HomeMy WebLinkAbout242093 2 /10/2015 CITY OF CARMEL, INDIANA VENDOR: 361528
® � ONE CIVIC SQUARE STAPLES BUSINESS ADVANTAGE CHECK AMOUNT: $"`*`1,124.97`
CARMEL, INDIANA 46032 DEPT DET CHECK NUMBER: 242093
PoBOX036 60696-3689 CHECK DATE: 02/10/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
911 4239099 3254440532 43.45 OTHER MISCELLANOUS
1081 4230200 3254440549 35.48 OFFICE SUPPLIES
1110 4230200 3255004131 62.35 OFFICE SUPPLIES
1205 4230200 3255004134 44.03 OFFICE SUPPLIES
1701 4230200 3255004137 26.89 OFFICE SUPPLIES
1081 4230200 3255004150 208.08 OFFICE SUPPLIES
1091 4230200 3255004151 337.25 OFFICE SUPPLIES
1125 4230200 3255004152 326.06 OFFICE SUPPLIES
911 4230200 32554440535 41.38 OFFICE SUPPLIES
INIUQICEtRrA'fvE;,�,y CU�,S1�Othl�lt= ;;J t v,f���3 Sl_1MM`'Rl�INVDIC�; -
1/17/15 DET 1061088 8032898689
Q-6
2/16/15 Net 30 Days 531.88
I"010E DETAIL _
staples Advantage Federal ID #:04-3390816
Bill to Account: 1030382 Ship to Account:. 3 CIVIC SQUARE
CITY OF CARMEL-NJPA CITY OF CARMEL
JIM SPELBRING ATTN: MARIE DOAN _
1 CIVIC SQUARE 3 CIVIC SQUARE
CARMEL, IN 46032 DELIVER BY 4PM
CARMEL, IN 46032
Budget Ctr 110 - POLICE DEPARTMENT Invoice Number: 3254440532
Budget Ctr Desc: order 7129994852-000-001
P 0 Number Ordered By MARIE DOAN
P o Desc order Date 1/12/15
Release
Release Desc
order order B/o Unit Ship Unit Extended
Line Item Number Description Qty Qty Meas Qty Price Price
1 071480 15 AAG MTH DSK PD 22 X 17 1 EA 1 7.74 7.74
2 356332 POWEREXTREME ELEC SHARPENER 1 EA 1 35.71 35.71
Freight: .00 Tax:( .0000 %) .00 sub-Total: 43.45
Total: 43.45
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Customer Service inquiries # 877-826-7755 Invoice Payment Inquiries 888-753-4104 Page: 1
Make checks a able to staples Advantage, Dept DET Po Box 83689, Chicago IL 60696-3689
IIVVflICE DATr Y CUSTOME�t .; µ a;t� SrUMMARY II1117QxCE
1/17/15 DET 1061088 8032898689
2/16/15 Net 30 Days 531.88
I"OICE DETAIL
staples Advantage Federal ID #:04-3390816
Bill to Account: 1030382 Ship to Account: 3 CIVIC SQUARE
CITY OF CARMEL-NJPA CITY OF CARMEL
JIM SPELBRING ATTN: MARIE DOAN _
1 CIVIC SQUARE 3 CIVIC SQUARE
CARMEL, IN 46032 DELIVER BY 4PM
CARMEL, IN 46032 _
0
Budget Ctr 110 - POLICE DEPARTMENT Invoice Number: 3254440535
Budget Ctr Desc: order 7130332418-000-001
P O Number Ordered By MARIE DOAN
P 0 Desc Order Date 1/16/15
Release
Release Desc
order order B/o unit ship Unit Extended
Line Item Number Description Qty 4ty Meas Qty Price Price
1 789344 CRYSTAL COVER CLEAR LTR 10OPK 1 PK 1 29.37 29.37
2 572697 BINDING COMBS 1/41N BLK 10OPK 1 PK 1 5.68 5.68
3 572699 COMBS 5/161N 100 PACK BLACK 1 PK 1 6.33 6.33
Freight: .00 Tax:( .0000 %) .00 sub-Total: 41.38
Total: 41.38
.............. .. ._......._... ..__.._... ........_ ........... ................... - . . ._.... ._ .. .. .... . . _.- -------------- ---:...
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Customer Service inquiries # 877-826-7755 Invoice Payment Inquiries 888-753-4104 Page: 1
Make checks a able to staples Advantage, Dept DET PO eox 83689, Chicago IL 60696-3689
VOUCHER NO. WARRANT NO.
ALLOWED 20
Staples Advantage
IN SUM OF $
Dept. DET
P.O. Box 83689
Chicago, IL 60696-3689 !
$84.83 i
ON ACCOUNT OF APPROPRIATION FOR
Project 2015-911 Task 2015-2
� I
I
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
hereby certify that the attached invoice(s), or
911 3254440535 42-302.00 $41.38
bill(s) is (are) true and correct and that the
911 3254440532 42-390.99 $43.45
l materials or services itemized thereon for
which charge is made were ordered and
received except
i
Tuesday, February 03, 2015
Major
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))
01/17/15 3254440535 $41.38
01/17/15 3254440532 $43.45
I hereby certify that the attached invoice(s), or bill(s), is (are)true and correct and I have audited same in accordance
with IC 5-11-10-1.6
, 20
Clerk-Treasurer
INVOICE DATE CUSTQMER SUMMOY,,INUOIGE'
1/24/15 DET 1061088 8032987550
2/23/15 Net 30 Days 967.00
INVOICED.EzuL
Staples Advantage Federal ID #:04-3390816
Bill to Account: 1030382 Ship to Account: 1 CIVIC SQUARE
CITY OF CARMEL-NJPA CITY OF CARMEL
JIM SPELBRING ATTN: LINDA TRAVISON o
1 CIVIC SQUARE 1 CIVIC SQUARE
CARMEL, IN 46032 DELIVER BY 4PM
HR
CARMEL, IN 46032
Budget Ctr 1205-DoA Invoice Number: 3255004134
Budget Ctr Desc: order 128479705-000-001
P 0 Number Ordered By LINDA TRAVISON
P O Desc Order Date 10/07/14
Release
Release Desc
order order B/0 unit Ship unit Extended
Line Item Number Description Qty Qty Meas Qty Price Price
1 306363 RED/GREEN FLAKES LETTERHEA 80C 7 PK 7 6.29 44.03
Freight: .00 Tax:( .0000 %) .00 sub-Total: 44.03
Total: 44.03
Backorder of 0128479705
- - - - ----- -- ------- ----- ------- --- - ---- -- ------ ------- -------.- ......... . .....- ....- - ....... . ..
Submitted To
FEB 0.9 2014
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Clerk YT ressurer
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Customer Service inquiries # 877-826-7755 Invoice Payment Inquiries 888-753-4104 Page: 1
Make checks ayable to
it Advantage, De t DET Po Box 83689, Chicago IL 60696-3689
VOUCHER NO. WARRANT NO.
III Staples Advantage ALLOWED 20
IN SUM OF$
Dept DET PO Box 83689
Chicago, IL 60696-3689
$44.03
I
I
ON ACCOUNT OF APPROPRIATION FOR
Administration Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1205 I 3255004134 I 42-302.00 I $44.03 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, February 09, 2015
Director, Administration
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))
01/24/15 3255004134 $44.03
I hereby certify that the attached invoice(s), or bill(s), is(are)true and correct and I have audited same in accordance
with IC 5-11-10-1.6
20
Clerk-Treasurer
' IM/OICE DATE>1{ CUSTOMER ',r,,,;,, ,; SUMMARY�INVOICE-
1/24/15 DET 1061088 8032987550
PLEASE pAY BY„r 'TERMS . n;', 4_;ff AMOUNT DUE
2/23/15 Net 30 Days 967.00
I"OICE DETAIL -_
Staples Advantage Federal ID #:04-3390816
0
Bill to Account: 1030382 Ship to Account: 1 CIVIC SQUARE
s
CITY OF CARMEL-NJPA CITY OF CARMEL
JIM SPELBRING ATTN: ANN DAVIS
1 CIVIC SQUARE 1 CIVIC SQUARE _
CARMEL, IN 46032 DELIVER BY 4PM
0
CARMEL, IN 46032
s�
_ Budget Ctr 140 - COMMON COUNCIL Invoice Number: 3255004137 -
Budget Ctr Desc: order 7130103785-000-002
P 0 Number ordered By ANN DAVIS
P O Desc order Date 1/13/15
Release
Release Desc
order order B/o unit ship unit Extended
Line Item Number Description Qty Qty Meas Qty Price Price
5 919932 ENVL DBL WD LSR W-2 1 PK 1 26.89 26.89
Freight: .00 Tax:( .0000 %) .00 sub-Total: 26.8989
Backorder of 7130103785 Total: 26.
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Customer Serviceinquiries # 877-826-7755 Invoice Payment Inquiries 888-753-4104 Page: 1
Make checks a able to St les Advantage, Dept DET PO Box 83689, chica o iL 60696-3689
Prescribed by State Board of Accounts City Form No.201(Rev.1995)
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice or bill to be properly itemized must show: kind of service, where performed, dates service rendered, by
whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc.
