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252006 12/02/15 CITY OF CARMEL, INDIANA VENDOR: 355628 ONE CIVIC SQUARE HOOSIER HERITAGE PORT AUTHORITY CHECK AMOUNT: $....***795.00* x. ,= CARMEL, INDIANA 46032 33 N 9TH ST SUITE 215 CHECK NUMBER: 252006 NOBLESVILLE IN 46060 CHECK DATE: 12/02/15 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1202 4344200 377 795.00 INTERNET LINE CHARGES Invoice Page I of 1 Invoice HIIPA-Technology Oversight Board 33 North 9th Street DATE INVOICE # Suite 215 11/10/2015 377 Noblesille,IN 46060 BILL TO SIHP TO City Of Carmel Attn: Terry Crockett Three Civic Square Carmel,IN 46032 DUE DATE P.O.NUMBER 12/10/2015 ITEM DESCRIPTION QTY RATE AMOUNT Bandwidth Service @ Expedient- Oct 2015 1.0 255.0 255.00 Bandwidth Service @ LB -Oct 2015 1.0 540.0 540.00 Subtotal 795.00 Thank you for your business! Phone 317-776-8268 0%Tax 0.00 Total 795.00 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)) 11/10/15 I 377 I I $795.00 1202 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 HOOSIER HERITAGE PORT AUTHORITY 33 N 9TH ST SUITE 215 IN SUM OF $ NOBLESVILLE, IN 46060 $795.00 ON ACCOUNT OF APPROPRIATION FOR PO#/Dept. INVOICE NO. I ACCT#/Fund AMOUNT Board Members 377 43-442.00 $795.00 1 hereby certify that the attached invoice(s), or 1202 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 Mon y, Nov ` ber 23, 2015 V Cost distribution ledger classification if claim paid motor vehicle highway fund