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239177 11/17/14 9, CITY OF CARMEL, INDIANA VENDOR: 00351028 ® t; ONE CIVIC SQUARE SIMON AND COMPANY INC CHECK AMOUNT: $*****3,339.48* WASHINGTON?�; CARMEL, INDIANA 46032 1660 L STREET NW,SUITE 501 CHECK NUMBER: 239177 ,'�lrori"�°' WASHINGTON DC 20036 CHECK DATE: 11/17/14 'DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 651 5023990 102814 2,412.83 OTHER EXPENSES 1160 4340400 31594 102814 926.65 PROFESSIONAL SERVICES S IMON AND COMPANY INCORPORATED Intergovernmental Reladons and Federal Affairs 1660 L Street N.W.•Suite 501 •Washington.D.C.20036 (202)659-2229^Fax(202)659-5234 o e-mail:/en.sinion(t—.vsimonconapcniy.com October 28, 2014 Mayor James Brainard One Civic Center Square. Carmel, Indiana 46032 STATEM-EN-T- - - - --- - — -- - - Oetober 2014 Summary oLaa or Activities Undertaken in the Last Month for Carmel Utilties Activ _. Date 1�escran""bora ' USCM Leadership Meeting September 27-29 Assistance to the Mayor in Sacramento during the USCM Leadership meeting focusing on strategy and priorities on federal programs for 2014-2015 and preparation of a summary; Washington Meetings September 24 Assistance to Mayor in Washington for infrastructure meeting sponsored by Governing and a follow-up meeting with U.S.News and World Report; Community Policing October 7-9 Meeting in Little Rock with COPS Office - and Justice Department staff and former President Bill Clinton focusing on the 20th - --anniversary of the COPS program and pending issues in community policing following Ferguson, and preparation of a summary; White House IGA Meeting October 14 Participated in a meeting with White House Office of Intergovernmental Affairs staff to discuss the President's priorities for the rest of the calendar year and how local governments can participate in on- going Administration initiatives such as Pre-K Expansion,Promise Zones,Climate Change, and My Brother's Keeper; 1 Veterans Memorial October 21 Prepared and forwarded background Reflecting Pool information on past federal spending in Carmel in 2002 that was used to construct the Veterans Memorial Plaza Reflecting Pool; TOD Planning Pilot Program October 9 Listened to a webinar hosted by the Federal Transit Administration,on its new Pilot Program for Transit-Oriented Development (TOD) Planning and prepared a follow-up summary; NEA Our Town Grant October 3 Prepared and forwarded a grant memo on Program the National Endowment for the Arts (NEA) release of Program Guidelines for Fiscal Year (FY) 2015 Our Town Grant Program to enhance livability and strengthen American,communities through_ the arts; Bloomberg Philanthropies October 17 Prepared and forwarded a grant memo on Public Art Challenge the Bloomberg Philanthropies announcement that it is accepting applications for a new grant program,the Public Art Challenge,to support temporary public art projects that celebrate creativity, enhance urban identity, encourage public- private partnerships; and drive economic development; Treasury CDFI Program October 17 Prepared and forwarded a grant memo on the Department of Treasury Community Development Financial Institutions Fund (CDFI Fund)release of a Notice of Funds Availability(NOFA)inviting applications for the Community Development Financial Institutions Program (CDFI Program) Fiscal-Year(FY) 2015 Funding Round to invest in CD_F_Is and to build their capacity to serve low-income people and communities that lack access to affordable financial products and services; 2 Washington Friday Report September 26 Prepared and forwarded the Washington Friday Report to the Mayor,which covered the following subjects: Attorney General Eric Holder Steps Down, My Brother's Keeper Community Challenge, Homeownership Summit,-HUD Promise Zones - Second Round, Building Community