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241154 01/13/15 CITY OF CARMEL, INDIANA VENDOR: 368053 +a 'I ONE CIVIC SQUARE TOSHIBA FINANCIAL SERVICES CHECK AMOUNT: $ .....367.95* 9M ° CARMEL, INDIANA 46032 PO BOX 790448 CHECK CHECK NUMBER: 241 154 ST LOUIS MO 63179-0448DATE: 3/15 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1160 R4353004 31761 269505087 367.95 COPIER LEASE AND MAIN I INVOICE NUMBER 269505087 Toshiba Financial Services Aprogram of U.S.Bank Equipment Finance DATE DUE TOTAL DUE 1/25/2015 $367.95—� TOSHIBA FINANCIAL SERVICES ''� _ 1310 MADRID STREET SUITE 101 MARSHALL,MN 56258 F1CHECK HERE IF ADDRESS CORRECTION IS NEEDED COMPLETE INFORMATION ON REVERSE SIDE PLEASE REFERENCE INVOICE#ON YOUR CHECK 000004015 1 AB 0.406 106481866846336 P PLEASE RETURN THIS PORTION WITH REMITTANCE PAYABLE TO: SHARON KIBBE CARMEL CITY OF 1 CIVIC SQUARE i1�i�nlllln��I�luI��II�I�I'��IIIII�III�IIII'Il�iln��llni�ll� CARMEL, IN 46032-2584 TOSHIBA FINANCIAL SERVICES P.O. BOX 790448 ST LOUIS, MO 63179-0448 790448 269505087 000036795 DATE OF INVOICE 1/1/2015 Toshiba Financial Services INVOICE NUMBER 269505087 A program of U.S.Bank Equipment Finance Customer Credit Account Number 1351340 DATE DUE TOTAL DUE TOSHIBA FINANCIAL SERVICES 1310 MADRID STREET SUITE 101 1/25/2015 $367.95 MARSHALL,MN 56258 800-828-8246 CUSTOMERSUPPORTEF@ONLI NECOMM ENT.COM PAGE 1 OF 2 FOR INVOICE INQUIRIES, PLEASE CONTACT US AT 800-828-8246 MESSAGES SAVE TIME:MAKE QUICK AND EASY ONLINE PAYMENTS BY VISITING HTTPS•/FINANCING.EPORTALDIRECT.COM CONTRACT NUMBER DATE DESCRIPTION AMOUNT GRP POOL 50359 POOL 1 12/25/2014-1/25/2015 CONTRACT PAYMENT 367.95 BLACK&WHITE CARMEL CITY OF 1 CIVIC SQ FL 3 CARMEL, IN 46032 500-0397813-000 TOSHIBA ES5540CT COPIER SERIAL NUMBER SCBAD24860 POOL COLOR CHECK WHICH APPLY: NEW BILLING ADDR._ NEW EQUIP.LOC. NAME ADDRESS ATTN (PHONE) (FAX) (CITY) (STATE) (ZIP CODE) (AUTHORIZED SIGNATURE) (COUNTY) DATE OF INVOICE 1/1/2015 Toshiba Financial Services INVOICE NUMBER 269505087 Aprogram of U.S.Bank Equipment Finance 1� •';�:F Customer Credit Account Number 1351340 DATE DUE TOTAL DUE TOSHIBA FINANCIAL SERVICES 1310 MADRID STREET SUITE 101 1/25/2015 $367.95 MARSHALL,MN 56258 800-828-8246 CUSTOMERSUPPORTEF@ONLINEGOMMENT.COM PAGE 2 OF 2 FOR INVOICE INQUIRIES, PLEASE CONTACT US AT 800-828-8246 CONTRACT NUMBER DATE DESCRIPTION AMOUNT CARMEL CITY OF 1 CIVIC SO FL 3 CARMEL,IN 46032 500-0397813-000 TOSHIBA ES5540CT COPIERS-CPC -- - ........... - -... - SERIAL NUMBER SOBAD24860-C ***A LATE CHARGE WILL BE ASSESSED IF PAYMENT IS NOT RECEIVED BY DUE DATE. IF FOR ANY REASON YOUR CHECK IS RETURNED FOR NON-PAYMENT YOU WILL PAY US A$30.00 FEE OR, IF LESS, THE MAXIMUM ALLOWED BY LAW OR THE CONTRACT.*** CHECK WHICH APPLY: NEW BILLING ADDR._ NEW EQUIP.LOC. NAME ADDRESS ATTN (PHONE) (FAX) (CITY) (STATE) (ZIP CODE) (AUTHORIZED SIGNATURE) (COUNTY) 1 � 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)) 01/01/15 269505087 $367.95 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 20Clerk-Treasurer VOUCHER NO. WARRANT NO. Toshiba Financial Services ALLOWED 20 IN SUM OF $ P. O. Box 790448 St. Louis, MO 63179-0448 $367.95 ON ACCOUNT OF APPROPRIATION FOR Mayor's Office PO#/Dept. INVOICE NO. I ACCT#!TITLE AMOUNT Board Members 31761 269505087 1 43-530.04:r$367.95 I 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, January 12, 2015 Mayor Title Cost distribution ledger classification if claim paid motor vehicle highway fund