182143 02/03/2010 L MF
CITY OF CARMEL, INDIANA VENDOR: 00351469 Page 1 of 1
•i 6 ONE CIVIC SQUARE XEROX CORP
is, CARMEL, INDIANA 46032 '0 BOX 802555 CHECK AMOUNT: $423.38
.o; CHICAGO IL 60680 -2555 CHECK NUMBER: 182143
CHECK DATE: 2/312010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1301 4353004 04537760 274.98 COPIER
209 R4353004 21196 045400738 148.40 COPIER LEASE
Y1
t XEROX CAPITAL 2369 THE EASY WAY Xe fo
TO ORDER SUPPLIES
SERVICES, L L C CALL OUR TOLL Purchase Order Number
FREE NUMBER
PO BOX 660502 1 -800-822 -2200
DALLAS TX Special Reference
75266 -0501 VIN00000X -000
Contract Number
Q Teiephone888 435 6333 PAYABLE UPON RECEIPT
Please Direct Inquiries To: Terms Of Payment
Ship To /Installed At: Bill To: ti
CITY OF CARMEL I
CU
CITY LAW OFF.
ELAINE BASS 045400738
4.11 1 CIVIC SQUARE Invoice Number
CARMEL I N 976584607
V 46032 Customer Number
DC425AC DIGITAL COPIER SER.# EYC- 017353
AMOUNT
BASE CHARGE JANUARY
148.40
METER USAGE 09 -28 -09 TO 01 -04 -10
METER 1 156791 158928 2137
PRINT CHARGES
U METER 1 PRINTS 2137
LESS ALLOWANCE 12933
NET BILLABLE PRINTS 0 .017000 .00
TOTAL EXCESS PRINT CHARGES .00
METER CRU KIT SER.# CRU32METR INCL
DC432/40 CTCH TRAY SER.# DC32CT INCL
SUB TOTAL 148.40
TOTAL 148.40
ALLOWANCE PRORATED FOR 097 DAYS
INVOICE FOR THE PERIODIC PAYMENT ON YOUR XEROX AGREEMENT
THIS AGREEMENT INCLUDES EQUIPMENT, MAINTENANCE AND SUPPLY CHARGES
THIS COST PER COPY AGREEMENT RENEWS ON 03 -30 -10
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. (7) 1/ 9�0
P. 0. Box 802555
Terms
Chicago, IL 60680 -2555
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
1 -12 -10 045400738 DC425AC Digital Copier Ser. EYE 017353 $148.40
$148.40
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
XCTOX CnrpOrgtinn IN SUM OF
P.O. Box 802555
Chicago, IL 60680 -2555
$148.40
ON ACCOUNT OF APPROPRIATION FOR
DEFERRAL FUND (Law)
430 -53004 Copier
4 f e 0 Board Members
PO# or INVOICE NO. ACCT #/TITLE AMOUNT y certify I hereb certif that the attached invoice(s), or
21196 045400738 $148.40 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
1.0 A. ___s'...e 2 90
ature
-,IMLIE /1
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
XEROX CAPITAL 0093 THE EASY WAY
TO ORDER SUPPLIES xerox
SERVICES, L L C CALL OUR TOLL Purchase Order Number
PO BOX 660502 1 822 2200
44 DALLAS TX Special Reference
75266 -0501 VIN00000X -000
Contract Number
0 Telephone
888 435 6333 NET 30 DAYS
Please Direct Inquiries To: Terms Of Payment
Ship To /Installed At: Bill To:
CARMEL CITY COURT 01
ONE CIVIC SQUARE Invoice Date
CARMEL IN 045537760
46032 Invoice Number
Cu
DC430 430W /DADF,DUP,2TR SER.# UHG- 031217
AMOUNT
BASE CHARGE DECEMBER
274.98
METER USAGE 09-30-09 TO 12 -30 -09
METER 1 220726 238096 17370
PRINT CHARGES
METER 1 PRINTS 17370
LESS ALLOWANCE 21233
CU LESS SERVICE CREDITS 310
U NET BILLABLE PRINTS 0 .013700 .00
TOTAL EXCESS PRINT CHARGES .00
C METER CRU KIT SER.# CRU32METR INCL
DC432/40 CTCH TRAY SER.# DC32CT INCL
SUB TOTAL 274.98
TOTAL 274.98
ALLOWANCE PRORATED FOR 091 DAYS
AT THE TIME OF BILLING, NO VALID METER READ WAS AVAILABLE,
SO METER USAGE WAS ESTIMATED. ANY OVERAGE /UNDERAGE WILL BE
ADJUSTED ON NEXT METER INVOICE. PLEASE VISIT OUR WEBSITE
AT WWW.XEROX.COM TO SUBMIT YOUR NEXT METER READ.
INVOICE FOR THE PERIODIC PAYMENT ON YOUR XEROX AGREEMENT
THIS AGREEMENT IN EQUT"P M IN I ENANCE AND SUPPLY CHARGES
TOTAL OF INVOICE MAY VARY ACCORDINI� TO METER USAGE BILLED
r_
XEROX FEDERAL IDENTIFICAT! #16- 0468020
Prescribed by State Board of Accounts City Form No. 201 (Rev. 1995)
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An nvoice 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
441
"`w Purchase Order No.
j 5 Terms
6 O Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
1/0 G 553 !00 i� r��r '9 91
Total 4a 1L f c 5
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
l.4rp‘4.4-0'n.J IN SUM OF$
Y0; f S.s
.c 1 6,a -;e75
ON ACCOUNT OF APPROPRIATION FOR
Board Members
Po# or INVOICE NO. ACCT #/TITLE AMOUNT I hereby ere y certify that the attached invoice(s), or
/30/ 0Y5 o ,5,3U- o q ce 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
A N„.. 4 ,ALI L .40
1
1 r fff
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund