304078 10/10/16 (9,
CITY OF CARMEL, INDIANA VENDOR: 369620
ONE CIVIC SQUARE MCCI INNOVATOINS CHECKAMOUNT: $*******885.40*
CARMEL, INDIANA 46032 PO BOX 2235 CHECK NUMBER: 304078
TALLAHASSEE FL 32316 CHECK DATE: 10/10/16
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1192 4351502 33667 00009459 885.40 ANNUAL SOFTWARE SUPPO
VOUCHER NO. WARRANT NO. Prescribed by state Board of Accounts City Form No.201 (Rev.1995)
MCCI INNOVATOINS ALLOWED 20 ACCOUNTS PAYABLE VOUCHER
PO BOX 2235 IN SUM OF$ CITY OF CARMEL
An invoice or bill to be properly itemized must show:kind of service,where performed,dates service
TALLAHASSEE, FL 32316 rendered,by whom,rates per day,number of hours,rate per hour,number of units,price per unit,etc.
$885.40 Payee
ON ACCOUNT OF APPROPRIATION FOR Purchase Order#
Dept of Community Service 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
33667 00009459 43-515.02 $885.40 1 hereby certify that the attached invoice(s),or 9/30/16 00009459 $885.40
1192 101 1192 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
Wednesday, October 05,2016
��
Mike Hollibaugh
Director
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
20Cost distribution ledger classification if claim paid motor vehicle highway fund. Clerk-Treasurer
'�c C 1
P.O.Box 2235 Tallahassee,FL 32316 INVOICE
FEIN:33-1069550
ExperienceExcellence Questions:flnance@mccinnovations.com
Bill To:
CARMEL,INDIANA Invoice Number 00009459
***tcrockett@carmel.in.gov
TERRY CROCKETT,IT DIRECTOR Invoice Date 8/23/2016
THREE CIVIC SQUARE PO Number 33667
CARMEL,IN 46032
Customer Id 60-61101
Payment Terms Net 30
Shipped Description Unit Price Extended Price
1 LF SOFTWARE ADDITIONAL $770.000 $770.00
1 LF SUPPORT ADD ON-Prorated 9 Months $115.400 $115.40
Subtotal $885.40
Discount $0.00
Freight $0.00
Tax $0.00
Total $885.40
Please remit one copy with payment
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