 675 1AC 12-3-13)--- -- -
Inspection Date Inspector Name Inspection Type Due
03/13/2013 CALHOUN JOSEPH S RE-INSPECTION--304623,04/05/2013 $ 25.00
PLEASE NOTE THIS SHEET CONTAINS 2 DUPLICATED INVOICE, PLEASE CUT SHEET ON
LINE AND RETURN BOTTOM COPY WITH PAYMENT
T-r horn+4.efofn+—n...r;—s.........
INVOICE FOR INSPECTION / CERTIFICATE FEES APR 18 2013
o 'tie State Form 356(R4/9-93)
Approved by the State Board of Accounts-1991
N' Division of Fire and Building Safety r
You can pay all your payments_online at-IDHS:web,site
1.Mail checks payable to DEPARTMENT OF HOMELAND SECURITY - - -
2. Mail 2nd copy&check to DEPARTMENT OF HOMELAND SECURITY https://myoracle.in.gov/dtbs/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 CLAY PARKS & RECREATION LATEST PLEASE j
304624 ATTN DAWN KOEPPER j INVOICE PAY THIS
DATE AMOUNT.
Owner Id 1411 E 116TH ST
j
759531 CARMEL, IN 46032-3455 04/05/2013
7
✓" i
Owner number User Name&Location of vessel MONON COMMUNITY CTR Fee
1235 CENTRAL PARK DR E $ 25.00
j CARMEL IN 46032 j
I
Serial number Description of vessel j Manufacturer Date Last Inspected
IW T Boiler iLOCHINVAR 03/13/2013
National Board No. Inspection agency Name of inspector (This fee is i
195396 TRAVELERS CALHOUN JOSEPH S prescribed by
I 675 1AC 12-3-13)
Inspection Date Inspector Name Inspection Type Due
03/13/2013 CALHOUN JOSEPH S RE-INSPECTION--304624,04/05/2013 $ 25.00
PLEASE NOTE THIS SHEET CONTAINS 2 DUPLICATED INVOICE, PLEASE CUT SHEET ON
LINE AND RETURN BOTTOM COPY WITH PAYMENT
Tear here and retain top portion for your records -- ----- - - - -- - - - -- -- --
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice of 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.
229400 Indiana Department of Homeland Security Terms
Fiscal Department
302 W Washington St., Rm E221
Indianapolis, IN 46204
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO # Amount
4/5/13 304619 Boiler certificates $ 25.00
4/5/13 304620 Boiler certificates $ 25.00
4/5/13 304621 Boiler certificates $ 25.00
4/5/13 304622 Boiler certificates $ 25.00
4/5/13 304623 Boiler certificates $ 25.00
4/5/13 304624 Boiler certificates $ 25 00
Total $ 150.00
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.
229400 Indiana Department of Homeland Security Allowed 20
Fiscal Department
302 W Washington St., Rm E221
Indianapolis, IN 46204 In Sum of$
$ 150.00
ON ACCOUNT OF APPROPRIATION FOR
109 - Monon Center
Po#or Board Members
INVOICE NO. ACCT#/TITL AMOUNT
Dept#
1093 304619 4358300 $ 25.00 1 hereby certify that the attached invoice(s), or
1093 304620 4358300 $ 25.00 bill(s) is (are)true and correct and that the
1093 304621 4358300 $ 25.00 materials or services itemized thereon for
1093 304622 4358300 $ 25.00 which charge is made were ordered and
1093 304623 4358300 $ 25.00 received except
1093 304624 4358300 $ 25.00
16-May 2013
Signature
$ 150.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund