HomeMy WebLinkAbout235968 08/13/14 ,_
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CITY OF CARMEL, INDIANA VENDOR: 229650
® �1 ONE CIVIC SQUARE OFFICE DEPOT INC CHECK AMOUNT: $*****1,124,12*
s. ,�: CARMEL, INDIANA 46032 PO BOX 633211 CHECK NUMBER: 235968
vy-,_ CINCINNATI OH 45263-3211 CHECK DATE: 08/13/14
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1203 4230200 1700492051 20.27 OFFICE SUPPLIES
1801 4230200 718143693001 54.06 OFFICE SUPPLIES
651 5023990 721221257001 4.82 OTHER EXPENSES
102 4467099 721306382001 195.99 OTHER EQUIPMENT
1207 4230200 721933900001 95.11 OFFICE SUPPLIES
1207 4230200 721938437001 12.49 OFFICE SUPPLIES
1207 4230200 721938438001 66.76 OFFICE SUPPLIES
1110 4239099 724236403001 3.72 OTHER MISCELLANOUS
1110 4230200 724236449001 163.10 OFFICE SUPPLIES
651 5023990 724288153001 217.42 OTHER EXPENSES
601 5023990 724410740001 13.63 OTHER EXPENSES
651 5023990 724410740001 8.19 OTHER EXPENSES
601 5023990 724410886001 150.37 OTHER EXPENSES
651 5023990 724410886001 90.23 OTHER EXPENSES
1205 4230200 724481391001 27.96 OFFICE SUPPLIES
ORIGINAL INVOICE 10001
Office Depot,Inc
Office POBOX630813 THANKS FOR YOUR ORDER
DEPOT. CINCINNATI OH IF YOU HAVE ANY QUESTIONS
45263-0813 OR PROBLEMS. JUST CALL US
FOR CUSTOMER SERVICE ORDER: (888) 263-3423
FOR ACCOUNT: (800) 721-6592
FEDERAL ID:59-2663954 INVOICE NUMBER AMOUNT DUE PAGE NUMBER
724236449001 163.10 Page 1 of 1
INVOICE DATE TERMS PAYMENT DUE
23-JUL-14 Net 30 24-AUG-14
BILL T0: SHIP T0:
4ATTN: ACCTS PAYABLE CARMEL POLICE DEPARTMENT
m CITY OF CARMEL
C? CITY IF CARMEL POLICE DEPT
r 1 CIVIC SQ 3 CIVIC SQ
m CARMEL IN 46032-2584 C=
C)
CARMEL IN 46032-2584
lilul�llulluu�lluIII lnIIII III IluIII lIII lnn11ll111111
ACCOUNT NUMBER IPURCHASE ORDER ISHIP TO ID ORDER NUMBER ORDER DATE SHIPPED DATE
86102185 1 1110 1724236449001 22-JUL-14 23-JUL-14
BILLING ID ACCOUNT MANAGER RELEASE JORDERED BY I DESKTOP COST CENTER
39940 1 1 IBLAINE MALLABER 1110
CATALOG ITEM N/ DESCRIPTION/ U/MQTY QTY QTY UNIT EXTENDED
MANUF CODE CUSTOMER ITEM N ORD SHP B/O PRICE PRICE
348037 PAPER,COPY,OD,CASE,10-RE CA 2 2 0 36.450 72.90
851001 OD 348037
810838 FOLDER,LTR,1/3CUT,100BX,M BX 8 8 0 7.050 56.40
810838 810838
574698 DIVIDER,A-Z,OD,LEATHER,BLA ST 20 20 0 1.690 33.80
OD574698 574698
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0
0
0
ib
0
0
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0
SUB-TOTAL 163.10
DELIVERY 0.00
SALES TAX 0.00
All amounts are based on USD currency TOTAL 163.10
To return supplies, please repack in original box and insert our packing list, or copy of this invoice. Please note problem so we may issue credit or
replacement, whichever you prefer. Please do not ship collect. Please do not return furniture or machines until you call us first for instructions. Shortage
or damage must be reported within 5,days after delivery.
ORIGINAL INVOICE 10001
oince Office Depot,Inc
PO BOX 630813 THANKS FOR YOUR ORDER
DEPOT. CINCINNATI OH IF YOU HAVE ANY QUESTIONS
45263-0813 OR PROBLEMS. JUST CALL US
FOR CUSTOMER SERVICE ORDER: (888) 263-3423
FOR ACCOUNT: (800) 721-6592
FEDERAL ID:59-2663954 INVOICE NUMBER AMOUNT DUE PAGE NUMBER
724236403001 3.72 Page 1 of 1
INVOICE DATE TERMS PAYMENT DUE
23-JUL-14 Net 30 24-AUG-14
BILL T0: SHIP T0:
ATTN: ACCTS PAYABLE
CITY OF CARMEL CARMEL POLICE DEPARTMENT
g CITY IF CARMEL POLICE DEPT
1 CIVIC SQ 3 CIVIC SQ
" CARMEL IN 46032-2584 o)� CARMEL IN 46032-2584
0 C'=�
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I1111111111111111111111111111111111111111111111111111111111111
ACCOUNT NUMBER PURCHASE ORDER iSHIP TO ID ORDER NUMBER ORDER DATE SHIPPED DATE
86102185 1 110 724236403001 22-JUL-14 23-JUL-14
BILLING ID ACCOUNT MANAGER RELEASE JORDERED BY IDESKTOP ICOST CENTER
39940 1 JBILAINE MALLABER 1 1110
CATALOG ITEM #/ DESCRIPTION/ U/M QTY QTY QTY UNIT EXTENDED
MANUF CODE CUSTOMER ITEM # ORD SHP 8/0 PRICE PRICE
565526 GLOVE,VINL,EXM,PF,S,100BX, BX 1 1 0 3.720 3.72
VSM200 565526
0)
0
0
0
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n
0
0
0
SUB-TOTAL 3.72
DELIVERY 0.00
SALES TAX 0.00
All amounts are based on USD currency TOTAL 3.72
To return supplies, please repack in original box and insert our packing List, or copy of this invoice. Please note problem so we may issue credit or
replacement, whichever you prefer. PLease do not ship coLLect. Please do not return furniture or machines until you caLL us first for instructions. Shortage
or damage must be reported within 5 days after delivery.
VOUCHER NO. WARRANT NO.
ALLOWED 20
Office Depot
IN SUM OF$
P.O. Box 633211
Cincinnati, OH 45263-3211
$166.82
ON ACCOUNT OF APPROPRIATION FOR
Carmel Police.Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1110 724236403001 42-390.99 $3.72 I hereby certify that the attached invoice(s), or
bill(s) is (are)true and correct and that the
1110 724236449001 42-302.00 $163.10
materials or services itemized thereon for
which charge is made were ordered and
received except
Thursday;August 07, 2014
Chief of Police
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
L �
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))
07/23/14 . 724236403001 supplies $3.72
07/23/14 724236449001 office supplies $163.10
1
I hereby certify that the attached invoice(s), or bill(s), is(are)true and correct and I have audited same in accordance
with IC 5-11-10-1.6
, 20
Clerk-Treasurer
ORIGINAL INVOICE 10001
Off ice ooff B Depot,Inc
PO BOX 630813 THANKS FOR YOUR ORDER
DEPOT, CINCINNATI OH IF YOU HAVE ANY QUESTIONS
45263-0813 OR PROBLEMS. JUST CALL US
FOR CUSTOMER SERVICE ORDER: (888) 263-3423
FOR ACCOUNT: (800) 721-6592
FEDERAL ID:59-2663954 INVOICE NUMBER AMOUNT DUE PAGE NUMBER
721306382001 195.99 Page 1 of 1
INVOICE DATE TERMS PAYMENT DUE
28-JUL-14 Net 30 31-AUG-14
BILL T0: SHIP T0:
ATTN: ACCTS PAYABLE
CITY OF CARMEL CITY OF CARMEL
4 CITY IF CARMEL CARMEL FIRE DEPT
1 CIVIC SQ �— 2 CIVIC SQ
0 CARMEL IN 46032-2584 m=
C) CARMEL IN 46032-2584
C)=
I�I��LIL�II�����IL��I�I��LLLI�I�tJ��LJII����L�ILLIJ
ACCOUNT NUMBER IPURCHASE ORDER ISHIP TO ID IORDER NUMBER IORDER DATE ISHIPPED DATE
86102185 1 120 1721306382001 25-JUL-14 28-JUL-14
BILLING ID ACCOUNT MANAGER RELEASE JORDERED BY IDESKTOP ICOST CENTER
39940 1 1 ISALLY LAFOLLETTE 1120
CATALOG ITEM #/ DESCRIPTION/ U/M QTY QTY QTY UNIT EXTENDED
MANUF CODE CUSTOMER ITEM # ORD SHP 8/0 PRICE PRICE
862818 SHREDDER,7-SHT,MICRO,MS- EA 1 1 0 195.990 195.99
3245001 862818
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SUB-TOTAL 195.99
DELIVERY 0.00
SALES TAX 0.00
All amounts are based on USD currency TOTAL 195.99
Toreturn supplies, please repack in original box and insert our packing list, or copy of this invoice. Please note problem so we may issue credit or
rep
lacement, whichever you prefer. Please do not ship collect. Please do not return furniture or machines until you call us first for instructions. Shortage
or damage must be reported within 5 days after deLivery.
i
VOUCHER NO. WARRANT NO.
ALLOWED 20
Office Depot
IN SUM OF$
P.O. Box 633211
Cincinnati, OH 45263-3211
$195.99
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1120 721306382001 102-670.99 $195.99 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
AUG 1 1 214
s I�
Fire Chief
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
i
i
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))
721306382001 $195.99
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
ORIGINAL INVOICE 10001 j
oince Office Depot,Inc
PO BOX 630813 THANKS FOR YOUR ORDER
DEPOT CINCINNATI OH IF YOU HAVE ANY QUESTIONS
45263-0813 OR PROBLEMS. JUST CALL US
FOR CUSTOMER SERVICE ORDER: (888) 263-3423
FOR ACCOUNT: (800) 721-6592
FEDERAL ID:59-2663954 INVOICE NUMBER AMOUNT DUE PAGE NUMBER
721933900001 95.11 Page 1 of 1
INVOICE DATE TERMS PAYMENT DUE
30-JUL-14 Net 30 31-AUG-14
BILL TO: SHIP TO:
ATTN: ACCTS PAYABLE CITY OF CARMEL CITY OF CARMEL GOLF COURSE
CITY IF CARMEL 12120 BROOKSHIRE PKWY
1 CIVIC S4 ti= CARMEL IN 46033-3314
S CARMEL IN 46032-2584 0�
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CD
I�I��I�Il��ll�n��l Il��l�l��l�l�l�i�lul��l��llln�n�ll�l�l�l
ACCOUNT NUMBER IPURCHASE ORDER SHIP TO ID ORDER NUMBER ORDER DATE SHIPPED DATE
86102185 1 905 GOLF COURSE 1721933900001 29-JUL-14 30-JUL-14
BILLING ID ACCOUNT MANAGER RELEASE ORDERED BY DESKTOP ICOST CENTER
39940 1 PAMELA LISTER 1905
CATALOG ITEM #/ DESCRIPTION/ U/M QTY QTY QTY UNIT EXTENDED
MANUF CODE CUSTOMER ITEM # ORD SHP B/O PRICE PRICE
273646 PAPER,COPY,WHITE CA 1 1 0 30.150 30.15
40428 273646
818629 PAPER,THRML,RL,OD,3-1/8",5 CT 1 1 0 51.000 51.00
818629 818629
210142 BATTERY,ALKALINE,MAX,AAA, PK 1 1 0 8.540 8.54
E92S16F4T 210142
865486 PEN,RETRCT,VEL DZ 1 1 0 5.420 5.42
RLC11BLK 865486
N
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01
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m
0
0
0
SUB-TOTAL 95.11
DELIVERY 0.00
SALES TAX 0.00
All amounts are based on USD currency TOTAL 95.11
To return supplies, please repack in original b and insert our packing list, or copy of this invoice. Please note problem so we may issue credit or
replacement, whichever you prefer. PleaserolLect. Please do not return furniture or machines until you call us first for instructions. Shortage
ora ^ must be reported within
ORIGINAL INVOICE 10001 j
Office pot,Inc THANKS FOR YOUR ORDER
PO BOX 630813
DEPOT CINCINNATI OH IF YOU HAVE ANY QUESTIONS
45263-0813 OR PROBLEMS. JUST CALL US
FOR CUSTOMER SERVICE ORDER: (888) 263-3423
FOR ACCOUNT: (800) 721-6592
FEDERAL ID:59-2663954 INVOICE NUMBER AMOUNT DUE PAGE NUMBER
721938437001 12.49 Page 1 of 1
INVOICE DATE TERMS PAYMENT DUE
30-JUL-14 Net 30 31-AUG-14
BILL TO: SHIP TO:
N ATTN: ACCTS PAYABLE CITY OF CARMEL GOLF COURSE
0, CITY OF CARMEL
CITY IF CARMEL 12120 BROOKSHIRE PKWY
Di 1 CIVIC SQ — CARMEL IN 46033-3314
o CARMEL IN 46032-2584 0-.
0 0�
C)
I�Inl�llnll�����llnll�l��l�l�l�l�l��ll,l��lllun��ll�l�l�l
ACCOUNT NUMBER IPURCHASE ORDER SHIP TO ID I ORDER NUMBER ORDER DATE SHIPPED DATE
86102185 905 GOLF COURSE 721938437001 29-JUL-14 30-JUL-14
BILLING ID ACCOUNT MANAGER RELEASE ORDERED BY DESKTOP ICOST CENTER
39940 PAMELA LISTER 1905
CATALOG ITEM H/ DESCRIPTION/ U/M QTY QTY QTY UNIT EXTENDED
MANUF CODE CUSTOMER ITEM N ORD SHP 8/0 PRICE PRICE
757647 SCISSORS,STRT,VALUE,3PK,8 EA 1 1 0 12.490 12.49
ACM13404 757647
N
r
m
0
0
0
r
0
0
0
49
SUB-TOTAL 12. I
DELIVERY 0.00
SALES TAX 0.00
All amounts are based on USD currency TOTAL 12.49
To return supplies, please repack in original box and insert our packing List, or copy of this invoice. Please note problem so we may issue credit or
replacement, whichever you prefer. Please do not ship collect. Please do not return furniture or machines until you call us first for instructions. Shortage
or dz --must_he_rpoortrrl_Nithip_5 day after delivery._._
ORIGINAL INVOICE 10001
Office Office Depot,30813 THANKS FOR YOUR ORDER
PO BOX 630813
DEPOT CINCINNATI OH IF YOU HAVE ANY QUESTIONS
45263-0813 OR PROBLEMS. JUST CALL US
FOR CUSTOMER SERVICE ORDER: (888) 263-3423
FOR ACCOUNT: (800) 721-6592
FEDERAL ID:59-2663954 INVOICE NUMBER AMOUNT DUE PAGE NUMBER
721938438001 66.76 Page 1 of 1
INVOICE DATE TERMS PAYMENT DUE
29-JUL-14 Net 30 31-AUG-14
BILL T0: SHIP TO:
CN ATTN: ACCTS PAYABLE CITY OF CARMEL GOLF COURSE
CITY OF CARMEL
CITY IF CARMEL 12120 BROOKSHIRE PKWY
o
1 CIVIC S4 CARMEL IN 46033-3314
CARMEL IN 46032-2584 O10�
o O�
o
I�I��I�IIL�II��nLII��LI�I��l�l�l�l�l��lnlulllnuull�l�l�l
ACCOUNT NUMBER IPURCHASE ORDER SHIP TO ID ORDER NUMBER ORDER DATE SHIPPED DATE
86102185 905 GOLF COURSE 721938438001 29-JUL-14 29-JUL-14
BILLING ID ACCOUNT MANAGER RELEASE I ORDERED BY DESKTOP ICOST CENTER
39940 1 1 1 PAMELA LISTER 1905
CATALOG ITEM #/ DESCRIPTION/ U/M QTY QTY QTY UNIT EXTENDED
MANUF CODE CUSTOMER ITEM # ORD SHP B/0 PRICE PRICE
265839 Kingston DataTraveler 101 EA 4 4 0 16.690 66.76
S7913511 265839
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0
0
0
C?
r
m
0
0
0
F_ SUB-TOTAL 66.76
DELIVERY 0.00
SALES TAX 0.00
All amounts are based on USD currency TOTAL 66.76
To return supplies, please repack in original box and insert our packing List, or copy of this invoice. Please note problem so we may issue credit for
�repLacecr_nt,_whichever you
prefer. Please do not ship collect. Please do not return furniture or machines until you call us first for instructions. Shortage
VOUCHER NO. WARRANT NO.
