246997 06/30/15 +ui C4AN
�>' 4� 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: 246997
±M ioN INDIANAPOLIS IN 46260 CHECK DATE: 06/30/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
102 4463202 COC1507 150.00 SOFTWARE
I
2113 Brewster Road (317)228-0857
Indianapolis,IN 46260 i w"'.tksoftwareinc.com
SOFTWARE
City of Carmel
Two Civic Square
Carmel, IN 46032
Attn.:Michelle T. Harrington, CPC
June 15, 2015
Invoice number. COC1507
TKSoftware Tax ID Number.35-1985893
Due Date: 7115115
HIPAA Transaction Services Detail:
Claims Fee Amount
July, 2015 services, minimum up to 450 $150.00
Claims in excess of 450, May 0 0.35 0.00
Amount Due:1 $150.00
Payment must be received by due date to avoid interest.
I
s
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
Nhom, 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))
COC 1507 $150.00
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.
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
1120 COC1507 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 JUN 2 9 2095
In
Fire Chief
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund