182612 02/17/2010 CITY OF CARMEL, INDIANA VENDOR: 343004 Page 1 of 1
ONE CIVIC SQUARE XEROX CORP CHECK AMOUNT: $208.64
CARMEL, INDIANA 46032
598 CHECK NUMBER: 182612
TO 602- CHECK DATE: 2/17/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 45766392 208.64 OTHER EXPENSES
XEROX CAPITAL 1494 THE EAST way 510994 p�
SERVICES, LLC TO ORDER SUPPLIES S10994
CALL OUR TOLL Purchase Order Number
F
PO BOX 660502 1a00- 822 -22oo
DALLAS TX Special Reference
75266 -0501
Contract Number
L Telephone888 435 -6333 PAYABLE UPON RECEIPT
Please Direct Inquiries To: Terms Of Payment
Ship To /Installed At: BIII To:
CITY OF CARMEL CITY OF CARMEL 02 -01 -10
G� WATER AND SEWER WATER AND SEWER Invoice Date
E UTILITY UTILITY 045766392
0 760 3RD AVE SW 760 3RD AVE SW Invoice Number
4-j CARMEL IN CARMEL IN 713281426
46032 46032
Customer Number
V
W7655P WC 7655 COP PRITR SER.# VDR- 557581
AMOUNT
BASE CHARGE FEBRUARY
476.84
METER READ METER READ NET COPIES
METER USAGE 12 -22 -09 TO 01 -22 -10
TOTAL BLACK 229441 230905 1464
TOTAL COLOR 39775 40820 1045
METER CHARGES
TOTAL BLACK 1464
V BLACK BILLABLE PRINTS 1464 .006000 8.78
.0 TOTAL COLOR 1045
LESS PRINT ALLOWANCE 250 `n
COLOR BILLABLE PRINTS 795 .089000 70.76
NET PRINT CHARGE 79.54
SINGLE LINE FAX KT SER.# FAXLINEI INCL
PROF FINISHER SER.# PROFNSHR INCL
PR /COPY /SCAN CNTRL SER.# SCANCTRLI INCL
SER.# TXC- 999999 INCL
SUB TOTAL 556.38
TOTAL 556.38
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
PLEASE INCLUDE THIS STUB WITH YOUR PAYMENT, OR WRITE YOUR INVOICE NUMEER(51 ON YOUR CHECK. When Paying By Mail
Ship To /Installed At Bill To Send Payment To:
CITY OF CARMEL CITY OF CARMEL XEROX CORPORATION
WATER AND SEWER WATER AND SEWER P.O. BOX 802555
UTILITY UTILITY CHICAGO IL
760 3RD AVE SW 760 3RD AVE SW 60680 -2555
CARMEL IN CARMEL IN
46032 46032
91
E1 Please check here if your Bill To" address or "Ship To /Installed At"
location has changed and complete reverse side. Invoice Amount
PLEASE PAY
16- 046 -8020 1 713281426 045766392 02 -01 -10 THIS AMOUNT 55b.38
RF079451 C 0715080 PVR00
03 6M4D 09AA H N1010 5TC5 2 115
202100008070060 0457663924 0300556382 271328142622
VOUCHER 097288 ..:WARRANT ALLOWED
343004 IN SUM OF
XEROX CORP
PO BOX 802555
CHICAGO, IL 60680
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO [NV ACCT* AMOUNT Audit Trail Code
45766392 01- 7360 -07 $208.64
1 ti
-5
Voucher Total $208.64
Cost distribution ledger classification if
claim paid under vehicle highway fund
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 of service rendered, by whom, rates per day, number of units,
price per unit, etc.
Payee
343004
XEROX CORP Purchase Order No.
PO BOX 802555 Terms
CHICAGO, IL 60680 Due Date 2/8/2010
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
2/8/2010 45766392 $208.64
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
Date Officer