242192 02/17/15 u ��q
?' *' CITY OF CARMEL, INDIANA VENDOR: 364386
® ONE CIVIC SQUARE KURT ANDERSON CHECK AMOUNT: $ .....'63.71'
CARMEL, INDIANA 46032 C/O ENGINEERING CHECK NUMBER: 242192
CHECK DATE: 02/17/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2200 4344100 63.71 CELLULAR PHONE FEES
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Kurt 's �ho., e txC� oriea
P A Y M E N T R E C E I P T
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Verizon Wireless
1950 E Greyhound Pass 2 a 00 ' L4L (o 3 1 00
Carmel, IN 46033-7730
(317) 580-9548
www.verizonwireless.com
Order Number: 288045
Order Location: M4912 01
Order Type: IS
Receive Location: M4912 01
Receipt Date/Time: 02/10/2015 13:08 ET
Rep: dibblde-E19H4
Register: 51
Pmt 1 of 1
Payment Type: A/C
Retail Sale
Item Price Price
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Accessories:
MIC34DUALVPC-F2
Vehicle Charger with
Dual Output $22.49 $22.49
SMG9001PKGSP
Tempered Glass Display
Protector for Galaxy S 5 $18.74 $18.74
SM-G900VSCOVBLK
Samsung S-View Cover
for Galaxy S5 $22.48 $22.48
IN State Sales Tax $4(,4-6
Total Taxes/Fees: $4.46
Total Due *: $68.17
Total Savings: $0.00 3
This Payment $68.17
Payment Method: A/C 685189580-1
Mobile 43178326104
Payment Signature:
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Customer Recycling Disclosure:
Electronic waste should be recycled or
disposed of properly. Contact http://
www.in.gov/recycle/ or call
800-988-7901.
Return Policy:
New and Certified Pre-Owned merchandise
items may only be returned or exchanged
within 14 days(02/24/2015) .
You are permitted to make one exchange.
A restocking fee of $35($70 for Netbooks,
Tablets and Notebooks) applies to any
return or exchange of a wireless device
(excluding Hawaii) .
See verizonwireless.com/returnpolicy for
complete details.
To receive a credit for the activation
fee, cancellations must occur within
3 days of activation of service.
Thank You
The NEW My Verizon.
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
Kurt Anderson Purchase Order No.
Terms
Date Due
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s) Amount
211012015 0 Phone case and charger $ 63.71
�I
Total $ 63.71
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.
,20
Clerk-Treasurer
VOUCHER NO WARRANT NO.
Kurt Anderson ALLOWED 20
IN SUM OF $
$ 63.71
ON ACCOUNT OF APPROPRIATION FOR
Board Members
PO#or INVOICE NO. ACCT#/TITLE AMOUNT
DEPT# I hereby certify that the attached invoice(s), or
0 0 2200-4344100 $ 63.71 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
2/16/2015
Signature
City Engineer
Cost Distribution ledger classification if Title
claim paid motor vehicle highway fund