Payee
r
i Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
1✓'Qi � S Y'��
Total
I hereby certify that the attached invoice(s), or bill(s), is (are)true and correct and I have audited same in accor-
dance with IC 5-11-10-1.6.
, 20
Clerk-Treasurer
VOUCHER NO. WARRANT NO.
ALLOWED 20
S IN SUM OF$
PO ��4
ON ACCOUNT OF APPROPRIATION FOR
Board Members
INVOICE NO. ACCT#/TITLE AMOUNT
DEPT.
# I hereby certify that the attached invoice(s),
0221 x.550 131 302— 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
20
Signat r
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund
INVOICE DATE CUSTOMER - SUMMARY-.INVOICE
� y 1/24/15 DET 1061088 8032987550
2/23/15 Net 30 Days 967.00
1"010E DETAIL
Staples Advantage Federal ID #:04-3390816
Bill to Account: 1030382 Ship to Account: 3 CIVIC SQUARE
v
CITY OF CARMEL-NJPA CITY OF CARMEL
JIM SPELBRING ATTN: BLAINE MALLABER s
1 CIVIC SQUARE 3 CIVIC SQUARE
CARMEL, IN 46032 DELIVER BY 4PM
CARMEL, IN 46032
0
Budget Ctr 110 - POLICE DEPARTMENT Invoice Number: 3255004131
Budget Ctr Desc: Order 71304'u7763-000-001
P 0 Number ordered By BLAINE MALLABER
P O Desc Order Date 1/20/15
Release
Release.Desc
order order B/o unit ship Unit Extended
Line Item Number Description Qty Qty Meas Qty Price Price
1 677797 SPLS LASER BUS CARD WHT 250PK 5 PK 5 12.47 62.35
Freight .00 Tax:( .0000 %) .00 Sub-Total: 62.35
Total: 62.35
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customer serviceinquiries # 877-826-7755 Invoice Payment Inquiries 888-753-4104 Page: 1
Make checks payable
to St les Advanta e, Det DET PO Box 83689, Chicago IL 60696-3689
VOUCHER NO. WARRANT NO.
ALLOWED 20
Staples Advantage
IN SUM OF$
Dept DET
P.O. Box 83689
Chicago, IL 60696-3689
$62.35
ON ACCOUNT OF APPROPRIATION FOR
Carmel Police Department
PO#/Dept. INVOICE NO. I ACCT#IrITLE AMOUNT Board Members
I
1110 j 8032987550 j 42-302.00 $62.35 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
Friday, February 06, 2015
Chief of Police
Title
i
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))
01/24/15 8032987550 business card stock $62.35
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
4;
`��'° `� 7 E
1/17/15 DET 1061088 8032898694
JAN 2 2015 ! " . ��' X ..nom}�.iu, � ybv �� `
..��� :its
$ :_ 2/16/15 Net 30 Days 35.48
INVOICE DEMUL _
staples Advantage Federal ID #:04-3390816
C
Bill to Account: 1030597 Ship to Account: CHERRYTREE ELEM
CARMEL CLAY PARKS AND RECREATION CHERRY TREE ELEMENTARY SCHOOL
PAULA SCHLEMMER ATTN: TIFFANY BUCKINGHAM
1411 E 116TH ST 13939 HAZEL DELL PKWY
CARMEL, IN 46032 ATTN: ASHLEY LIVINGSTON �
CARMEL, IN 46033 �
Budget Ctr 1082-2-4230200 CHERRY TREE ELEMENTARY Invoice Number: 3254440549
Budget Ctr Desc: Order 71300.62110-000-001
P 0 Number xx-1602 Ordered By ; DAWN KOEPPER
P 0 Desc Order Date 1/13/15 L
Release �—
Release Desc
order order B/o unit Ship unit Extended
Line Item Number Description Qty Qty Meas Qty Price Price
1 569264 SLIM CLIPBOARD STORAGE BOX 4 EA 4 8.87 35.48
Freight: .00 Tax:( .0000 %) .00 sub-Total: 35.48
Total: 35.48
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Customer service inquiries 1877-826-7755 Invoice Payment inquiries 888-753-4104 Page: 1
Make checks a able to sta les Advantage, Dept DET Po Box 83689, Chita o IL 60696-3689
' I�IVOICEDA7,F;,r', CUS�'OM�R�s.r.w..t�'���,:tw?r�� ` SLJN�h�gRY'INVOIC_F�=
