240779 01/07/15 CITY OF CARMEL, INDIANA VENDOR: 367042
ONE CIVIC SQUARE PAPERLESS BUSINESS SYSTEMS CHECK AMOUNT: $**...**720.00*
CARMEL, INDIANA 46032 1417 FOURTH AVE,4TH FLOOR CHECK NUMBER: 240779
SEATTLE WA 98101 CHECK DATE: 01/07/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1125 R4355300 37904 S006176 720.00 EREQUESTER LICENSE
= _ Invoice
paperless
business systems
1417 Fourth Avenue,4th Floor Invoice Number SO-06176
Seattle,WA 98101 Invoice Date December 16,2014
p 206.256.0771 Purchase Order Supplemental
f 206.282.3312 Customer Number CACL001
SOLD TO: SHIP TO:
Carmel Clay Parks&Recreation Carmel Clay Parks& Recreation
Attention: Accounts Payable Attention: Accounts Payable
1411 E 116th Street 1411 E 116th Street
Carmel, IN 46032 Carmel, IN 46032
SALES ORDER TERMS PBS CONTACT
SO-06176 10 days of receipt Accounts Receivable
Description Amount
eRequester Hosted(SAAS)
5 Additional Named Users(55 total) 720.00
12 month subscription(will be prorated on the renewal of the complete system)
7DEC 1 7 2014
BY:
A 11/2%monthly charge is payable on all overdue balances.
The grant of any license or right is conditioned on receipt of full payment.
All payments and dollar amounts are in U.S.Dollars.
Remit to:Paperless Business Systems, Inc.,1417 Fourth Avenue,4th Floor,Seattle,WA 98101
p 206.256.0769 f 206.282.3312 www.paperlessbusiness.com ardepartment@paperlessbusiness.com TOTAL AMOUNT USD $720.00
Wire Information: Swift#BOFAUS314 Bank of America,WA3-177-01-01
Bank Name:Bank of America Routing M 125000024 408 Pike St.Seattle,WA 98101
ABA#026009593 Account#:138019775709(savings)
i
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice of 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.
367042 Paperless Business Systems Terms
1417 Fourth Avenue, 4th Floor
Seattle, WA 98101
Invoice Invoice Description
Date Number (or note attached invoice(s)or bill(s)) PO# Amount
12/16/14 S006176 Additional user license 37904 $ 720.00
Total $ 720.00
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
120
Clerk-Treasurer
l — —
Voucher No. Warrant No.
367042 Paperless Business Systems Allowed 20
1417 Fourth Avenue, 4th Floor
Seattle, WA 98101
In Sum of$
$ 720.00
ON ACCOUNT OF APPROPRIATION FOR
101 General Fund
PO#orBoard Members
INVOICE NO. CCT#/TITL AMOUNT
Dept#
37904 F S006176 4355300 $ 720.00 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
January 2, 2015
Signature
$ 720.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund