226718 12/03/2013 CITY OF CARMEL, INDIANA VENDOR: 00351351 Page 1 of 1
ONE CIVIC SQUARE JACOB-DIETZ, INC
CHECK AMOUNT: $178.70
CARMEL, INDIANA 46032 130 S EWING ST
"' 'r°• INDIANAPOLIS IN 46201
CHECK NUMBER: 226718
CHECK DATE: 12/3/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4239099 58266 178 . 70 OTHER MISCELLANOUS
JDJACOB-DiETz, 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 10/31/2013 58266
Bill To: Ship To:
Carmel Police Department Carmel Police Department
3 Civic Square 3 Civic Square_
Carmel, IN 46032 Carmel, IN 46032
P.O.No. Work Order# Terms Due Date Rep Project
30143,30142 10/31/2013 Cannel Police Depart...
Quantity Description Rate Amount
9 Fire Extinguisher annual inspection 3.00 27.00
1 10# CO2 test&recharge 26.00 26.00
1 Truck charge 18.00 18.00
Vehicles
6 Fire Extinguisher annual inspection 3.00 18.00
2 5# ABC recharge 15.50 31.00
2 5# ABC hydrotest 13.65 27.30
3 OR27 Neck o-ring 1.30 3.90
1 340036K Neck o-ring 2.00 2.00
1 Gauge o-ring 0.75 0.75
1 Kidde Valve Stem 5.00 5.00
1 Amerex stem 6.00 6.00
1 Badger stem 7.00 7.00
Kidde stem _ _ _ _ 5.25 5.25
2 Pull Pin 0.75 1.50
Pay online at:
https://ipn.intuit.coin/pngpn3hk
Subtotal $178.70
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 $178.70
VOUCHER NO. WARRANT NO.
ALLOWED 20
Jacob-Dietz, Inc.
IN SUM OF $
130 South Ewing Street
Indianapolis, IN 46201
$178.70
ON ACCOUNT OF APPROPRIATION FOR
Carmel Police Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1110 I 58266 I 42-390.99 I $178.70 1 hereby certify that the attached invoice(s), or
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
Tuesday, November 26, 2013
Chief of Police
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
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))
10/31/13 58266 fire extinguisher maintenance $178.70
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