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305695 11/28/16 CITY OF CARMEL, INDIANA VENDOR: 366767 CHECK AMOUNT: S"'"""27.53` ONE CIVIC SQUARE VAN AUSDALL & FARRAR 4 ?� CARMEL, INDIANA 46032 PO BOX 713683 CHECK NUMBER: 305695 CINCINNATI OH 45271-3683 CHECK DATE: 11/28/16 k ETON� DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1115 4351501 208983 27.53 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 IN.SUM OF$ Y PO BOX 713683 -:CIT 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. " $27.5 1.3 Payee Purchase Order# ON ACCOUNT OF APPROPRIATION:FOR 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 208983 43-515.01 $27.53 1 hereby certify that the attached invoice(s),or 11/4/16 208983 $27.53 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,.November 15,2016 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 classification if claim paid motor vehicle highway fund. Clerk-Treasurer Van /msdall MAIL REMITTANCE TO: CONTRACT INVOICE & Farrar VAN AUSDALL AND FARRAR, INC. cMUhcwaOGY PO BOX 713683,Cincinnati,OH 45271-3683 Invoice Number: 208983 .&NC-ONS 4�,0,< - Phone(317) 6342913 Fax(317)638-1843 Email invoice questions to: Invoice Date: 11/04/2016 billing@vanausdall.com Bill To: CARMEL COMMUNICATIONS CENTER Customer: CARMEL COMMUNICATIONS CENTER 31 1ST AVENUE NW 31 1ST AVENUE NW CARMEL,IN 46032 CARMEL,IN 46032 ACCOUnt NOaxr Payment Terms 4 � . Ue© 6 " . �nYalGe Toltdl t a A.x> 68Ie3ilC8 D11e 510850 NET10 11/14/2016 $ 27.53 $ 27.53 ;Gontrajc ,Numbeir „ , ;CCljlfaclE .. . ., ,x GgntractAmount„ ,y O„Nukttberr<<. Start DateFacq tlydte 167511=04 317-460-6174 $ 27.53 07/01/2016 06/30/2017 Summary: Contract base rate charge for this billing period $0.00 Contract overage charge for the 10/01/2016 to 10/31/2016 overage period $27.53** *Sum of equipment base charges **See overage details below $27.53 Detail: E_gwpment included under this contract � �,y _ � f � t� �� „^ 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 28,086 28,346 260 0 260 $0.005808 $1.51 Color CLR-16751-20( 21,687 22,193 506 0 506 $0.051425 $26.02 $27.53 Customer Number:510850 Invoice Number: 208983 Invoice SubTotal $27.53 Please Include Invoice Number on Remittance Tax: $0.00 Invoice Total $27.53 Thank you for your business! Balance Due: $27.53 Page I of 1