Trust and Justice, Senate Democrats' Lame Duck Agenda Includes MFA, Grants This Week, Importance of Infrastructure Investment, Disaster Resilience and Climate Change,and Music of the Month; October 3 Prepared and forwarded the Washington Friday Report to the Mayor,which covered the following subjects:U.S. Conference of Mayors Leaders in Sacramento, My Brother's Keeper Community Challenge, Transportation: Back. to the Future, Transit-Oriented Development Webinar, HUD Promise Zones - Second Round, Grants This Week, Climate Action Champions Competition, Freight Traffic: Growth But Congestion, and EPA Chief and Others on the Water Rule; October 10 Prepared and forwarded the Washington Friday Report to the Mayor,which covered the following subjects: COPS - 20 Great Years, New Challenges, Obama Administration Response to the Ebola Pandemic, Promise Zones Webinar, Transportation:Calls for a Long-Term Bill This Year, Gearing Up for the Next ACA - - _- - Open Enrollment—Period, Manufacturing- Institutes, Grants This Week, Infrastructure,Comment Period for Water Rule Extended,and Assessing Reforms to the Housing Finance System; 3 I Washington Friday Report October 17 Prepared and forwarded the Washington Friday Report to the Mayor,which covered the following subjects: Federal Government Responds to Ebola Threat, Tax Extenders, A Busy Transportation Week, A New Deficit Low, EPA Ozone Proposal, Progress Report on Helping Long-Term Unemployed, Public Art Challenge, Defense Department Prepares for Climate Change, Grants This Week, Mayors and Entrepreneurship, "Stop and Frisk," and Bethesda Urban Partnership. Professional Services for the Month of October 2014..............................$2,083.00 Expenses (see attached summary and receipts 71.4%)...................................$329.83 - T,OTAL-)"10 ThTT-DUE.............................................................. ... .............$2,412.83 LEONARD S. SIMON President 4 VOUCHER # 145890 WARRANT# ALLOWED 357028 IN SUM OF $ SIMON & COMPANY INC. 1660 L Street, N.W., Ste 501 Washington, DC 20036 Carmel Wastewater Utility ON ACCOUNT OF APPROPRIATION FOR Board members PO# INV# ACCT# AMOUNT Audit Trail Code 102814 01-7360-08 $2,412.83 Voucher Total $2,412.83 Cost distribution ledger classification if claim paid under 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 of service rendered, by whom, rates per day, number of units, price per unit, etc. Payee 357028 SIMON &COMPANY INC. Purchase Order No. 1660 L Street, N.W., Ste 501 Terms Washington, DC 20036 Due Date 10/31/2014 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) Amount 10/31/201, 102814 $2,412.83 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 jV/d., Com^ ✓�t� Date Officer SINION AND COMPANY INCORPORATED Intergovernmental Relations and Federal Affairs 1660 L Street N.W.•Suite 501 •Washington,D.C.20036 (202)659-2229•Fax(202)659-5234^e-mail:len.simon asinzoncompony.com October 28, 2014 Mayor James Brainard One Civic Center Square Carmel, Indiana 46032 STATEMENT October 2014 Summary of Major Activities Undertaken in the Last Month for the City of Carmel Activi Date Description USCM Leadership Meeting September 27-29 Assistance -to the Mayor in Sacramento during the USCM Leadership meeting focusing on strategy and priorities on federal programs for 2014-2015 and pre aration of a summary; Washington Meetings September 24 Assistance to Mayor in Washington for infrastructure meeting sponsored by Governing and a follow-up meeting with U.S.News and World Report; Community Policing October 7-9 Meeting in Little Rock with COPS Office and Justice Department staff and former President Bill_Clinton focusing on the 20th anniversary of the COPS program and pending issues in community policing following Ferguson, and preparation of a summary; White House IGA Meeting October 14 Participated in a meeting with White House Office of Intergovernmental Affairs staff to discuss the President's priorities for the rest of the calendar year and how local governments can participate in on- going.Administration initiatives such as Pre-K Expansion,Promise Zones,Climate Change, and My Brother's Keeper; - .. 