248559 08/12/15 (9,
CITY OF CARMEL, INDIANA VENDOR: 366767
ONE CIVIC SQUARE VAN AUSDALL & FARRAR CHECK AMOUNT: $********23.95*CARMEL, INDIANA 46032 PO BOX 713683 CHECK NUMBER: 248559
CINCINNATI OH 45271-3683 CHECK DATE: 08/12/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1115 4351501 118139 23.95 EQUIPMENT MAINT CONTR
Van Ammidall MAIL REMITTANCE TO: CONTRACT INV®ICE
& Farrar.""" VAN AUSDALL AND FARRAR, INC.
ORCE oiocr r PO BOX 713683, Cincinnati, OH 45271-3683 Invoice Number: 118139
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I S ;3 Phone(317) 634-2913 Fax(317) 638-1843
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Email invoice questions to: Invoice Date: 07/31/2015
billing@vanausdall.com
Bill To: CARMEL COMMUNICATIONS CENTER Customer: CARMEL COMMUNICATIONS CENTER
31 1ST AVENUE NW 31 1ST AVENUE NW
CARMEL,IN 46032 CARMEL, IN 46032
z::;: 0*jjpentTerms _,'. Due Date ' :. Invoice Total Balance Due_, '
510850 NET10 08/10/2015 $ 23.95 $ 23.95
Coli ractNumber.. , .'Contact ContractAinount,. 'P.O.Number, Stmt Date•.,, .`' Exp:Date,
16751-03 317-460-6174 $ 23.95 07/01/2015 — 06/30/2016
Remarks
Summary:
Contract base rate charge for this billing period $0.00
Contract overage charge for the 07/01/2015 to 07/31/2015 overage period $23.95**
*Sum of equipment base charges **See overage details below $23.95
Detail:
Equipment included"under this contract
Number Serial Number Base Charge Location
71869 W493L400357 $0.00 CARMEL COMMUNICATIONS CENTER 31 LST AVENUE NW
RICOH AFICIO MPC3002 CARMEL,IN 46032
Meter Type Meter Group Begin Meter End Meter Credits Total Covered Billable Rate Overage
B\W BW-16751-200 20,093 20,618 525 0 525 $0.005280 $2.77
Color CLR-16751-20( 14,139 14,592 453 0 453 $0.046750 $21.18
$23.95
Customer Number: 510850 Invoice Number: 118139 Invoice SubTotal $23.95
Please Include Invoice Number on Remittance Tax: $0.00
Invoice Total $23.95
Thank you for your business! Balance Due: $23.95
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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 Date Invoice# Description Amount
Dept. Fund# (or note attached invoice(s) or bill(s))
07/31/15 I 1 18139I I $23.95
1115 101
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
VOUCHER NO. WARRANT NO.
ALLOWED 20
VAN AUSDALL& FARRAR
PO BOX 713683 IN SUM OF $
CINCINNATI OH 45271-3683
$23.95
ON ACCOUNT OF APPROPRIATION FOR
PO#/Dept. INVOICE NO. I ACCT#/Fund AMOUNT Board Members
11813943-515.01 $23.95 1 hereby certify that the attached invoice(s), or
1115 I I 101
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
Monday, August 10, 2015
r
er C 'ckett, irector
Cost distribution ledger classification if
claim paid motor vehicle highway fund