302294 08/22/16 �r.4�q
_,,,f CITY OF CARMEL, INDIANA VENDOR: 366767
® ONE CIVIC SQUARE VAN AUSDALL& FARRAR CHECK AMOUNT: $********23.78*
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CARMEL, INDIANA 46032 PO BOX 713683 CHECK NUMBER: 302294
M�ioN.�o` CINCINNATI OH 45271-3683 CHECK DATE: 08/22/16
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1115 4351501 191737 23.78 EQUIPMENT MAINT CONTR
VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201(Rev.1995)
ALLOWED 20 ACCOUNTS PAYABLE VOUCHER
VAN AUSDALL& FARRAR
PO.BOX 713683 pIN SUM OF$ CITY OF CARMEL
An invoice or bill to be properly itemized must show:kind of service,.where performed,dates service
CINCINNATI, OH 45271-3683 rendered,by whom,rates per day,number of hours,rate per hour,number of units,price per unit,etc.
$23.78 Payee
ON ACCOUNT OF APPROPRIATION FOR Purchase Order#
Communications 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
191737 43-515.01 $23.78 1 hereby certify that the attached invoice(s),or 8/9/16 191737 $23.78
1115 101 1115 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
Tuesday,August 16;2016
Terry Crockett
Director
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 class ification.if claim paid motor vehicle highway fund. Clerk-Treasurer
Van.Allusdall MAIL REMITTANCE TO: CONTRACT INVOICE
& Forriar - VAN AUSDALL AND FARRAR,INC.
OffKE PO BOX 713683,Cincinnati,OH 45271-3683 Invoice Number: 191737
SNCSN`'"'"S Phone(317)6342913 Fax(317)638-1843
��� VjV Email invoice questions to: Invoice Date: 08/09/2016
billing@vanausdall.com
Bill To: CARMEL COMMUNICATIONS CENTER Customer: CARMEL COMMUNICATIONS CENTER
31 IST AVENUE NW 31 1ST AVENUE NW
CARMEL,IN 46032 CARMEL,IN 46032
w ;:Acxoutrt°No Pa!mentTerms Dae'Date .,z2nvo�ce That Balance Die
510850 NET10 08/19/2016 $23.78 $ 23,78
16751-04 317-460-6174 --$23.7807/01/2016 06/30/2017
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Summary:
Contract base rate charge for this billing period $0.00
Contract overage charge for the 07/01/2016 to 07/31/2016 overage period $23.78**
*Sum of equipment base charges **See overage details below $23.78
Detail:
Egwprnent Anel du ed under this contract `r��, _ _ ����'� '-� � ��
Number Serial Number Base Charge Location
71869 W493L400357 $0.00 CARMEL COMMUNICATIONS CENTER 31 IST 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 26,620 26,925 305 0 305 $0.005808 $1.77
Color CLR-16751-20( 19,514 19,942 428 0 428 $0.051425 $22.01
$23.78
Customer Number: 510850 Invoice Number: 191737 Invoice SubTotal $23.78
Please Include Invoice Number on Remittance Tax: $0.00
Invoice Total $23.78
Thank you for your business! Balance Due: $23.78
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