221475 07/02/2013 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: $50.00
302 W WASHINGTON ST,RM 246 CHECK NUMBER: 221475
ON` INDIANAPOLIS IN 46204-2739
CHECK DATE: 7/2/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4350100 288872 25 . 00 BUILDING REPAIRS & MA
1110 4350100 311211 25 . 00 BUILDING REPAIRS & MA
jar"'&°< INVOICE FOR INSPECTION / CERTIFICATE FEES
i dye State Form 356(R4/9-93)
w+ �� Approved by the State Board of Accounts-1991
N� Division of Fire and Building Safety
Deis'- 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://myoracia.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
288872 C/O ROBERT ROBINSON INVOICE PAY THIS
DATE AMOUNT!
Owner Id THREE CIVIL SQUARE -
640037 CARMEL, IN 46032
06/18/2013 -•
Owner number User Name&Location of vessel POLICE DEPT Fee
651.660 3 CIVIC SQUARE $ 25.00
CARMEL IN 46032
-- - - -- -
Serial number Description of vessel Manufacturer Date Last Inspected
1 ZK3857844 SERVICE WATER HEATER LOCHINVAR 05/22/2013
i
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
05/22/2013 CALHOUN JOSEPH S RE-INSPECTION-B-288872,06/18/2013 $ 25.00
PLEASE NOTE THIS SHEET CONTAINS 2 DUPLICATED INVOICE, PLEASE CUT SHEET ON
LINE AND RETURN BOTTOM COPY WITH PAYMENT
INVOICE FOR INSPECTION / CERTIFICATE FEES
& ie State Form 356(R4/9-93)
I� Approved by the State Board of Accounts-1991
N t 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/idhsFeesF!nes/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
INVOICE PAY THIS
311211 C/O ROBERT ROBINSON i
� DATE (AMOUNT.
Owner Id THREE CIVIL SQUARE
CARMEL, IN 46032 06/18/2013
640037 i \/
Owner number User Name&Location of vessel Fee
POLICE DEPT
3 CIVIC SQ $ 25.00
CARMEL IN 46032
Serial number Description of vessel i Manufacturer Date Last Inspected
DB8819991 ( SERVICE WATER HEATER � LOCHINVAR 05/22/2013
National Board No. Inspection agency Name of inspector (This fee is
TRAVELERS CALHOUN JOSEPH S prescribed by
- - - 675 1AC 12-3-13)
--- -- - --------- ---- --
Inspection Date Inspector Name Inspection Type Due
05/22/2013 CALHOUN JOSEPH S RE-INSPECTION-B-311211,06/18/2013 $ 25.00
PLEASE NOTE THIS SHEET CONTAINS 2 DUPLICATED INVOICE, PLEASE CUT SHEET ON
LINE AND RETURN BOTTOM COPY WITH PAYMENT
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))
06/18/13 311211 service water heater $25.00
06/18/13 288872 service water heater $25.00
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.
ALLOWED 20
Department of Homeland Security
Boiler & Pressure Vessel Safety Division
IN SUM OF $
302 W. Washington Street, RM 246
Indianapolis, IN 46204-2739
$50.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel Police Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1110 311211 43-501.00 $25.00 I hereby certify that the attached invoice(s), or
bill(s) is (are) true and correct and that the
1110 288872 43-501.00 $25.00
materials or services itemized thereon for
which charge is made were ordered and
received except
Tuesday, June 25, 2013
Chief of Police
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund