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i CITY OF CARMEL, INDIANA VENDOR: 370698
ONE CIVIC SQUARE CORT GOVT ACCOUNTS DEPARTMENICHECK AMOUNT: S"""""1,308.20'
CARMEL, INDIANA 46032 PO BOX 3536 CHECK NUMBER: 305523
+q��TON_�� CAPITAL HEIGHTS MD 20791 CHECK DATE: 11/28/16
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1205 4358500 5756399 1,308.20 CENSUS & ELECTION FEE
VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201(Rev.1995)
CORT GOVT ACCOUNTS DEP+ RTMENT ALLOWED 20 ACCOUNTS PAYABLE VOUCHER
PO BOX 3536 IN SUM OF$ CITY OF CARMEL
An invoice or bill to be properly itemized must show:kind of service,where performed,dates service
CAPITAL HEIGHTS, MD 20791 rendered,by whom,rates per day,number of hours,rate per hour,number of units,price per unit,etc.
$1,308.20 Payee
ON ACCOUNT OF APPROPRIATION FOR Purchase Order#
General Administration 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
5756399 43-585.00 $1,308.20 1 hereby certify that the attached invoice(s),or 11/8/16 5756399 $1,308.20
1205 101 1205 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, November 15,2016
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
20Cost distribution ledger classification if claim paid motor vehicle highway fund. Clerk-Treasurer
LAO
•
PO Box 3536 INVOICE# 5756399
Capitol Heights,MD 20791-3536
LEASE# 898749
CUSTOMER# 1232984
NAnf:City of Carmel 1NVOICE DATE 11/8/2016
ADDRESS I:Aft:Dept of Administration PO# 33900
ADDRESS 2: One Civic Square CORT Tax ID# 14-1543982
CITY,ST ZIP: Carmel,IN 46032 DUNS# 071078786
NJPA Contract# 031715-COR
_ Item No. Item/Code Period Type
1 Furniture Rental 10/1-10/31/16 Monthly Charge - — $1,266:00
1 Furniture Rental 11/1-11/30/16 Monthly Charge $1,266.00
1 Complete Pickup 11/1/2016 Prorate Credit ($1,223.80)
Furniture Location:
1374 Rangeline Road
Carmel,IN 46032
Sworn Kltecil
NOV 15 2016
TOTAL DUE $1,308.20
QUESTIONS? Please call Denise Miller at 301.324.8655 or email at denise.miller@cort.com
Terms:Net 30