244530 04/21/15 ..veq • CITY OF CARMEL, INDIANA VENDOR: 358122
114 ONE CIVIC SQUARE L-COM GLOBAL CONNECTIVITY CHECK AMOUNT: $********84.45"
?� CARMEL, INDIANA 46032 PO BOX 55758 CHECK NUMBER: 244530
BOSTON MA 02205-5758 CHECK DATE: 04/21/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1115 4237000 2506690 10.95 REPAIR PARTS
1115 4237000 32679 2506690 73.50 CAT 6 SHIELD
INVOICE
LMCor,
�® Global Please Remit to: Bank Transfers o.
C Connectivity P•O.Box 55758 Citibank,Miami,FL
Boston,MA 02205-5758 Branch 0 61-Boca Raton,FL.
ABA#266-086-554
978-682-6936 978-689-9484 Account 4 9119834971
Swift Code:CITIUS33
Account Name:L-com,Inc.
Invoice# 2506690 Invoice Date 09-Apr-15 Page# 1 US fiends only
Sold CARMEL,CITY OF COMMUNICATIONS DEPT
TO: 31 FIRST AVE NW Ship CARMEL,CITY OF COMMUNICATIONS DEPT
CARMEL,IN 46032 TO: Attn: PO#32679
31 FIRST AVE NW
CARMEL,IN 46032
—Shi Vim--- -Ship Date Due Date -Purchase-Order# -- -Our-Order --Order~Date- -—
FX OD 09-Apr-15 09-May-15 32679 4136034 09-Apr-15
Shi meet# Terms Buyer Account# Salespeople
5185898 NET 30 JANET ARNONE 171655 80 1 616
ORD QT,V% UNIT
LIN%ITEM,#(DESCRIPTION CU$TOMEit ITEM# U/M BALANCE SHIPPED' PRICE ."'AMOUNT
�.
Thank you for your order,we appreciate your business.
1 TI)G1026KS-C6 EA 10, 10 7.35000 73.50
CAT 6 SHLD-RW-KEYSTONE CPLR' 0
ALL CLAIMS MUST BE MADE SEVEN(7)DAYS AFTER RECEIPT.
CERTIFICATE OF�COMPLIANCE:This is to certify that the product shipped against your purchase order Subtotal (USD) 73:50'
conforms to the requirements of your purchase order.
CERTIFICATE OF ORIGIN:This Certifies the items listed above originated in the country indicated on the
individual packaging label.Thomas Barczak,Corporate Quality Manager
Freight(USD) 10.95
Total(USD) 84.45
SHIPPING TRACKING# 002191173561820 X
Created On: 04/09/15 4:32:33 PM - Printed-On:' 04/I0/15=8A&27-AIvI --
c � � INDIANA RETAIL TAX EXEMPT PAGE
liy ®,11r Carmel CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 32679
35-60000972
ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES,A/P
CARMEL, INDIANA 46032-2584 VOUCHER, DELIVERY MEMO, PACKING SLIPS,
FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL-1997 SHIPPING LABELS AND ANY CORRESPONDENCE.
PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION
419/2015 Network Cabling Couplers
L-Com Global Connectivity Carmel Communication Center
VENDOR
SHIP 31 1 st Ave NW
P.O. Box 55756 TO Carmel, IN 46032 /
Boston, MA 02205-5758 (317)571-2576
CONFIRMATION BLANKET CONTRACT PAYMENTTERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Account 42-377.00
10 Each CAT 6 SHLD RJ45 Keystone CPLR TDG1026KS-C6 $7.35 $73.50
Suis Total: $73.50
/l
((j���;. �..J,1 F , ;,G;'i.',I `�g.'' 'ti'•._...-..may
Rluoto No.9$Q
Send Invoice To:
J;).L.
Carmel Communication Center
31 1 st Ave NW
Carmel, IN 46032-
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
1115 Communications PAYMENT $73.50
• A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O.
NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND
VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED.
SHIPPING INSTRUCTIONS I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN
SHIP REPAID. THIS APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER.
•
•C.O.D.SHIPMENTS CANNOT BE ACCEPTED. '
• ORDERED BY
PURCHASE ORDER NUMBER MUST APPEAR ON ALL
SHIPPING LABELS.
•THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. 4
® CLERK-TREASURER
DOCUMENT CONTROL NO. 3 2 6 7 9 A.P.V. COPY-SIGN AND RETURN TO CLERK'S OFFICE
VOUCHER NO. _WARRANT NO.—_-
ALLOWED 20
'IN THE SUM OF$
ON ACCOUNT OF APPROPRIATION FOR
Board Members
PO#or INVOICE NO. ACCT#frITLE AMOUNT
DEPT.# 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
1 •
-
20
Signature
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
I
-- - _ 0 --
VOUCHER NO. WARRANT NO.
ALLOWED 20
L-COM GLOBAL CONNECTIVITY
PO BOX 55758
IN SUM OF $
BOSTON MA 02205-5758
$84.45
ON ACCOUNT OF APPROPRIATION FOR
Communications
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
32679 2506690 42-370.00 $73.50 1 hereby certify that the attached invoice(s), or
bill(s) is (are)true and correct and that the
1115 2506690 42-370.00 $10.95
materials or services itemized thereon for
which charge is made were ordered and
received except
I
Friday, April 17, 2015
Ter rocket, Director
Cost distribution ledger classification if
claim paid motor vehicle highway fund
i
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))
04/09/15 2506690 $73.50
04/09/15 2506690 $10.95
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