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322256 02/27/18 CITY OF CARMEL, INDIANA VENDOR: 371592 'i ONE CIVIC SQUARE AMAZON CAPITAL SERVICES CHECK AMOUNT: $""'"'52 52' CARMEL, INDIANA 46032 Po Box 035184 CHECK NUMBER: 322256 SEATTLE WA 98124-5184 CHECK DATE: 02/27/18 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1207 4230200 1FHC3G1V6R7Y 52.52 OFFICE SUPPLIES VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201 (Rev.1995) Vendor# 371592 ALLOWED 20 ACCOUNTS PAYABLE VOUCHER AMAZON CAPITAL SERVICES IN SUM OF$ CITY OF CARMEL PO BOX 035184 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. SEATTLE, WA 98124-5184 Payee $52.52 Purchase Order# ON ACCOUNT OF APPROPRIATION FOR Brookshire Golf Course 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 1 FHC-3G1 V-6R7Y 42-302.00 $52.52 1 hereby certify that the attached invoice(s),or 2/16/18 1 FHC-3G1 V-6R7Y Office Supplies $52.52 1207 101 1207 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 Monday, February 19,2018 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 amazonbusiness Invoice For customer support and disputes,visit www.amazon.com/contact-us. Invoice Date 16-Feb-2018 Invoice Summary Payment due by March 18, 2018 Invoice# 1FHC-3G1V-6R7Y m.. _ _.__ _ _.•....____n _. ___� _ ,._._ __,....w......_....__._ __...w........ Account# AlPUBUF913SWOD Item Subtotal $ 52.52 Order# 114-7458380-5269808 Shipping&Handling $ 0.00 Payment Terms Net 30 Promos&Discounts $ 0.00 Sales Tax $ 0.00 Bill To Brookshire Golf Club Amount Due $ 52.52 USD Pam Lister 12120 Brookshire Parkway Carmel,IN 46033 Order Information Ship To Ordered By Pamela Lister Brookshire Golf Club 12120 Brookshire Parkway Remit To Carmel,IN 46033 Account Name:Amazon Capital Services, Inc. Sales Tax based on Ship To address Bank Name:Wells Fargo Bank ACH Routing#(ABA): 121000248 Bank Account#(DDA):4122416308 SWIFT Code:WFBIUS6S Mail Check Payments To Amazon Capital Services PO Box 035184 Seattle,WA 98124-5184 Include Amazon invoice number(s)in the descriptive field of your electronic funds transfer payment. Email ar-businessinvoicing@amazon.com with questions regarding payments or invoices,or to submit your remittance detail. Accounts Receivable can also be reached at 1-888-283-2209. Invoice Details Description Qty Unit Price Item Subtotal Konica Bizhub C451 Waste Toner Bottle Yield 57,000, 1 $52.52 $52 ASIN;:13002FYSKVU4 Sold by.-Networking Hardwares LLC Page 1 of 1