1 Veterans Memorial October 21 Prepared and forwarded background Reflecting Pool information on past federal spending in Carmel in 2002 that was used to construct the Veterans Memorial Plaza Reflecting Pool; TOD Planning Pilot Program October 9 Listened to a webinar hosted by the Federal Transit Administration,on its new Pilot Program for Transit-Oriented Development (TOD) Planning and prepared a follow-up summary; NEA Our Town Grant October 3 Prepared and forwarded a grant memo on Program the National Endowment for the Arts (NEA) release of Program Guidelines for Fiscal Year (FY) 2015 Our Town Grant Program to enhance livability and strengthen American communities through the arts; Bloomberg Philanthropies October 17 Prepared and forwarded a grant memo on Public Art Challenge the Bloomberg Philanthropies announcement that it is accepting applications for a new grant program, the Public Art Challenge,to support temporary public art projects that celebrate creativity, enhance urban identity, encourage public- private partnerships, and drive economic development; Treasury CDFI Program October 17 Prepared and forwarded a grant memo on the Department of Treasury Community Development Financial Institutions Fund (CDFI Fund)release of a Notice of Funds Availability(NOFA)inviting applications for the Community Development Financial Institutions Program (CDFI Program) Fiscal Year (FY) 2015 Funding Round to invest in CDFIs and to build their capacity to serve low-income people and communities that lack access to affordable financial products and services; 2 Washington Friday Report September 26 Prepared and forwarded the Washington Friday Report to the Mayor,which covered the following subjects: Attorney General Eric Holder Steps Down, My Brother's Keeper Community Challenge, Homeownership Summit, HUD Promise Zones - Second Round, Building Community Trust and Justice, Senate Democrats' Lame Duck Agenda Includes MFA, Grants This Week, Importance of Infrastructure Investment, Disaster Resilience and Climate Change,and Music of the Month; October 3 Prepared and forwarded the Washington Friday Report to the Mayor,which covered the following subjects:U.S. Conference of Mayors Leaders in Sacramento, My Brother's Keeper Community Challenge, Transportation: Back to the Future, Transit-Oriented Development Webinar, HUD Promise Zones - Second Round, Grants This Week, Climate Action Champions Competition, Freight Traffic: Growth But Congestion, and EPA Chief and Others on the Water Rule; October 10 Prepared and forwarded the Washington Friday Report to the Mayor,which covered the following subjects: COPS - 20 Great Years, New Challenges, Obama Administration Response to the Ebola Pandemic, Promise Zones Webinar, Transportation: Calls for a Long-Term Bill This Year, Gearing Up for the Next ACA Open Enrollment Period, Manufacturing Institutes, Grants This Week, Infrastructure,Comment Period for Water Rule Extended,and Assessing Reforms to the Housing Finance System; 3 Washington Friday Report October 17 Prepared and forwarded the Washington Friday Report to the Mayor,which covered the following subjects: Federal Government Responds to Ebola Threat, Tax Extenders, A Busy Transportation Week, A New Deficit Low, EPA Ozone Proposal, Progress Report on Helping Long-Term Unemployed, Public Art Challenge, Defense Department Prepares for Climate Change, Grants This Week, Mayors and Entrepreneurship, "Stop and Frisk," and Bethesda Urban Partnership. Professional Services for the Month of October 2014.................................$833.00 Expenses (see attached summary and receipts 28.6%)................................ .. -j32.12 l TOTAL AMOUNT DUE....................................................... . . ............. .....$9 .12 LEONARD S. SIMON t aaaJJJ President V , 4 i ° SIMON AND COMPANY communications ° •' 004000000224940 - 0270482120 10/09/14 $1,824.47 STATEMENT OF ACCOUNT: SIMON AND COMPANY Payments Federal Surcharges and Taxes continued PREVIOUS BALANCE 886.22 Cost Recovery Fee 1.04 BALANCE BEFORE NEW CHARGES: Federal Excise Tax 0.33 886.22 Federal Regulatory Fee 2.75 Product Charges Federal Universal Service Fund 12.63 Surcharge Product FR Date TO Date Quantity Each Amount Property Tax Allotment Fee 7.90 Integrated Services Total Federal Surcharges and Taxes 24.65 Additional Network Access 10/09/14 11/08/14 1 341.00 341.00 Charge State and Local Surcharges and Taxes IP Flex 5 Mbps EoC 10/09/14 11/08/14 1 375.00 375.00 911 VOIP Tax 48 36.48 XO IP LD Business Plan 2000 10/09/14 11/08/14 1 60.00 60.00 DC State&Local Sales Tax 1.11 Total Integrated Services 776.00 State Universal Service Fund Surcharge 0.86 Voice Utility Users Tax/Business 35.44 Verified Account Codes 10/09/14 11/08/14 1 10.00 10.00 Total State and Local Surcharges and Taxes 73.89 Total Voice 10.00 Total Product Charges 786.00 Summary Other Charges TOTAL CURRENT CHARGES $938.25 �. .._.. . Quantity Each Amount Other TOTAL AMOUNT DUE: $1,824.47 Access Recovery 1 74.68 74.68 Administrative Service Charge 1 12.50 12.50 Total Other 87.18 Total Other Charges 87.18 Product Usage Charges Calls Minutes Amount Local Area 218 848.9 .00 Long Distance Inter-State Long Distance 83 673.2 .00 International 6 199.1 28.24 Site to Site Local Area 34 117.7 .00 Total Usage Charges Y8.Y4- Fees And Charges Late Charge on Past Due Balance 13.29 Total Fees and Charges 13.29 Product Discounts Premium DSC 20%IP Flex (75.00) Total Product Discounts (75.00) INDYSTAR BRANDON KEY October 2014 — -� Share digital access I _ i. INDYSTAIt ; Manage account 1-f _ — - ----- ------------ ------ — ---- Newsletter settings j. Full access: Digital only 1 Access eNewspaper j Billing info Monthly rate: $12.00 f. F Need help?Call Customer Service at 1-888-357-7827 { or email them at indianapolisstar@gannett.com i } Interested in print delivery? t Upgrade today to enjoy the convenience of home delivery,with money- Call Customer Service at saving coupons,ad inserts and more. 1-888-357-7827 to add print delivery. I 812 Monthly Subscription Charge for the Indianapolis Star etreAM INVOICE 90 Account Number 409408309 Billing Date 9/21/14 Due Date 10/5/14 Previous Balance. $116.85. Service from 8/4/14 to 11/2/14 Payments-Thank You $0.00 Number of days in billing period 91 Payments received after 9/19/14 will not appear on this notice. Credits $0.00 Service adjustments occurring after 9/21/14 will appear on future notices. New Charges $0.00 Make checks payable to:The New York Times. 039035 '000001641 Amount Due . $116.85 409408309'092114 90 R112 MF 1 t" For Customer Care,call 7 days a week: III I�IIIIII�I'lIlI1'III'IIIIII'IIIIIIIII'I'I'I�IIIIII�IIIIIII�I�I "-�` 1-800-NYTIMES (1-800-698-4637) . NONE SIMON CO Email:customercare@nytimes.com 1660 L ST NW STE 501 Monday-Friday 5AM-12 Midnight ET 2 WASHINGTON DC 20036-5662 Saturday&Sunday 5AM-5PM ET or visit our Web site: http://homedelivery.nytimes.com (see reverse for more information) 0 A p . 