'ALLOWED 20
Office Depot
IN SUM OF$
P.O. Box 633211
Cincinnati, OH 45263-3211
$174.36
ON ACCOUNT OF APPROPRIATION FOR
Brookshire Golf Club
PO#/Dept. INVOICE NO. ACCT#!TITLE AMOUNT Board Members
1207 721938438001 42-302.00 $66.76 1 hereby certify that the attached invoice(s), or
1207 721933900001 42-302.00 $95.11 bill(s) is (are)true and correct and that the
1207 I 721938437001 I 42-302.001 $12.49
materials or services itemized thereon for
which charge is made were ordered and
received except
Monday,fkugust 11, 2014
f
Director, Brookshire olf Club
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 b
P P Y P � Y
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))
07/29/14 721938438001 Office Supplies $66.76
07/30/14 721933900001 Office Supplies $95.11
07/30/14 I 721938437001 I Office Supplies I $12.49
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
ORIGINAL INVOICE 10001
Off ice Office Depot,Inc
PO BOX 630813 THANKS FOR YOUR ORDER
DEPOT. CINCINNATI OH IF YOU HAVE ANY QUESTIONS
45263-0813 OR PROBLEMS. JUST CALL US
FOR CUSTOMER SERVICE ORDER: (888) 263-3423
FOR ACCOUNT: (800) 721-6592
FEDERAL ID:59-2663954 INVOICE NUMBER AMOUNT DUE PAGE NUMBER
724288153001 217.42 Page 1 of 1
INVOICE DATE TERMS PAYMENT DUE
23-JUL-14 Net 30 24-AUG-14
BILL TO: SHIP TO:
ATTN: ACCTS PAYABLE
CITY OF CARMEL CITTY OF CARMEL
g CITY IF CARMEL WASTE WATER TREATMENT
1 CIVIC SQ = 9609 HAZEL DELL PKWY
a CARMEL IN 46032-2584 C)=
C)
INDIANAPOLIS IN 46280-2935
ACCOUNT NUMBER PURCHASE ORDER SHIP TO ID ORDER NUMBER ORDER DATE SHIPPED DATE.
86102185 IPAUL - PRINTER & INK 651 724288153001 22-JUL-14 23-JUL-14
BILLING ID ACCOUNT MANAGER RELEASE ORDERED BY DESKTOP ICOST CENTER
39940 PAUL ARNONE 1651
CATALOG ITEM #/ DESCRIPTION/ U/M QTY QTY QTY UNIT EXTENDED
MANUF CODE CUSTOMER ITEM # ORD SHP B/0 PRICE PRICE
108953 INK,HP 21,TWIN PACK,BLACK PK 2 2 0 23.800 47.60
C9508FN#140 108953
891336 CARTRIDGE,INKJET,HP22,TRI EA 2 2 0 14.290 28.58
C9352AN#140 891336
231822 TONER,LJ CE278A,HP,BLACK EA 2 2 0 70.620 141.24
CE278A 231822
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0
0
0
SUB-TOTAL 217.42
DELIVERY 0.00
SALES TAX 0.00
All amounts are based on USD currency TOTAL 217.42
To return supplies, please repack in original box and insert our packing list, or copy of this invoice. Please note problem so we may issue credit or
replacement; whichever you prefer. Please do not ship collect. Please do not return furniture or machines until you call us first for instructions. Shortage
or damage must be reported within 5 days after delivery.
VOUCHER # 145251 WARRANT# ALLOWED
229650 IN SUM OF $
OFFICE DEPOT INC - USE THIS ONE
PO BOX 633211
CINCINNATI, OH 45263-3211
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO# INV# ACCT# AMOUNT Audit Trail Code
72428815300 01-7202-05 $217.42
Voucher Total $217.42
Cost distribution ledger classification if
claim paid under 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 of service rendered, by whom, rates per day, number of units,
price per unit, etc.
Payee
229650
OFFICE DEPOT INC - USE THIS ONE Purchase Order No.
PO BOX 633211 Terms
CINCINNATI, OH 45263-3211 Due Date 8/5/2014
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
8/5/2014 7242881530( $217.42
1 hereby certify that the attached invoice(s), or bill(s) is(are)true and
correct and I have 1audited same in accordance with IC 5-11-10-1.6
Date Officer
ORIGINAL INVOICE 10000
xsiPOBosos3 THANKS FOR YOUR ORDER
Office
0 CINCINNATI OH IF YOU HAVE ANY QUESTIONS
0DEPOT 45263-0813 OR PROBLEMS. JUST CALL US
FOR CUSTOMER SERVICE ORDER: (888) 263-3423
0 FOR ACCOUNT: (800) 721-6592
0
0 FEDERAL ID:59-2663954 INVOICE NUMBER _ AMOUNT_DUE PAGE NUMBER
0 7181436930_01 54.06 _Page 1 of 1
_
INVOICE DATE _ TERMS _ I PAYMENT DUE
_ 27-.JUN-14 Net 30 31-JUL-14
0
BILL TO: SHIP TO
N ATTN: ACCTS PAYABLE —
CARMEL REDEV COMM _ CARMEL REOEV COMM
30 W MAIN ST STE 220 30 W MAIN ST STE 220
N CARMEL IN 46032-1938 CARMEL IN 46032-1764
N
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I�9u��Iinlln�nll���I�I���III�Ieu�II�I��I�I�inl�I�nII��I
ACCOUNT NUMBER PURCHASE_ ORDER SHIP TO ID IORDER NUMBER ORDER DATE SHIPPED DATE
43520732 30WESTMAINrST 1718143693001 26-JUN-14 27-JUN-14
BILLING ID ACCUUNT-MAN'AGERTELEASE ORDERED BY IDESKTOP COST CENTER
CATALOG ITEM !t/ -� ( DESCRIPTION/ U/M wry QTY I QTY UNIT EXTENDED
MANUF' CODE CUSTOMER ITEM tl ORD SHP B/O PRICE PRICE
348037 PAiPER,COPY,OD,CASE,O-RE CA 1 1 0 38.160 38.16
8510010 D 348037
472198 PLATE,VVISESIZE,PATHWAYS, EA 1 1 0 13.380 13.38
UX9WS 472198
508506 s=ORK,PLAS"IIC,100CT,VIHI"fE PK 1 1 0 2.520 2.52
3585490685 508506
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' -- --�— SUB-TOTAL 54.06
i
DELIVERY 0.00
&ALES TAX. ----- ---__. ------ — - - - --- -`0.0U
All amounts are based on USD currency TOTAL 54.06
To return supplies, please repack in original box and insert our packing List, or copy of this invoice. Please note problem so we may issue credit or
repLacement, whichever you prefer. Please do not ship collect. Please do not return furniture or machines until you call us first for instructions. Shortage
or damage must be reported within 5 days after delivery.
