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HomeMy WebLinkAbout259208 05/31/16 0��( F CITY OF CARMEL, INDIANA VENDOR: 368235 ONE CIVIC SQUARE TOSHIBA BUSINESS SOLUTIONS, USA CHECK AMOUNT: $....****85.10* �� CARMEL, INDIANA 46032 PO BOX 436357 CHECK NUMBER: 259208 a,tinN�, LOUISVILLE KY 40253 CHECK DATE: 05/31/16 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 2201 4351501 12722181 42.55 EQUIPMENT MAINT CONTR 2201 4351501 12798026 42.55 EQUIPMENT MAINT CONTR VOUCHER NO. WARRANT NO. Prescribed by state Board of Accounts City Form No.201 (Rev.1995) TOSHIBA BUSINESS SOLUTIONS, USA ALLOWED 20 ACCOUNTS PAYABLE VOUCHER PO BOX 436357 IN SUM OF$ CITY OF CARMEL An invoice or bill to be properly itemized must show:kind of service,where performed,dates service LOUISVILLE, KY 40253 rendered,by whom,rates per day,number of hours,rate per hour,number of units,price per unit,etc. $42.55 Payee Purchase Order# ON ACCOUNT OF APPROPRIATION FOR Street Department Terms Date Due PO# ACCT# DATE INVOICE# DESCRIPTION DEPT# INVOICE# Fund# AMOUNT Board Members DEPT# FUND# (or note attached invoice(s)or bill(s)) AMOUNT 12798026 43-515.01 $42.55 l hereby certify that the attached invoice(s),or 5/19/16 12798026 $42.55 2201 201 2201 201 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 Tuesday, May 24,2016 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 Cost distribution ledger classification if claim paid motor vehicle highway fund. Clerk-Treasurer 260oStanley Gault Pkwy. MAINTENANCE INVOICE ImIII TOSHIBA Suite 026 BUSINESS SOLUTIONS LoisvIOIe,KY 40223 P gece Number: 127 18of 1 I IIj111]111 III I III�1��j II�I IIID Tel: KY 502-489-6700,IN 317- Invoice Date: 19-MAY-16 SHIPTO: CITY OF CARMEL Invoice Period: (05/24/16-06/23/16) 3400 W 131ST STRET Customer Number: TOBC84M CARMEL,IN 46074 Site ID: 1140752 TOTAL DUE $45.53 BILLTO: CITY OF CARMEL REMITTO: TOSHIBA BUSINESS SOLUTIONS,USA 1 CIVIC SQUARE P.O.Box 436357 CARMEL,IN 46032 LOUISVILLE,KY 40253 ----------------------------------------------------------PLEASE CUT ALONG LINE AND RETURN WITH REMITTANCE------------------------------------------------- CONTRACT INCLUSIONS PO NUMBER CONTRACT NO. PAYMENTTERMS CUSTOMER NUMBER PARTS,LABOR,TONER 1140752 1210227-501C DueuponReceipt I TOBC84M MODEL/SERIAL/LOCATION METER COST START END AMOUNT DESC. QTY DESCRIPTION PER COPY METER METER ESTUD103555C/SC7CF58741 2000 ALLOWANCE[5/24/2016-6/23/2016] .008 0 0 $16.00 ESTUD103555C/SC7CF58741 500 ALLOWANCE(5/24/2016-6/23/2016] .0531 0 0 $26.55 NO&Ti U. *UST©MER NIYK4R MAY HAV EHAN D PLEAS P.DATE YOUR RECOR© ACCORD` TOTAL SALES TAX AMOUNT TAX RATE FREIGHT AMOUNT TOTAL DUE $42.55 $2.98 $0.00 1$45-.53 Sirnpli your payments! _V41-5 Electronic Payment now available when you sign up for Electronic Invoicing payments. Toshlbals new Electronic Payment and Electronic Invoicing programs give you the benefits of Ilk Sign ` Increased ease,accuracy,security,and timeliness. IMP- wellsave time as • E-mall directly to another department for questions or authorization -- • Faster and more secure than traditional mall Go online to find OU-t more and enroll today: k http:/lbusinesstoshba.com/eakerregiaterldoRegMer.jap Toshiba Business Solutions 2600 Stanley Gault Pkwy.,Suite 400,Louisville,KY 40223 2845-52-5230-05192016 Form ST-105 Indiana Department of Revenue State Forin 49065 R4/8-05 General Sales Tax Exemption Certificate Indiana registered retail merchants and businesses located outside Indiana may use this certificate.The claimed exemption must be allowed by Indiana code. Exemption statutes of other states are not valid for purchases from Indiana vendors.This exemption certificate can not be issued for the purchase of Utilities Vehicles Watercraft,or AfrcLaff Purchaser must be registered with the Department of Revenue or the appropriate taxing authority of the purchaser's state of residence. Sales tax must be charged unless all information in each section is Hilly completed by the purchaser.Purchasers not able to provide all required information must pay the tax and may file a claim for refund(Form GA-110L)directly with the Department of Revenue. I Name of Purchaser CITY OF CARMEL Business Address ONE CIVIC SQUARE City CARMEL State IN Zip 46032 µo ' Purchaser must provide minimum of one ID number below.* Provide your Indiana Registered Retail Merchant's Certificate 0031201550 020 4'0° TID and LOC Number as shown on your Certificate............................... �a fir+: TIM(10 digits) LOC#(3 digits) If not registered with the Indiana DOR,provide your State Tax ' ID Number from another State................................................................ *See instructions on the reverse side if you do not have either number. State ID# State of Issue of Is this a ®blanket purchase exemption request or a ❑single purchase exemption request? (check one) VQ-Q d Description of items to be purchased. Purchaser must indicate the type of exemption being claimed for this purchase. (check one or explain) ❑ Sales to a retailer,wholesaler,or manufacturer for resale only. ❑ Sale of manufacturing machinery,tools,and equipment to be used directly in direct production. j ❑ Sales to nonprofit organizations claiming exemption pursuant to Sales Tax Information Bulletin#10. (May not be used for personal hotel rooms and meals.) t1 $❑ Sales of tangible personal property predominately used(greater then 50 percent)in providing public transportation-provide USDOT#. i s%v A person or corporation who is hauling under someone else's motor carrier authority,or has a contract as a school bus operator,must provide their SS#or FID#in lieu of a State ID#in Section#1. USDOT# M ❑ Sales to persons,occupationally engaged as farmers,to be used directly in production of agricultural products for sale. Note:A farmer not possessing a State Business License#may enter a FID#or a SS#in lieu of a State ID#in Section#1, j 3 Sales to a contractor for exempt projects(such as public schools,government,or nonprofits). 1�.�® Sales to Indiana Governmental Units(agencies,cities,towns,municipalities,public schools,and state universities). I 50 T 11 Sales to the United States Federal Government-show agency name. Note:A U.S.Government agency should enter its Federal Identification Number(FID#)in Section#1 in lieu of a State ID#. ❑ Other-explain. i i i I hereby certify under the penalties of perjury that the property purchased by the use of this exemption certificate is to be used for an exempt NA purpose pursuant to the State Gross Retail Sales Tax Act,Indiana Code 6-2.5,and the item purchased is not a utility,vehicle,watercraft,or aircraft. KOM j -V A I confirm my understanding th t- se,(either negligent or intentional),and/or fraudulent use of this certificate may subject both me personally and/or the business entity I pr to the imposition of x,int e ,and civil and/or criminal penalties. ;e Signature of Purchaser Date 1/1/2016 Am -. Printed Name CHRISTINE S. PAULEY Title CLERK-TREASURER The Indiana Department of Revenue may request verification of registration in another state if you are an out-of-state purchaser. Seller must keep this certificate on file to support exempt sales. VOUCHER NO. WARRANT NO. ALLOWED 20 TOSHIBA BUSINESS SOLUTIONS, USA PO BOX 436357 IN SUM OF $ LOUISVILLE, KY 40253 $42.55 ON ACCOUNT OF APPROPRIATION FOR Street Department PO#/Dept. INVOICE NO. ACCT#/Fund AMOUNT Board Member: I 12722181 I 43-515.01 I $42.55 1 hereby certify that the attached invoice(s), or 2201 201 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 Tuesday, May 10, 2016 d Cost distribution ledger classification if claim paid motor vehicle highway fund 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)) 04/19/16 12722181 $42.55 2201 201 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 2600stanleyGaultPkwy. MAINTENANCE INVOICE � TOSHIBA BUSINESS SOLUTIONS Lou sv lle,KY 40223 Pagece Number: 127221811of 1 III II I III�]]II III III SII Tel: KY 502-489-6700,IN 317- Invoice Date: 19-APR-16 SHIPTO: CITY OF CARMEL Invoice Period: (04/24/16-05/23/16) 3400 W 131ST STRET Customer Number: TOBC84M CARMEL,IN 46074 Site ID: 1140752 TOTAL DUE $45.53 BILLTO: CITY OF CARMEL REMITTO: TOSHIBA BUSINESS SOLUTIONS,USA 1 CIVIC SQUARE P.O.Box 436357 CARMEL,IN 46032 LOUISVILLE,KY 40253 ---------------------------------------------------------•PLEASE CUT ALONG LINE AND RETURN WITH REMITTANCE-------------------------------------------------e CONTRACT INCLUSIONS PO NUMBER CONTRACT NO. PAYMENT TERMS CUSTOMER NUMBER PARTS,LABOR,TONER 1140752 1 1210227-501 DueUponReceipt TOBC84M MODEL/SERIAL/LOCATION METER COST START END AMOUNT DESC. QTY DESCRIPTION_ _ PER-COP-YMETER—_METER_ ESTUD103555C/SC7CF58741 2000 ALLOWANCE[4/24/2016-5/23/2016] .008 0 0 $16.00 ESTUD103555C/SC7CF58741 500 ALLOWANCE[4/24/2016-5/23/20161 .0531 0 0 $26.55 N'@jTi-:Y0. ,, C- St%@IVI gR NUMBER MA HAV, CHANGED .LEASE UP.DA.,T Y,O.UR REG9R05 ACCOR_DINGI TOTAL SALES TAX AMOUNT TAX RATE FREIGHT AMOUNT TOTAL DUE $42.55 $2.98 $0.00 $45.53 Simplify your payments! Simplify