229198 2/11/2014 CITY OF CARMEL, INDIANA VENDOR: 363272 Page 1 of 1
ONE CIVIC SQUARE JAMES P SPELBRING CHECK AMOUNT: $9.95
CARMEL, INDIANA 46032 16233 HOWDEN DRIVE
ory�a WESTFIELD IN 46074 CHECK NUMBER: 229198
CHECK DATE: 2/11/2014
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1201 4358800 593368 9 . 95 TESTING FEES
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Invoices paid on 1/31/2014
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Account Information
IntelliCorp Account ID: CIT00071
Account Name: City of Carmel
Billing and Payment Information
Name on Card: James Spelbring Card Type:
Address: 16233 Howden Drive Card Number: xxxxxxxxxxxx
City: Westfield Transaction Id: 214825
State: IN Transaction Date: 01/31/2014
Zip: 46074 Amount Paid: $9.95
Phone Number: (317)571-2465
Email: losoelbring@carmel.in.gpv
Invoices Paid Summary
Invoice# Invoice Date Account Id Amount
593368 11/30/2013 CIT00071 $9.95
Total:
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Contact Info Feedback
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��a' FEB 10 2014
Clerk Treasurer
1 of 1 1/31/2014 2:54 PM
° ° O oo Please Remit To:
�����'���� ,6 IntelliCorp Records,Inc. . Intellicorp
... 3000 Auburn Drive,Suit 410 General Post Office
Beachwood,OH 44122 PO Box 27903
New York NY 10087-7903
United States
Fed ID #11-3661488
INVOICE,
Customer: Amount Due: 9.95 USD
CITY OF CARMEL
JIM SPELBRING
ACCOUNTS PAYABLE
ONE CIVIC SQUARE
CARMEL IN 46032
Invoice No: 593368
Account ID: CIT00071
Invoice Date: November 30,2013
Item Description Quantity Rate Net Amount
INSCC Indiana Single County Criminal Search 1 2.49 2.49
OFAC Government Sanctions(OFAC,DDTC,AECA,BIS,GSA) 1 2.49 2.49
SSNVER SSN Verification 1 '2.49 2.49
SUPER Criminal SuperSearch 1 2.48 2.48
For Billing Questions Phone: 216-450-5300 Invoice net: 9.95
Fax: 216-450-5301 Sales Tax: 0.00
TERMS DUE UPON RECIEPT-LATE PAYMENTS ARE SUBJECT TO SERVICE INTERRUPTION.
Invoice Total: 9.95 USD
VOUCHER NO. WARRANT NO.
James P. Spelbring ALLOWED 20
l
IN SUM OF $
16233 Howden Dr
Westfield, IN 46074
$9.95
ON ACCOUNT OF APPROPRIATION FOR
Carmel HR Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1201 593368 43-588.00 $9.95
I hereby certify that the attached invoice(s), or
I I I
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
Monday, February 10, 2014
Director, HR
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))
01/31/14 593368 Reimburse IntelliCorp payment $9.95
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