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
q4l�
-{—
o _ � e -211
I Purchase Order No.
�7 U X 332 I I Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
(-27—R 7191436 300 0 ' 'I e u ' be 5S , °
0
Total S
1 hereby certify that the attached invoice(s), or bill(s), is (are) true and correct and I have audited same in accor-
dance with IC 5-11-10-1.6.
, 20
Clerk-Treasurer.
VOUCHER NO. WARRANT NO.
I� ALLOWED 20
Dl e ped n� IN SUM OF $
Bny (33Z
(1h Of) �5263-3211
$
54,06
ON ACCOUNT OF APPROPRIATION FOR
161/��34zo�
Board Members
Po#or INVOICE NO. ACCT#/TITLE AMOUNT I herebyi that the attached invoice(s),
DEPT.# certify
TS 4303 0 W0260 5�� 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
S' ivAt re
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
ORIGINAL INVOICE 10001
OinceAr Office Depot,Inc
PO BOX 630813 THANKS FOR YOUR ORDER
DEPOT. CINCINNATI OH IF YOU.HAVE ANY QUESTIONS
45263-0813 OR PROBLEMS. JUST CALL US
FOR CUSTOMER SERVICE ORDER: (888) 263-3423
FOR ACCOUNT: (800) 721-6592
FEDERAL ID:59-2663954 INVOICE NUMBER AMOUNT DUE PAGE NUMBER
724410740001 21.82 Pagel of 1
INVOICE DATE TERMS PAYMENT DUE
24-JUL-14 Net 30 24-AUG-14
BILL T0: SHIP T0:
ATTN: ACCTS PAYABLE
CITY OF CARMEL CITY OF CARMEL UTILITIES
4 CITY IF CARMEL WATER DEPT
1 CIVIC SQA 30 W MAIN ST FL 2
S CARMEL IN 46032-2584
i? o= CARMEL IN 46032-1938
o=
I�I��I�Ilnll���nll�nl�l��l�l�l�l�lulul��lll�n�ull�l�l�l
ACCOUNT NUMBER PURCHASE ORDER SHIP TO ID ORDER NUMBER ORDER DATE SHIPPED DATE
86102185 601 724410740001 23-JUL-14 24-JUL-14
BILLING ID ACCOUNT 14ANAGER RELEASE ORDERED BY DESKTOP ICOST CENTER
39940 1 1 SCOTT CAMPBELL 1601
CATALOG ITEM #/ DESCRIPTION/ U/M QTY QTY I QTY UNIT EXTENDED
MANUF CODE CUSTOMER ITEM # ORD SHP B/O PRICE PRICE
240531 INDEX,90#,8.5X11,BLUE PK 3 3 0 6.440 19.32
49121 •240531
855946 RUBBERBANDS,SZ64,1# BG 1 1 0 1.870 1.87
2464408 855946
856333 RUBBERBANDS,#33,1/4# BG 1 1 0 0.630 0.63
24331308 856333
�3
� o
C?
gl -
m
SUB-TOTAL 21.82
DELIVERY 0.00
SALES TAX 0.00
All amounts are based on USD currency TOTAL 21.82
To return supplies, please repack in original box and insert our packing list, or copy of this invoice. Please note problem so we may issue credit or
replacement, whichever you prefer. Please do not ship collect. Please do not return furniture or machines until you call us first for instructions. Shortage
or damage must be reported within 5 days after delivery. '
ORIGINAL INVOICE 10001
Of f ice ice Depot,Inc
PO BOX 630813 THANKS FOR YOUR ORDER
DEPOT CINCINNATI OH IF YOU HAVE ANY QUESTIONS
45263-0813 OR PROBLEMS. JUST CALL US
FOR CUSTOMER SERVICE ORDER: (888) 263-3423
FOR ACCOUNT: (800) 721-6592
FEDERAL ID:59-2663954 INVOICE NUMBER AMOUNT DUE PAGE NUMBER
724410886001 240.60 Page 1 of 1
INVOICE DATE TERMS PAYMENT DUE
24-JUL-14 Net 30 24-AUG-14
BILL T0: SHIP T0:
ATTN: ACCTS PAYABLE
A
CITY OF CARMEL CITY OF CARMEL UTILITIES
g CITY IF CARMEL WATER DEPT
o 1 CIVIC SQ 30 W MAIN ST FL 2
CARMEL IN 46032-2584 m=
S 0= CARMEL IN 46032-1938
I�Inllll��ll�����llnllllul�lllllllnl��l��lll�u�l�ll�l�lll
ACCOUNT NUMBER PURCHASE ORDER I SHIP TO ID IORDER NUMBER JORDER DATE SHIPPED DATE
86102185 1601 724410886001 23-JUL-14 24-JUL-14
BILLING ID TACCOUNT MANAGER RELEASE ORDERED BY I DESKTOP ICOST CENTER
39940 1 1 ISCOTT CAMPBELL 1601
CATALOG ITEM #/ DESCRIPTION/ U/M QTY QTY QTY UNIT EXTENDED
MANUF CODE CUSTOMER ITEM # ORD SHP B/0 PRICE PRICE
374236 PRINTER,LASERJET,PRO EA 1 1 0 240.600 240.60
CZ195A#BGJ 374236
SD. 3 7
3
l0.
