182162 02/03/2010 CITY OF CARMEL, INDIANA VENDOR: 00351469 Page 1 of 1
ONE CIVIC SQUARE XEROX CORP CHECK AMOUNT: $506.63
*1�; CARMEL, INDIANA 46032 PO Box 802555
=V;, off CHICAGO IL 60680 -2555 CHECK NUMBER: 182162
CHECK DATE: 2/3/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
209 R4353004 21196 045766389 506.63 COPIER LEASE
it
'"XEROX CAPITAL 1493 TO ORDER EA WAY
Su PLIES NOT REQUIRED ,-e-
O SERVICES, L L C CALL OUR TOLL Purchase Order Number xerox
O PO BOX 660502 1-800 -822 -200
4../ DALLAS TX Special Reference
CS 75266 -0501 DUM00000X -000
E Contract Number
O (a Telephone888 435 6333 NET 30 DAYS
Please Direct Inquiries To: Terms Of Payment
Ship To /Installed At: Bill To:
1....1' CITY OF CARMEL CITY OF CARMEL 02 01 10
CU t LAW OFFICE LAW OFFICE
Invoice Date
E,.' 1 CIVIC SQ 1 CIVIC SQ 045766389
O CARMEL IN CARMEL IN Invoice Number
+a 46032 46032 711428953
vi 1. Customer Number
V
W7655P WC 7655 COP -PRNTR SER.# VDR- 548166
AMOUN- T
BASE CHARGE JANUARY
453.76
METER READ METER READ NET COPIES
METER USAGE 12 -22 -09 TO 01 -22 -10
TOTAL BLACK 146918 150332 3414
TOTAL COLOR 30938 31782 844
METER CHARGES
CU TOTAL BLACK 3414
,V LESS PRINT ALLOWANCE 5000
0 BLACK BILLABLE PRINTS 0 .006000 .00
TOTAL COLOR 844
LESS PRINT ALLOWANCE 250
COLOR BILLABLE PRINTS 594 .089000 52.87
NET PRINT CHARGE 52.87
ADVANCED FINISHER SER.# ADVFNSHR INCL
SER.# CBO- 999999 INCL
PR /COPY /SCAN CNTRL SER.# SCANCTRL INCL
SUB TOTAL 506.63
TOTAL 506.63
INVOICE FOR THE PERIODIC PAYMENT ON YOUR XEROX AGREEMENT
THIS_ AGR. E -E-ME,NT- INCLUDES- -EQU- I- PMENT,_- MA-I_- NTENANCE AND-SWIRLY-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
Purchase Order No. 011/94P E
f'. 0. Box 802555
Terms
Chicago, IL 60680 -2555
Date Due
invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
2 -1 -10 045766389 W7655 WC 7655 Cop -Prntr SN VDR- 548166 $506.63
$506.63
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
$506.63
ON ACCOUNT OF APPROPRIATION FOR
DEFERRAL FUND 209
430 -53004 Copier
&,e/6(4/4/16(-X-12 a Board Members
Po# or INVOICE NO. ACCT #Tl ITLE AMOUNT y certify invoice( s), I hereb certif that the attached invoices or
21196 045766389 $506.63 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
�.r 20 0
e P
Cost distribution ledger classification if
Title
claim paid motor vehicle highway fund