245944 06/03/15 �
vY CITY OF CARMEL, INDIANA VENDOR: 367042
® ONE CIVIC SQUARE PAPERLESS BUSINESS SYSTEMS CHECK AMOUNT: $****10,432.92*
:9 u!_4Qgy?�; CARMEL, INDIANA 46032 1417 FOURTH AVE,4TH FLOOR CHECK NUMBER: 245944
�'dr`6N SEATTLE WA 98101 CHECK DATE: 06/03/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4355200 500006374 5,216.46 SUBSCRIPTIONS
1091 4355200 S00006374 5,216.46 SUBSCRIPTIONS
. w
Invoice
1417 Fourth Ave.,4th Floor Invoice Number SO-0006374
Seattle,Washington 98101 Invoice Date 5/12/2015
" p. 206.256.0771 Payment Terms Before Renewal
peperiess f. 206.282.3312 PO Number
husiness systems
FMAY 14 2015
SOLD TO: _ SHIP TO,-
Carmel Clay Parks& Recreation Carmel Clay Parks& Recreation
1
411 E 116th Street 1411 E 116th Street
Carmel, IN 46032 Carmel, IN 46032
United States United States
Description Amount
eRequester Hosted
eRequester Hosted Subscription(SAAS) Hosting period:5/28/15-5/27/16 $8,476.92
Hosted Receiving Module $1,956.00
All payments and dollar amounts are in U.S. Dollars. SubTotal $10,432.92
Remit to:Paperless Business Systems,Inc.,1417 Fourth Avenue,4th Floor,Seattle,WA 98101 Tax $0.00
p.206.256.0771 f.206.282.3312'www.paperlessbusiness.com'ardepartment@paperlessbusiness.com Total $10,432.92
Bank of America,WA3-177-01-01 Wire Information: ACH Information:
408 Pike St. ABA#026009593 Routing#:125000024
Seattle,WA 98101 Swift#:BOFAUS3N Acct#:138019775709(Savings)
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.
367042 Paperless Business Systems Terms
1417 Fourth Avenue, 4th Floor
Seattle, WA 98101
Invoice Invoice Description
.Date Number (or note attached invoice(s)or bill(s)) PO# Amount
5/12/15 S00006374 eRequester subscription 5/28/15-5/27/16 38525- $ 5,216.46
5/12/15 S00006374 eRequester subscription 5/28/15-5/27/16 38525 $ 5,216.46
Total $ 10,432.92
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
I
Voucher No. Warrant No.
367042 Paperless Business Systems I Allowed 20
W4' Fourth Avenue, 4th Floor
Seattle,WA 98101
In Sum of$
$ 10,432.92-
ON ACCOUNT OF APPROPRIATION FOR j
108 ESE/109 Monon Center
i'
PO#or Board
Board Members
INVOICE NO. CCT#/TITL AMOUNT
y
1091 S00006374 4355200 $ 5,216.46 1 hereby certify that the attached invoice(s), or
1081-99 S00006374 4355200 $ 5,216.46 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
May 28, 2015
Signature
$ 10,432.92 Accounts Pdyable.Coordinator..
Cost distribution ledger classification if _ Title
claim paid motor-vehicle highway fund