! FEB -5 2015 V 1/24/15 DET 1061088 8032987554
7E4tMS f,,`` AMO NT DUE :w
,._�ur.�..}rA ,::,..ter. �-�..,�'..fn� ,y,:._
2/23/15 Net 30 Days 871.39
INVOICEDET.uL
staples Advantage Federal ID #:04-3390816
0
8111 to Account: 1030597 Ship to Account: 1411 E 116TH ST
CARMEL CLAY PARRS AND RECREATION CITY OF CARMEL
PAULA SCHLEMMER ATTN: DAWN KOEPPER
1411 E 116TH ST 1411 E 116TH ST
CARMEL, IN 46032 CARMEL, IN 46032
0
Budget Ctr 1125-100-010-4230200 ADMINISTRATION Invoice Number: 3255004152 �
Budget Ctr Desc: order : 7130484440-000-001
P-O-Number 37997 ordered By DAWN-KOEPPER
P O Desc Order Date 1/20/15
Release
Release Desc
order order B/o unit ship Unit Extended
Line Item Number Description Qty Qty Meas Qty Price Price
1 135848 STAPLES 8.5x11 COPY CS 2 CT 2 39.60 79.20
2 572353 TAPE MASKING GENERL PURPOSElIN 2 RL 2 1.38 2.76
3 575699 FILE POCKET 1524EB LTR 3.5 1 BX 1 32.64 32.64
4 726597 REINFORCD HANGFLDR STD GRN LTR 3 BX 3 13.29 39.87
5 351843 POST-IT 1.5X2 GRNR CNRY 12PK 1 PK 1 5.07 5.07
6 564231 POST-IT 3X3 ULTRA NOTES 1 PK 1 13.59 13.59
7 388163 INDEX MONTHLY BK 4 ST 4 5.19 20.76
8 051165 HI-LITER 25025 BROAD TIP F/YE 1 DZ 1 6.53 6.53
9 049022 HIGHLIGHTER MAJOR ACCENT PNK 1 DZ 1 6.53 6.53
10 471514 . SHARPIE CHISEL DZ BLK 1 DZ 1 12.61 12.61
11 474344 SHARPIE CHISEL DZ RED 1 DZ 1 16.39 16.39
12 086791 2015 DAILY ATAGLNC REFILL 3X6 1 EA 1 4.19 4.19
13 649280 TAPE DOUBLE -SIDED W/DISPENSER 1 PK 1 5.19 5.19
14 186999 CLASP ENV BRN KRAFT 6X9 -100 1 BX 1 5.44 5.44
15 233577 7.5X10.5 CLASP ENV 10OCT BROWN 1 BX 1 8.45 8.45
16 449460 CLASSIC COMFORT LASER PT GN 3 EA 3 22.28 66.84
Freight: .00 Tax:( .0000 .00 sub-Total: 326.06
Total: 326.06
AO Office Supplies
GLAccount# 1125102-4230200
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Customer Service inquiries # 877-826-7755 Invoice Payment Inquiries 888-753-4104 Page: 1
Make checks a able to 5ta les Advantage, Det DET PO Box 83689, chic. o IL 60696-3689
•�.���'`����r�'"~'�+� �x�11%Ox�E D�A7��1�`'CU§'f�MEI�,�„. ;� �,'Y^� �;UMMQ`RY INVOICE:
FEB —5 2015 1/24/15ppy. DET 1061088 8032987554
� C terT�
BY.- _�� �O I:EAS�E Pb 2/23/15 T � i �
Net 30 Days 871.39
INVOICE DEMUL _
Staples Advantage Federal ID #:04-3390816
Bill to Account: 1030597 Ship to Accounts 1235 CNTRL PK E
CARMEL CLAY PARES AND RECREATION CITY OF CARMEL
PAULA SCHLEMMER ATTN: LINDA ACOSTA -
1411 E 116TH ST 1235 CENTRAL PARK DR E
CARMEL, IN 46032 DLV BEFORE 4PM
CARMEL, IN 46032
Budget Ctr 1091-4230200 MCC ADMINISTRATION Invoice Number: 3255004150 �
Budget Ctr Desc: order 131266888-000-001
P O Number xx-1631 -Ordered By DAWN KOEPPER -
P 0 Desc Order Date 1/20/15
Release
Release Desc
order order B/O unit Ship unit Extended
Line Item Number Description Qty Qty Meas Qty Price Price
1 517581 INDEX CARD RULD 1 SIDE 3X5 WE 2 PK 2 .47 .94
2 752602 KLEENEX ANTI-VIRAL FACE TISSUE 1 PK 1 5.56 5.56
4 837543 SPLS MINISTERED EX CABLE 3.5MM 1 EA 1 3.58 3.58
6 575837 *5 CASE's 8.5X11 COPY PAPER 1 PK 1 198.00 198.00
Freight: .00 Tax:( .0000 .00 Sub-Total: 208.08
Total: 208.08
ESE Office Supplies
GLAccount# 1081099-4230200
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Customer Service inquiries 871-826-7755 Invoice Payment Inquiries 888-753-4104 Page: 1
Make checks a able to St les Advanta e, De t DET PO Box 83689, chits o IL 60696-3689
J >rr
-- �✓' -b I�U1/;QICE�DATE�, �;CUSTrJMER,;�; SUMMAR1f INVOICE?'