0 . • Previous Balance $116.85 Subscriber Name: SIMON CO Amount Due $116.85 NI14osztaso35 000001e41 DETACH AND MAIL WITH YOUR PAYMENT.PLEASE MAKE SURE THE ADDRESS SHOWS THROUGH THE WINDOW. SIMON CO 4094083099%21/14 110/5/14 $116.85 SWITCH TO CONVENIENT AUTO-MATIC'BILLING >, SUPPORT EDUCATION I authorize payment of this and all future billing amounts using the credit card You cavi make a donation to The New York Times's classroom programs,once or regularly. or bank account below. See reverse for details.Check below: Signature ADD-ON DONATION. In addition to my subscription . • ■• • payment,I would like to donate to provide The Times ❑ CREDIT CARD-Charge the credit card circled below for each to schools.(Write In your donation amount at right.) billing period. RECURRING DONATION. I would like to donate • • WE] Wd the amount I have written in the EDUCATION DONATION box each time I pay my subscription Invoice. Please remind me on future invoices. Account Number Exp Date �I� I 1 nl r �Il�nd null Ills till rl r t BANK ACCOUNT WITHDRAWAL-Deduct my payment from my bank VIII III I I I I I I I I II II I I I I II I II account for each billing period. I have read and a9 `'+ reed to the terms on ^+ Y �►. the back of this notice.Please enclose a voided check for the bank Zhe New Mork el tm.t0 account you wish to use. PQ BOX 371456 El CHANGE OF ADDRESS-Check here-if you have a change to name, address or phone number and complete the boxes on the back. PITTSBURGH PA 15250-7456 Z 03 3201129 092114 232202 409408309 00116855 St,ephanie McIntosh From: Len Simon <len.simon@simoncompany.com> Sent: Friday,October 10, 201412:43 PM To: 'Stephanie McIntosh' Subject: FW:Your receipt No.204085115713 Wall Street Journal From: i i"unes Store [mailto:do_not_reply@itunes.confl Sent: Friday, October 10, 2014 2:40 AM To: len.simon@simoncompany.com Subject: Your receipt No.204085115713 f iTunes receipt Billed To: len.simon@simoncompany.com Order ID: M2MDXFBN9B LEONARD SIMON Receipt Date: 10/09/14 1660 L Street N.W. Order Total: $24.31 Washington, DC 20036-5603 Billed To:Visa .... 2007 USA Item Seller Type Unit Price The Wall Street Journal.,The Wall Street Journal (Automatic WALL STREET JOURNAL Subscription $22.99 Renewal) Renewal Report a Problem View Privacy Policy Subtotal: $22.99 Tax: $1.32 Order Total: $24.31 Please retain for your records. Please See Below For Terms And Conditions Pertaining To This Order. Apple Inc. You can find the iTunes Store Terms of Sale and Sales Policies by launching.your iTunes application and clicking on Terms of Sale or Sales Policies Answers to frequently asked questions regarding the Tunes Store can be found at http://www.apple.com/support/itunes/store/ Apple ID Summary• Purchase History Apple respects your privacy. Information regarding your personal information can be viewed at https://www.apple.com/legal/privacy/ Copyright @ 2014 Apple Inc:All rights reserved 1 FCRQ01L DATE 9/12/2014 CALL. }`' NAME..ID 3897 77 K.ingto NE_ 20, Flpor SthIN vo Po wash ington,-DC204o2 INVOICE 365660-1 www.cgrollcall.com TAX ID 13-3723190 000 432 2250`•202 65p 6621 Fait"202A50 6760 E-mail:oontr&bf @cgrollrall.corn DUNS#780247644 QRTR 4038467 B STEPHANIE CARTER SSTEPHANIE CARTER L SIMON&COMPANY INC I S SONO&COMPANY INC L STE 501 P 1660 L ST NW 1660 L ST NW WASHINGTON,DC 20036 T WASHINGTON DC 20036 T .o 0 Rerlodical ;Start Expire, Copses Subscription; F. Dafie' Date= Prlce Previous payments(Inc tax) 8/19/2014 8/18/2015 "'$10,046.i6 $000 Budget Tracker - - Taxes{>ff applicable) $136 56 *DUE UPON RECEIPT* -' Balance Due $2511 56 ❑ Payment Enclosed imU;5 dollar'sinad6 payable(o,CO-Roll Call,Inc. PLEASE PAY or ❑Mastercard U Visa ❑.A-hmenc'an ExpI`esS <retpired'information) Card Number pease_ist a I digits) Expiration'Date Slgnature If your paymenC_has been sent,thank you and Daytime Phone-Number please:disregardahrstptice` CQ:.is:partof Cd R011 Gall,operated by CC1 Roll Cat'I,ine: Please return this top portion with payment Thankyou! Customer Record Tear Here CG R. L 77 KSOr i&NE Sth'Eloor www,egiollcb 140M = 800 432 2250; 202 650 6621 Subscnptlon Tltle'_'BGTR ArnoUnt Paid Fax 202650;6760 