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243821 03/31/15 CITY OF CARMEL, INDIANA VENDOR: 368575 ONE CIVIC SQUARE TK SOFTWARE CHECK AMOUNT: 150.00' s ,?a CARMEL, INDIANA 46032 2113 BREWSTER ROAD CHECK NUMBER: 243821 INDIANAPOLIS IN 46260 CHECK DATE: 03/31/15 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 102 R4463202 24621 COC1504 150.00 BILLING 2113 Brewster Road (317)228-0857 Indianapolis,IN 46260 www.&softwareinc.com SOFTWARE City of Carmel Two Civic Square Carmel, IN 46032 Attn.:Michelle T. Harrington, CPC March 15, 2015 Invoice number. COC1504 TKSoftware Tax ID Number.35-1985893 Due Date:4/15115 HIPAA Transaction Services Detail. Claims Fee Amount April,2015 services,minimum up to 450 $150.00 Claims in excess of 450,February 0 0.35 0.00 Amount Due: $150.00 Payment must be received by due date to avoid interest. VOUCHER NO. WARRANT NO. ALLOWED 20 TK Software IN SUM OF$ 2113 Brewster Road Indianapolis, IN 46260 $150.00 ON ACCOUNT OF APPROPRIATION FOR Carmel Fire Department PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members 24621 COC1504 102-632.02 $150.00 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 MAR 3 0 �0�5 t Fire Chief Title Cost distribution ledger classification if claim paid motor vehicle highway fund iPrescribed 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)) COC1504 $150.00 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 5-11-10-1.6 120 Clerk-Treasurer