FEB —5 2015 1/24/15 n DET 1061088 8032987554
O P fpSE PAY BY f} tokenA.MOUNT,,DIJE x..
� '-- " 2/23/15 Net 30 Days 871.39
1"010EDEZUL
staples Advantage Federal ID #:04-3390816
8111 to Account: 1030597 Ship to Account: 1235 CNTRL PK 8
CARMEL CLAY PARKS AND RECREATION CITY OF CARMEL
PAULA SCHLEMMER ATTN: ANNE MARIE BESSLER
1411 E 116TH ST 1235 CENTRAL PARK DR E
CARMEL, IN 46032 DLV BEFORE 4PM
CARMEL, IN 46032
Budget ctr 1091-4230200 MCC ADMINISTRATION Invoice Number: 3255004151
Budget Ctr Desc: Order 7130415971-000-001
P 0 Number 3991 Ordered By ANNE MARIE BESSLER
P 0 Desc Order Date 1/20/15
Release
Release Desc
order order B/o unit Ship unit Extended
Line Item Number Description Qty Qty Meas Qty Price Price
1 479880 SPLS 1X2 5/8 LSR/I] LBL 100SH 2 BX 2 9.76 19.52
3 433263 PILOT VRAZOR LIQ INK AST 8 2 PK 2 10.71 21.42
6 605012 SM CLEAR WIRE HOOK VALUE PACK 1 PK 1 6.83 6.83
7 1015831 EXPO LOW ODOR OF 8PK AST 1 PK 1 7.88 7.88
8 793178 COMMAND POSTER STRIP VALUE PK 1 PK 1 10.49 10.49
9 071457 15 AAG YR WALLCAL ERAS 24 X 36 1 EA 1 24.09 24.09
10 490935 PASTELS 8.5X11 PINK PAPER RM 1 RM 1 5.14 5.14
11 386659 ROLL THERMAL 3-1/8X230 2 CT 2 106.63 213.26
12 765321 AVY LSR LBL 1UP 25 FULL SHT 2 PK 2 14.31 28.62
Freight: .00 Tax:( .0000 %) .00 Sub-Total: 337.25
Total: 337.25
Office Supplies &Receipt Paper
37995
Account# 1091000-4230200
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Customer Service inquiries # 877-826-7755 Invoice Pa ent Inquiries 888-753-4104 Page: 1
Make checks ayable to sta les Advantage, De t DET PO Box 83689, Chica o iL 60696-3689
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.
361528 Staples Business Advantage Terms
Dept DET 2368
P.O. Box 83689
Chicago, IL 60696-3689
Invoice Invoice Description
Date Number (or note attached invoice(s)or bill(s)) PO# Amount
1/17/15 3254440549 . Office supplies xx1602 $ 35.48
1/24/15 3255004152 Office supplies 37997 $ 326.06
1/24/15 3255004150 Office supplies_ _. xx1631 $ 208.08
1/24/15 3255004151 Office supplies 37995 $ 33725
Total $ 906.87
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
Voucher No. Warrant No.
361528 Staples Business Advantage Allowed 20
Dept DET 2368
P.O. Box 83689 j
Chicago, IL 60696-3689 In Sum of$
'I
$ 906.87
I
ON ACCOUNT OF APPROPRIATION FOR 4;
101 General/108 ESE/109 Monon Center
II
PO#orBoard Members
Dept#
INVOICE NO. ACCT#/TITLE AMOUNT
'
1081-2 3254440549 4230200 $ 35.48 1 hereby certify that the attached invoice(s), or
1125 3255004152 4230200. $ 326.06 bill(s) is(are)true and correct and that the
1081-99 3255004150 4230200 $ 208.08 materials or services itemized thereon for
1091 3255004151 4230200 $ 337.25 which charge is made were ordered and
received except
February 5, 2015
i
Signature
$ 906.87, I Accounts Payable Coordinator
Cost distribution ledger classification if + Title
claim paid motor vehicle highway fund
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