your Electronic Payment now available When you sign up for Electronic Invoicing Toshiba's new Electronic Payment and Electronlc Invoicing programs give you the benefits of Sign up to Increased ease,accuracy, security,and timeliness.salve time as ; ' + E-mail directly to another department for questions or authorizationwell as the - -- - = + Faster and more secure than traditional mall Go online to find out more and enroll today, � - httpJfhusinesatoshba.corn/eskermgifiteridoReglaierjsp . Toshiba Business Solutions 2600 Stanley Gault Pkwy.,Suite 400,Louisville,KY40223 2845-52-5230-04202016 Form ST-105 Indiana Department of Revenue State Form 49065 R4/8-05 General Sales Tax Exemption Certificate Indiana registered retail merchants and businesses located outside Indiana may use this certificate.The claimed exemption must be allowed by Indiana code. Exemption statutes of other states are not valid for purchases from Indiana vendors.This exemption certificate can not be issued for the purchase of Utilities Yehieles, t ra a t,or Afrcr_aff Purchaser must be registered with the Department of Revenue or the appropriate taxing authority of the purchaser's state of residence. I Sales tax must be charged unless all information in each section is fully completed by the purchaser.Purchasers not able to provide all required j information must pay the tax and may file a claim for refund(Form GA-110L)directly with the Department of Revenue. I sn" Name of Purchaser CITY OF CARMEL ^, ONE CIVIC SQUARE GARMEL State IN Zi 46032 Business Address City p Purchaser must provide minimum of one ID number below.* „. Provide your Indiana Registered Retail Merchant's Certificate T1D and LOC Number as shown on your Certificate................. 0031201550 •� 020 p TID#(10 digits) LOC#(3 digits) `ds If not registered with the Indiana DOR,provide your State Tax IDNumber from another State................................................................ *See instructions on the reverse side if you do not have either number. State IDN State of Issue Is this a ®blanket purchase exemption request ora ❑single purchase exemption request? (check one) ham, M1 $ Description of items to be purchased. Purchaser must indicate the type of exemption being claimed for this purchase. (check one or explain) ''❑ Sales to a retailer,wholesaler,or manufacturer for resale only. I n ❑ Sale of manufacturing machinery,tools,and equipment to be used directly in direct production. C1 Sales to nonprofit organizations claiming exemption pursuant to Sales Tax Information Bulletin#10. p`ry (May not be used for personal hotel rooms and meals.) i 5 C:3 Sales of tangible personal property predominately used(greater then 50 percent)in providing public transportation-provide USDOT#. ± A person or corporation who is hauling under someone else's motor carrier authority,or has a contract as a school bus operator,must ''s21 provide their SS#or FID#in lieu of a State ID#in Section#1. USDOT# chi) xd; a?!�® Sales to persons,occupationally engaged as farmers,to be used directly in production of agricultural products for sale, j Note:A farmer not possessing a State Business License#may enter a FID#or a SS#in lieu of a State ID#in Section#1. I -i-x ❑ Sales to a contractor for exempt projects(such as public schools,government,or nonprofits}. Tk ® Sales to Indiana Governmental Units(agencies,cities,towns,municipalities,public schools,and state universities). 5 C3 Sales to the United States Federal Government-show agency name. Note:A U.S.Government agency should enter its Federal Identification Number(FID#)in Section#1 in lieu of a State ID#. 1 �'r s ❑ Other-explain. ' s`� I hereby certify under the penalties of perjury that the property purchased by the use of this exemption certificate is to be used for an exempt purpose pursuant to the State Gross Retail Sales Tax Act,Indiana Code 6-2.5,and the item purchased is not a utility,vehicle,watercraft,or aircraft. b`I corm m understanding t t l se, either ne k ent or intentional,and/or fraudulent use of this certificate may subject both me personally Y g ( ' S 'g ) t; and/or the business entity I ep7 to the impositionof x;int e ,and civil and/or criminal penalties. uz e+3 Signature of Purchaser Date 1/1/2016 Printed Name CHRISTINE S. PAULEY Title CLERK-TREASURER The Indiana Department of Revenue may request verification of registration in another state if you are an out-of-state purchaser. Seller must keep this certificate on file to support exempt sales.