Name ID, 3897 Method of Payment` E mad;contracks[cgroilcalic0m-. In' voice' 365660 Date ;. Keep this bottom portion fo;your records RECEIPT ;ental Agreement Number: 397432523 : lehicle Number: 67246130 'OUR INFORMATION ;IMON,LEONARD _ ;APID RDI JJ698J H YA T T BUDGET DISC: 1� SIMON AND COMPANY. INC REGENCY � 'AYMENT METHOD: 'OUR RENTAL Leonard Simon icked up: SMF 1660 L street Nw Suite 501 late/Time: SEP 27, 2014@12:38PM Washington Dc 20036 returned: SMF late/Time: SEP 30, 2014@04:48AM Resv #F: 14634452 'eh Group: Compact 'eh Charged: Compact 'ehiele: FORD'FOCUS You have checked out of Room 844 ldometer Out: 6947 dometer In: 7002 uel Reading: 'OUR VEHICLE CHARGES Date Description Amou Sep 27 Group. Room $159. sep. 27Occupancy Tax $19. 3 DY@ 30.00 90.00 Sep 27 Sacramento Tourism Asses $4. ISCOUNT 5.0 4.50 Sep 27 CA Tourism Assessment $0. OUR TIME AND MILEAGE: 85.50 Sep 27 Parking valet $25. Sep 28 In, Room Dining Dinner $27:. Sep 28 Grop Room $159. 'OUR TAXABLE FEES Sep 28 occupancy Tax $19, Sep 28 Sacramento Tourism Asses $4. *11 .11% FEE 9.75 Sep 28 CA Tourism Assessment $0. UEL SERVICE 13.99 Sep 28 Parking valet $25. 'Sep 29 Internet-'(Gue'st) $9,: TP SR$ 0.75DY 2.25 Sep _29 Guest Room 'Internet Adj Mr. Len Simon Room No. : 324 1660 L Street NW Arrival : 10-07-14 Suite 501 Departure : 10-09-14 Washington, DC 20.036 Folio No. United States Conf. No. : 47913 Company Name: US Conference Cashier No. : 2 Group Name: USCM Custom Ref. _Date Description Charges Credits 10-07-14 Suite Service Food Dinner 24.17 Room#324 : CHECK#0030373 10-07-14 ROOM CHARGE 155.00 10-07-14 State Tax 10.08 10-07-14 Countv Tax 1.55 10-07-14 City Tax 2.33 10-07-14 Tourism Tax 3.10 . 10-07-14 LRAP Tax 3.10 10-08-14 ROOM CHARGE 155.00 10-08-14 State Tax 10.08 10-08-14 County Tax 1.55 10-08-14 City Tax 2.33 10-08-14 Tourism Tax 3.10 10-08-14 LRAP Tax 3.10 Total Charges 374.49 Total Credits 0.00 Palanca ?74,.10 Guest Signature:. Page No.1 of 1 111 W.Markham Street I Little Rock,Arkansas 72201 ph:501.374.7474 I toll free: 1.877.637.0037 fx:501.370.7091 www.capitalhotel.com Len Simon From: Square [noreply@messaging.squareup.com] Sent: Friday, October 10, 2014 12:26 AM To: len.simon@simoncompany.com Subject: Receipt from Taxi Custom Amount Subtotal Tip Total . 1 'i I HITCH I CAB #FEDERAL 33 ;;,F..; ;}; J116 i (202) 810-4482 - i_iCh WASHINGTON, DC ?L+,!ER 2E' 09/24/14 12:29 Filomena Ristorante pa)1� AOL-"Best Italian" DIST.... 2.70 1063 Wisconsin Ave, N.W. FARE...$ 12.43 t _. . Washington D.C. - ;:•a1_;ii, DC TIP....$ 2.74 � (202) 338-8800 ,_4 14,09 i- EXTRAS.$ 1.25 TOTAL..$ 16.42 ; Server: Gino DOB: 09/24/20 1..40 02:06 PM 09/24/20 47 sable 84/1 3/300 : MID 445100500997 , 3 2.133 !� ,$ 1.25 AUTH 07755D SALE SIGN HERE: .$ 12.20 Card #XXXXXXXXXXX..___- 62914E Magnetic card present: Yes Card Entry Method: S ;;,;2c_i0; uA J: _AL'.97 5,_C; Approval: 08800D ere: Amount: $ 82.9 - ------ + Gratuity: Total: I agree to pay the above total amount according to the card -issue agreement. X Za9at-"USA Top Italian" Washingtonian-"Best Pasta" Washingtonian-"Top Italian" ***CUSTOMER COPY*** 1 TAXV CAB RECEIPT di Az DATE TIME 1 640 lr CAB# ORIGIN I N&V$tvv1n DESTINATION I cir_fJATl IRF VOUCHER NO. WARRANT NO. ALLOWED 20 Simon and Company IN SUM OF$ 1660 L Street N.W. Washington, D.C. 20036 �a�s � ON ACCOUNT OF APPROPRIATION FOR Mayor's Office PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members 31594 Statement 43-404.00 -JU65.1-2-- I hereby certify that the attached invoice(s), or _ bill(s) is (are)true and correct and that the • �'S materials or services itemized thereon for 'which charge is made were ordered and received except Monday, November 03, 2014 Mayor 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)) 10/28/14 Statement $965.12 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