221583 07/02/2013 CITY OF CARMEL, INDIANA VENDOR: 00351351 Page 1 of 1
1� ONE CIVIC SQUARE JACOB-DIETZ,INC
CARMEL, INDIANA 46032 130 S EWING ST CHECK AMOUNT: $845.90
o� INDIANAPOLIS IN 46201 CHECK NUMBER: 221583
CHECK DATE: 7/2/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4350900 57487 425 . 90 OTHER CONT SERVICES
1120 4350900 8625 312 . 00 OTHER CONT SERVICES
651 5023990 8626 108 . 00 OTHER EXPENSES
I]JACOB-nETZ, INC. Invoice
FIRE PROTECTION SPEC 1 A l 1ST S
130 South Ewing St. Date Invoice#
Indianapolis, IN 46201
317-631-2304 Fax 317-631-3117 6/14/2013 8625
Bill To: Ship To:
City of Carmel Fire Department
One'Civic Square
Carmel, IN 46032.
P.O.No. Work Order# Terms Due Date Rep Project
30990,30991,31000,31001 6/14/2013
Quantity Description Rate Amount
1 Semi-annual inspection of kitchen hood fire system for station 41 58.00 58.00
2 Fusible links 8.00 16.00
1 Semi-annual inspection of kitchen hood fire system for station 45 58.00 58.00
2 Fusible links 8.00 16.00
1 Semi-annual inspection of kitchen hood fire system for station 46 58.00 58.00
3 Fusible links 8.00 24.00
1 Semi-annual inspection of kitchen hood fire system for station 42 58.00 58.00
3 Fusible links 8.00 24.00
Subtotal $312.00
Sales Tax (0.0%) $0.00
If not paid by due date,late charges will be assessed at the rate of 1.5%per month. Total $312.00
I
J1JJAC0B-nETZ, 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
130 South Ewing St. Date Invoice#
Indianapolis,IN 46201
317-631-2304 Fax 317-631-3117 5/31/2013 57487
Bill To: Ship To:
Carmel Fire Department
2 Civic Square
0
Carmel, IN 46032
P.O.No. Work Order# Terms Due Date Rep Project
29485,28844,28828 5/31/2013 Carmel Fire Departm...
Quantity Description Rate Amount
6 New 5#ABC Fire Extinguisher w/vehicle brkt 51.70 310.20
1 2-1/2 Gallon Water hydrotest 19.00 19.00
1 20#ABC recharge 40.50 40.50
1 OR27 Neck o-ring 1.30 1.30
3 OR29 Neck o-ring 1.30 3.90
1 Badger stem 7.00 7.00
2 Amerex stem 6.00 12.00
1 100 psi gauge(water) 5.50 5.50
2 Air Valve for water ext 3.50 7.00
2 Pull Pin 0.75 1.50
1 Truck charge 18.00 18.00
Pay online at:
https:Hipn.intuit.com/gqsp7nz5
Subtotal $425.90
Sales Tax (0.0%) $0.00
If not paid by due date,late charges will be assessed at the rate of 1.5%per month. Total $425.90
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))
8625 $312.00
57487 $425.90
1 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
Jacob Dietz
IN SUM OF $
130 S. Ewing Street
Indianapolis, IN 46201
$737.90
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1120 8625 43-509.00 $312.00 1 hereby certify that the attached invoice(s), or
1120 57487 43-509.00 $425.90 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
JUL
Fire Chief
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
JDJACOB-DETZ,
INC. Invoice
PROTECTION SPECIALISTS
130 South Ewing St. Date Invoice#
Indianapolis,IN 46201
317-631-2304 Fax 317-631-3117 6/14/2013 8626
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
25396 6/14/2013 Carmel Utilities
Quantity Description Rate Amount
1 Semi-annual inspection of dry chemical Fire Protection-system for 90.00 90.00
HHW trailer
2 Quick Response Fusible Link 212 degree 9.00 18.00
I
Subtotal $108.00
Sales Tax(0.0%) $0.00
If not paid by due date,late charges will be assessed at the rate of 1.5%per month. Total $108.00
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.
130 S. EWING STREET Terms
Indianapolis, IN 46201 Due Date 6/25/2013
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
6/25/2013 8626 $108.00
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
Date Off er
VOUCHER # 135880 WARRANT # ALLOWED
351351 IN SUM OF $
JACOB-DIETZ, INC.
130 S. EWING STREET
Indianapolis, IN 46201
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO# INV# ACCT# AMOUNT Audit Trail Code
8626 01-720H-08 $18.00
8626 01-736H-08 $90.00
Voucher Total $108.00
Cost distribution ledger classification if
claim paid under vehicle highway fund