n
0
0
0
SUB-TOTAL 240.60
DELIVERY 0.00
SALES TAX - 0.00
All amounts are based on USD currency TOTAL 240.60
To return supplies, please repack in original box and insert our packing List, or copy of this invoice. Please note problem so we may issue credit or
replacement, whichever you prefer. Please do not ship coLLect. Please do not return furniture or machines until you call us first for instructions. Shortage
or damage must be reported within 5 days after delivery.
VOUCHER # 141308 WARRANT# ALLOWED
229650 IN SUM OF $
OFFICE DEPOT INC - USE.THIS ONE
PO BOX 633211
CINCINNATI, OH 45263-3211
Carmel Water Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO# INV# ACCT# AMOUNT Audit Trail Code
72441074000 01-6200-07 $13.63 l
0 b�,00,07
Voucher Total
Cost distribution ledger classification if
claim paid under 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 of service rendered, by whom, rates per day, number of units,
price per unit, etc.
Payee
229650
OFFICE DEPOT INC - USE THIS ONE Purchase Order No.
PO BOX 633211 Terms
CINCINNATI, OH 45263-3211 Due Date 8/1/2014
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
8/1/2014 7244107400( $13.63
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
el
Date Officer
ORIGINAL INVOICE 10001
oincePOB Depot,Inc
PO BOX 630813 THANKS FOR YOUR ORDER
DEPOT CINCINNATI OH IF YOU HAVE ANY QUESTIONS
45263-0813 OR PROBLEMS. JUST CALL US
FOR CUSTOMER SERVICE ORDER: (888) 263-3423
I
FOR ACCOUNT: (800) 721-6592
FEDERAL ID:59-2663954 INVOICE NUMBER AMOUNT DUE PAGE NUMBER
721221257001 4.82 Pae 1 of 1
INVOICE DATE TERMS PAYMENT DUE
25-JUL-14 Net 30 24-AUG-14
BILL T0: SHIP T0:
Iq ATTN: ACCTS PAYABLE HOUSEHOLD HAZARDOUS WASTE
CITY OF CARMEL
CITY IF CARMEL 901 N RANGELINE RD
g 1 CIVIC S4 CARMEL IN 46032-1361
S CARMEL IN 46032-2584 0
o pOH
Illullll�llln�nllullllnl�l�l�l�l��l��l��llln�n�ll�l�l�l
ACCOUNT NUMBER PURCHASE ORDER ISHIP TO ID IORDER NUMBER ORDER DATE SHIPPED DATE
86102185 1 jHHLD HZRD WASTE 1 721221257001 24-JUL-14. _ 25-JUL-14
BILLING ID ACCOUNT MANAGER RELEASE ORDERED BY I DESKTOP ICOST CENTER
39940 1 1 JLISA KEMPA 1 1601
CATALOG ITEM #/ DESCRIPTION/ U/MQTY QTY QTY UNIT EXTENDED
MANUF CODE CUSTOMER ITEM # ORD SHP B/0 PRICE PRICE
723688 NOTES,3X3,POP-UP,DEEP,CLR PK 1 1 0 4.820 4.82
OD-3312PD 723688.
' o
0
n
0
r
0
0
0
SUB-TOTAL 4.82
DELIVERY 0.00
SALES TAX 0.00
All amounts are based on USD currency TOTAL 4.82
Toreturn supplies, please repack in originaL box and insert our packing List, or copy of this invoice. Please note problem so we may issue credit or
replacement, whichever you prefer. Please do not ship collect..PLease do not return furniture or machines until you call us first for instructions. Shortage
or damage must be reported within 5 days after delivery.
ORIGINAL INVOICE 10001
Off ice Office Depot,Inc
PO BOX 630813 THANKS FOR YOUR ORDER
DEPT. CINCINNATI OH IF YOU HAVE ANY QUESTIONS
45263-0813 OR PROBLEMS. JUST CALL US
FOR CUSTOMER SERVICE ORDER: (888) 263-3423
FOR ACCOUNT: (800) 721-6592
FEDERAL ID:59-2663954 INVOICE NUMBER AMOUNT DUE PAGE NUMBER
724410740001 21.82 Page 1 of 1
INVOICE DATE TERMS PAYMENT DUE
24-JUL-14 Net 30 24-AUG-14
BILL TO: SHIP TO:
arTN: ACCTS PAYABLE = CITY OF CARMEL UTILITIES
CITY OF CARMEL
0 CITY IF CARMEL WATER DEPT
1 CIVIC SQ 30 W MAIN ST FL 2
o CARMEL IN 46032-2584
g o= CARMEL IN 46032-1938
ACCOUNT NUMBER PURCHASE ORDER SHIP TO ID ORDER NUMBER ORDER DATE SHIPPED DATE
86102185 1 1601 724410740001 23-JUL-14 24-JUL-14
BILLING ID ACCOUNT MANAGER RELEASE JORDERED BY DESKTOP ICOST CENTER
39940 ISCOTT CAMPBELL 601
CATALOG ITEM #/ DESCRIPTION/ UIM QTY QTY QTY UNIT EXTENDED
MANUF CODE CUSTOMER ITEM # ORD SHP B/0 PRICE PRICE
240531 INDEX,90#,8.5X11,BLUE PK 3 3 0 6.440 19.32
49121 •240531
855946 RUBBERBANDS,SZ64,1# BG 1 1 0 1.870 1.87 7-j
2464408 855946
856333 RUBBERBANDS,#33,1/4# BG 1 1 0 0.630 0.63 l
2433808 856333
• - I
I
� 3 0
0
0
SUB-TOTAL 21.82
DELIVERY 0.00
SALES TAX 0.00
All amounts are based on USD currency TOTAL 21.82
To return supplies, please repack in original box and insert our packing List, or copy of this invoice. Please note probLem so we may issue credit or
replacement, whichever you prefer. PLease do not ship collect. Please do not return furniture or machines until you call us first for instructions. Shortage
or damage must be reported within 5 days after deLivery.
A DETACH HERE A
CUSTOMER NAME BILLING ID INVOICE NUMBER INVOICE INVOICE AMOUNT ENCLOSED
DATE AMOUNT
CITY OF CARMEL 39940 724410740001 24-JUL-14 21.82
FLO 000399402 724410740DO19 00000002182 1 4
Please OFFICE DEPOT Please returnthis stub with your payment to
Send Your PO Box 633211 ensure prompt credit to your account.
Check to: Cincinnati OH 45263-3211
` Please DO NOT staple or fold. Thank You.
ORIGINAL INVOICE 10001
OfficeOffice Depot,Inc
PO BOX 630813 THANKS FOR YOUR ORDER
CINCINNATI OH IF YOU HAVE ANY QUESTIONS
DEPOT. 45263-0813 OR PROBLEMS. JUST CALL US
FOR CUSTOMER SERVICE ORDER: (888) 263-3423
FOR ACCOUNT: (800) 721-6592
FEDERAL ID:59-2663954 INVOICE NUMBER AMOUNT DUE PAGE NUMBER
724410886001 240.60 Page 1 of 1
INVOICE DATE TERMS PAYMENT DUE
24-JUL-14 Net 30 24-AUG-14
BILL TO: SHIP TO:
ATTN: ACCTS PAYABLE CITY OF CARMEL UTILITIES
m CITY OF CARMEL
o CITY IF CARMEL WATER DEPT
1 CIVIC SQA 30 W MAIN ST FL 2
o CARMEL IN 46032-2584 m=
i; o= CARMEL IN 46032-1938
LCCOUNT NUMBER IPURCHASE ORDER SHIP TO ID IORDER NUMBER JORDER DATE SHIPPED DATE
36102185 1 601 1724410886001 23-JUL-14 24-JUL-14
3ILLING ID ACCOUNT MANAGER RELEASE ORDERED BY DESKTOP COST CENTER .
19940 SCOTT CAMPBELL 601
:ATALOG ITEM #/ DESCRIPTION/ U/MQTY QTY QTY UNIT EXTENDED
MANUF CODE CUSTOMER ITEM # ORD SHY 8/0 PRICE PRICE
374236 PRINTER,LASERJET,PRO EA 1 1 0 240.600 240.60
CZ195A#BGJ 374236 j
J
i
SD.
37
�0 3
5 o
n
n
0
0
0
SUB-TOTAL 240.60
DELIVERY 0.00
SALES TAX 0.00
All amounts are based on USD currency TOTAL 240.60
To return supplies, please repack in original box and insert our packing List, or copy of this invoice. Please note problem so we may issue credit or
replacement, Whichever you prefer. Please do not ship collect. Please do not return furniture or machines until you call us first for instructions. Shortage
or damage must be reported within 5 days after delivery.
A DETACH HERE A
CUSTOMER NAME BILLING ID INVOICE NUMBER INVOICE INVOICE AMOUNT ENCLOSED
DATE AMOUNT
CITY OF CARMEL 39940 724410886001 24-JUL-14 240.60 A/')
x
FLO 000399402 7244108860013 00000024060 1 9
Please OFFICE DEPQT Please return this stub with your payinent to
Send Your PO Box 633211 ensure prompt credit to your account.
Check to: Cincinnati OH 45263-3211 —
Please DO NOT staple or fold.Thank You.
VOUCHER # 145211 WARRANT# ALLOWED
229650 IN SUM OF $
OFFICE DEPOT INC - USE THIS ONE
PO BOX 633211
CINCINNATI, OH 45263-3211
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO# INV# ACCT# AMOUNT Audit Trail Code
I
72122125700 01-7200-01 $4.82
I '
I '
ol.72o6.07
5�
7-7 Yq(67 Y00o 0/.�2�� �� $. 19
I
Voucher Total
Cost distribution ledger classification if
claim paid under 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 of service rendered, by whom, rates per day, number of units,
price per unit, etc.
Payee
229650
OFFICE DEPOT INC- USE THIS ONE Purchase Order No.
