247929 07/28/15 CITY OF CARMEL, INDIANA VENDOR: 366094
® l ONE CIVIC SQUARE KONICA MINOLTA PREMIER FINANCE CHECK AMOUNT: S"'"""'"815.05'
f. r° CARMEL, INDIANA 46032 PO BOX 642333 CHECK NUMBER: 247929
s _oH � PITTSBURGH PA 15264-2333 CHECK DATE: 07/28/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1801 4353099 63008426 815.05 OTHER RENTAL & LEASES
Please remember to reference Account Schedule#(s)pertaining to your request(s).
Phone#: 800-452-1623
- Fax: 319-841-6324
KONICA MINOLTA Correspondence Only:PO BOX 3083
CEDAR RAPIDS IA 52406-3083
KONICA MINOLTA PREMIER FINANCE
P.O.BOX 642333 Billing ID Number 90136094394
PITTSBURGH PA 15264-2333
Invoice Number 63008426
10822 1 MB 0.436 Invoice Date 07/05/2015
10822
#BWNHXFZ
51 Due Date: 08/13/2015
#0901 3609 4394 5# Current Items Due: 815.05
CITY OF CARMEL REDEVELOPMENT
30 W MAIN ST STE 220
CARMEL IN 46032-1938 Total Amount Due: 815.05
KMPN P
Our Federal Tax Id# 941686094
INVOICE FOR CURRENT ITEMS DUE
Account Schedule Due Date Purchase Order Number Line Item Acct/Sched
Number Equipment Description Amount Total
7715414-001
KONICA MINOLTA COPIER
MODEL: BIZHUB C452 SERIAL: AOP2011010435
ALLOWANCE: 5,000 619.86
08/13/2015 MINIMUM CHARGES DUE 619.86
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METER-ID : 2 DESC :COLOR
MODEL: BIZHUB C452 SERIAL: AOP2011010435
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ENDING READING : 06/24/2015 91,000 USAGE 5,965
BEGINNING READING: 03/24/2015 85,035 ALLOWANCE: 4,500
EXCESS CHARGES DUE: 1,465 @ 0.133233= 195.19
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EXCESS USAGE CHARGE 195.19
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METER-ID : 1 DESC :B&W
MODEL: BIZHUB 0452 SERIAL: AOP2021010435
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ENDING READING : 06/214/2015 114,654 USAGE 4,249
BEGINNING READING: 03/24/2015 110,405 ALLOWANCE: 15,000
E?:CESS CHARGES DUE: 0 @ 0.000000= 0.00
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ACCOUNT SCHEDULE 7715414-001 TOTAL 815.05
a
Please include your Billing ID number on all correspondence.
All correspondence should be sent to the correspondence only address,which is indicated on the front of this invoice.
Payments: Please detach the remit to portion of this invoice and mail your payment(s) to our payment processing center using the
return envelope provided. Please send only the remit to portion with your payment - retain the top portion of the invoice for your
records.
Sales, Use, Rental Tax (Tax): The sales, use, or rental tax rate is determined by the location of the leased equipment, when
applicable. Equipment location changes are subject to approval. Prior to the equipment being moved, the lessor is to be notified. Call
the Customer Service number on the front of this invoice for instructions for reporting an equipment location change. If you are sales
tax exempt, fax a completed,signed exemption certificate, including your account schedule number,to the fax number on the front of
the invoice or mail a copy to the correspondence only address on the front of the invoice,Attention: Sales Tax Exemption.
Personal Property Taxes: Personal Property Tax is assessed on leased equipment as required by the local taxing jurisdiction. If
the lessor is required to report and pay the tax bill, the lessee will be billed for reimbursement as agreed to in the lease agreement.
This may be invoiced separately and/or included in this invoice. If the Lessee paid property taxes directly to the taxing jurisdiction hi
error,please contact the jurisdiction for instructions to file for a refund and pay the amount on your invoice from the lessor.
Taxes are determined by the location of the leased equipment, when applicable. Equipment location changes are subject to approval.
Prior to the equipment being moved, the lessor is to be notified. Call the Customer Service number on the front of this invoice for
instructions for reporting an equipment location change.
Purchase Order Number(s): For your convenience we can display your purchase order number on your invoice. However, the
contract terms and conditions are not modified in any way by your purchase order. If you need your purchase order number to appear
on the invoice or if you need to update your purchase order information, fax a copy of the purchase order including your account
schedule number(s), the purchase order effective and expiration dates to the fax number on the front of the invoice or mail a copy to
the correspondence only address referenced on the front of this invoice.
Late Charges: To avoid late charges, all payments must be received by the due date. Late charges will be added to your invoice
consistent with the terms and conditions of your contract.
Insurance: Your contract requires you to provide and maintain insurance coverage against all risks of loss for your equipment, and
provide proof of coverage information. Please be sure we are named as LOSS PAYEE and Additional Insured and your account
schedule number appears on the certificate and fax a copy to the fax number on the front of the invoice or mail a copy to the
correspondence only address.
Name Changes: Fax a copy of the amendment that was filed with the secretary of state, including your account schedule number,to
the fax number on the front of the invoice or mail a copy to the correspondence only address. Changes are subject to fees.
Acceptable Forms of Payment: We will accept payments in the form of company checks, (or personal checks in the case of sole
proprietorships), direct debit, or wires only. Cash and cash equivalents are not acceptable forms of payment and such forms of
payment may delay processing or be returned. Furthermore, only you or your authorized agent as approved may remit payments on
these accounts.
Disputed Payments: Without prejudice to any of our rights and remedies under your contract, all written communication
concerning disputed amounts, including any check or other payment instrument that (a) indicates that the written payment constitutes
"payment in full" or is tendered as full satisfaction of a disputed amount or (U) is tendered with other conditions or limitation must be
mailed or delivered to us at the correspondence only address and not to the payment address.
Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No.201(Rev.1995)
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
►E6i(e Premier Ejh&R(e Purchase Order No.
PO BOX jT 2.133 Terms
1 fs6ur�h . PA 15W-2. 13 Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
I-5—k5 Og L6 kk4e 6
Total S/5.037/Snr
1 hereby certify that the attached invoice(s), or bill(s), is (are) true and correct and I have audited same in accor-
dance with IC 5-11-10-1.6.
, 20
Clerk-Treasurer
VOUCHER NO. WARRANT NO.
ALLOWED 20
6,11k minah Pittner Row ow - IN SUM OF $
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P'jj5�A[ h , PA I52b42333
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ON ACCOUNT OF APPROPRIATION FOR
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Board Members
PO#or
DEPT.# INVOICE NO. ACCT#/TITLE AMOUNT 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
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