181687 01/20/2010 CITY OF CARMEL, INDIANA VENDOR: 00351469 Page 1 of 1
r.'411 .o ONE CIVIC SQUARE XEROX CORP CHECK AMOUNT: $561.93
s, CARMEL, INDIANA 46032 PO BOX 802555
CHICAGO IL 60680 -2555 CHECK NUMBER: 181687
CHECK DATE: 1/20/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
209 R4353004 21196 045174149 561.93 COPIER LEASE
XEROX CAPITAL 0653 THE EASY WAY NOT REQUIRED xerox
c TO ORDER SUPPLIES J
O S E R V I C E S L L C CALL Purchase Order Number
PO BOX 660502 1 -800 -822 -2200
wiftl
0 DALLAS TX Special Reference
E 75266 -0501 DUM00000X -000
Contract Number
O Telephone888 435 6333 NET 30 DAYS
Please Direct Inquiries To: Terms Of Payment
Ship To /Installed At: Bill To:
L. CITY OF CARMEL CITY OF CARMEL 01
a LAW OFFICE LAW OFFICE Invoice Date
1 CIVIC SQ 1 CIVIC SQ 045174149
+4 CARMEL I N CARMEL I N Invoice Number
VI 46032 46032 711428953
V Customer Number
W7655P WC 7655 COP -PRNTR SER.# VDR- 548166
AMOUNT
BASE CHARGE DECEMBER
453.76
METER READ METER READ NET COPIES
METER USAGE 11 -21 -09 TO 12 -22 -09
TOTAL BLACK 141453 146918 5465
TOTAL COLOR 29504 30938 1434
METER CHARGES
V TOTAL BLACK 5465
•O LESS PRINT ALLOWANCE 5000
BLACK BILLABLE PRINTS 465 .006000 2.79
O TOTAL COLOR 1434
1. 4 LESS PRINT ALLOWANCE 250
COLOR BILLABLE PRINTS 1184 .089000 105.38
NET PRINT CHARGE 108.17
ADVANCED FINISHER SER.# ADVFNSHR INCL
SER.# CBO- 999999 INCL
PR /COPY /SCAN CNTRL SER.# SCANCTRL INCL
SUB TOTAL 561.93
TOTAL 561.93
INVOICE FOR THE PERIODIC PAYMENT ON YOUR XEROX AGREEMENT
THIS AGREEMENT INCLUDES EQUIPMENT, MAINTENANCE AND SUPPLY CHARGES
TOTAL OF INVOICE MAY VARY ACCORDING TO METER USAGE BILLED
XEROX FEDERAL IDENTIFICATION #16-0468020
Prescribed by State Board of Accounts City Form No, 201 (Rev. 1995)
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
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.
Payee
Xerox Corporation q l
Purchase Order No. P
P. O. Box 802555
Terms
Chicago, IL 60680 2555
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
1 -8 -09 045174149 WC 7655 COP PRNTR, Ser. #VDR- 548166 $561.93
$561.93
Total
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
Clerk- Treasurer
VOUCHER NO. WARRANT NO.
ALLOWED 20
Xerox Corporation IN SUM OF
P.O. Box 802555
Chicago, IL 60680 -2555
$561.93
ON ACCOUNT OF APPROPRIATION FOR
DEFERRAL FUND (Law)
430 -53004 Copier
)4,64t,1,14,6reAf262 D. Board Members
Pots or INVOICE NO. ACCT #/TITLE AMOUNT y y invoice( s), I hereby certify that the attached invoices or
21196 045174149 $561.93 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
AEG, 20 0
l �7
vig
Cost distribution ledger classification if
Title
claim paid motor vehicle highway fund