PO BOX 633211 Terms
CINCINNATI, OH 45263-3211 Due Date 8/1/2014
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
8/1/2014 7212212570( $4.82
I hereby certify that the attached invoice(s), or bill(s) is (are)true and
correct and I have audited same in accordance with IC 5-11-10-1.6
Date Officer
ORIGINAL INVOICE 10001
Office Orroe Depot,Inc
PO BOX 630813 THANKS FOR YOUR ORDER
DEPOT CINCINNATI OH IF YOU HAVE ANY" QUESTIONS
45263-0813 OR PROBLEMS. JUST CALL US
FOR CUSTOMER SERVICE ORDER: (888) 263-3423
FOR ACCOUNT: (800) 721-6592
FEDERAL ID:59-2663954 INVOICE NUMBER AMOUNT DUE PAGE NUMBER
724481391001 27.96 Pae 1 of 1
INVOICE DATE TERMS PAYMENT DUE
24-JUL-14 Net 30 24-AUG-14
i
BILL T0: SHIP T0:
ATTN: ACCTS PAYABLE
CITY OF CARMEL CITY OF CARMEL
0 CITY IF CARMEL DEPT OF ADMINISTRATION
4 1 CIVIC SQA 1 CIVIC SQ
o CARMEL IN 46032-2584 m=
0 a= CARMEL IN 46032-2584
ILIL 11111111111111111111111111II VIII VIII VIII V III11II111111 .
ACCOUNT NUMBER PURCHASE ORDER SHIP TO ID ORDER NUMBER ORDER DATE SHIPPED DATE
86102185 195 724481391001 23-JUL-14 24-JUL-14
BILLING ID ACCOUNT MANAGER RELEASE JORDERED BY DESKTOP ICOST CENTER
39940 1 IJIM SPELBRING 195
CATALOG ITEM #/ DESCRIPTION/ U/M QTY QTY QTY UNIT EXTENDED
MANUF CODE CUSTOMER ITEM # ORD SHP B/O PRICE PRICE
711938 PEN,STEEL,RT,MED,1PK,BLK EA 4 4 0 6.990 27.96
34511 711938
Submitted To
AUG 112014
0
0
co
Clerk Treasurer
SUB-TOTAL 27.96
DELIVERY 0.00
SALES TAX 0.00
All amounts are based on USD currency TOTAL 27.96
Toreturn supplies, please repack in original box and insert our packing List, or copy of this invoice. Please note problem so we may issue credit or _ .
rep Lacement, whichever you prefer. Please do not ship collect. Please do not return furniture or machines until you call us first for instructions. Shortage
r damage must be reported within 5 days after delivery.
VOUCHER NO. WARRANT NO.
ALLOWED 20
Office Depot
IN SUM OF$
PO Box 633211.
Cincinnati, OH 45263-3211
$27.96
ON ACCOUNT OF APPROPRIATION FOR
Administration Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1205 724481391001 42-302.00 $27.96 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
Monday, August 11, 2014
w
Director,Administrate n
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
j Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s)or bill(s))
07/24/14 724481391001 $27.96
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
ORIGINAL INVOICE 10001
ornce Once Depot,Inc
PO BOX 630813 THANKS FOR YOUR ORDER
DEPOT. CINCINNATI OH IF YOU HAVE ANY QUESTIONS
45263-0813 OR PROBLEMS. JUST CALL US
FOR CUSTOMER SERVICE ORDER: (888) 263-3423
FOR ACCOUNT: (800) 721-6592
FEDERAL ID:59-2663954 INVOICE NUMBER AMOUNT DUE PAGE NUMBER
1700492051 20.27 Page 1 of 1
INVOICE DATE TERMS PAYMENT DUE
28-JUL-14 Net 30 31-AUG-14
BILL TO: SHIP TO:
N ATTN: ACCTS PAYABLE CITY OF CARMEL
CITY OF
CARMEL OFFICE OF THE MAYOR
N 1 CIVIC SQ C'4� 1 CIVIC SQ
o CARMEL IN 46032-2584 m=
0- CARMEL IN 46032-2584
ACCOUNT NUMBER PURCHASE ORDER SHIP TO ID I ORDER NUMBER ORDER DATE SHIPPED DATE
_ 86102185 160 1700492051 28-JUL-14 28-JUL-14
BILLING ID ACCOUNT MANAGER RELEASE ORDERED BY DESKTOP COST CENTER
39940 B 1 1 1160
CATALOG ITEM #/ DESCRIPTION/ U/M QTY QTY QTY UNIT EXTENDED
MANUF CODE CUSTOMER ITEM # ORD SHP B/0 PRICE PRICE
Note:SPC 80105625356 Date:28-JUL-14 Location:0476 Register:002 Trans#:05857
630524 BINDR ULTRADUTY 1"DR C EA 2 2 0 7.990 15.98
W866-14-519PP
Department:MAYORS OFFICE
630524 Coupon Discount -EA 2 2 0 -3.990 -7.98
W866-14-519PP
Department:MAYORS OFFICE
630524 BINDR ULTRADUTY 1"DR C EA 2 2 0 4.090 8.18
W866-14-519PP
N
n
Department:MAYORS OFFICE o
630524 BINDR ULTRADUTY 1"DR C EA 1 1 0 4.090 4.09 N
W866-14-519PP o
0
0
Department:MAYORS OFFICE
SUB-TOTAL 20.27
DELIVERY 0.00
SALES TAX 0.00
All amounts are based on USD currency TOTAL 20.27
To return supplies, please repack in original box and insert our packing list, or copy of this invoice. Please note problem so we may issue credit or
replacement, whichever you prefer. Please do not ship collect. Please do not return furniture or machines until you call us first for instructions. Shortage
or damage must be reported within 5 days after delivery.
i
i
VOUCHER NO. WARRANT NO.
ALLOWED 20
Office Depot, Inc.
j IN SUM OF$
P. O. Box 633211
Cincinnati, OH 45263-3211 i
$20.27
ON ACCOUNT OF APPROPRIATION FOR
Community Relations
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT 1 Board Members
I hereby certify that the attached invoice(s), or
1203 1700492051 42-302.00 $20.27
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,August 11,2014
Director,&mmunity Relations/Economic Development
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
f 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))
07/28/14 1700492051 $20.27
i
I
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