249046 08/26/15 +ur CSA*F!
CITY OF CARMEL, INDIANA VENDOR: 368575
® ONE CIVIC SQUARE TK SOFTWARE CHECK AMOUNT: $ ....`150.00"
,,, q CARMEL, INDIANA 46032 2113 BREWSTER ROAD CHECK NUMBER: 249046
'yi_oN��`� INDIANAPOLIS IN 46260 CHECK DATE: 08/26/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
102 4463202 COC1509 150.00 SOFTWARE
2113 Brewster Road (317)228-0857
Indianapolis,IN 400 www.&softwareinc.com
SOFTWARE
City of Carmel
Two Civic Square
Carmel, IN 46032
Attn.: Michelle T. Harrington, CPC
August 15, 2015
Invoice number. COC1509
TKSoftware Tax ID Number:35-1985893
Due Date:9115115
e
HIPAA Transaction Services Detail:
Claims Fee Amount
September, 2015 services, minimum up to 450 $150.00
Claims in excess of 450,July 0 0.35 0.00
Amount Due: $150.00
Payment must be received by due date to avoid interest.
'rescribed by State Board of Accounts City Form No.201 (Rev,1995)
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
4n invoice or bill to be properly itemized must show: kind of service,where performed, dates service rendered, by
nrhom, 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 1509 $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 COC1509 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
� f
V 141
s;
Fire Chief
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund