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HomeMy WebLinkAbout332046 11/13/18 y ur..C�gM ! � CITY OF CARMEL, INDIANA VENDOR: 372925 j ONE CIVIC SQUARE FORMSTACK LLC CHECK AMOUNT: $*******253.42* 9 ?� CARMEL, INDIANA 46032 8604 ALLISONVILLE RD CHECK NUMBER: 332046 SUITE 300 CHECK DATE: 11113/18 INDIANAPOLIS IN.46250 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1081 4239039 00050023 253.42 GENERAL PROGRAM SUPPL ACCOUNTS PAYABLE VOUCHER CITY OF CARMEL VOUCHER NO. WARRANT NO. An invoice of bill to be properly itemized must show;kind of service,where performed,dates service rendered,by Vendor# 2 r]��C Allowed 20_ whom,rates per day,number of hours,rate per hour,number of units,price per unit,etc. Formstack i� ! V Payee 8604 Allisonville Road,Suite 300 Indianapolis, IN 46250 In Sum of$ Purchase Order# Formstack Terms $ 253.42 8604 Allisonville Road,Suite 300 Date Due Indianapolis, IN 46250 ON ACCOUNT OF APPROPRIATION FOR 108-ESE Fund PO#or INVOICE NO. ACCT#/TITLE AMOUNT Invoice Description Dept# Invoice Date Number (or note attached invoice(s)or bill(s)) PO# Amount Users added for ESE Staff to Forms 1081-99 INV00050023 4239039 $ 253.42 Board Members 9/25/18 INV00050023 Subscription xx7467 $ 253.42 I hereby certify that the attached invoice(s),or 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 $ 253.42 Total $ 253.42 November 4,2018 1 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 Cost distribution ledger classification if claim paid motor vehicle highway fund Signature 120_ Accounts Payable Coordinator Clerk-Treasurer INVOICE ZCE ED w��! 20]8 Account: : Carmel Clay Parks voice Date: 09/2572078 voice#• N000050023 Billing Contact: Dawn Koepper j - ymen Terms: IDue .pon Receipt,. dkoepper@carmelclayparks.com Due Date: 09/25/2018- Purchasel6rd lci� - Account Number: A00018025 Billing:Address: .. 1411 E 116th Street formstack Account ID: 643930 N Salesforce:Org IDc, ULL Carmel,:Indiana 46 032 Unified-States: - NOU.O 6 7.01 e . . . Charge Summa Rate Plan:` Charge.Detail - Amice'Period - Quantity' -_ Unit Price Amount(USD)' Workflow Users Workflow Users-Proration 09/01/2018-10/07/2018 25• $100.00 $258.42 _ Annual• Invoice Totals:: . Gross Amount- $25342 1 00 - t 3 42 .i. -Subtotal, i $25 Questions about your_bill?Please visit- I - - - - 4-.-,-. - - - -- -- -- support.formstack.coni to submit a ticket. . Tax: , $0.00 I. -Total I $253.42 { — .00 Payments Applied: $0 _e .- - Invoice Balanc $253�d2 - - paying monthly?..Get 2 months free by switching to annual.billing!* . _ *Does hot a I ..to HIPAA accounts Pp Y Copyright©2018 For�tstack, All Rights Reserved. lr�dia,na,alis, .ISR 4625