183256 03/16/2010 CITY OF CARMEL, INDIANA VENDOR: 362651 Page 1 of 1
i 0 ONE CIVIC SQUARE DE LAGE LANDEN CHECK AMOUNT: $136.00
CARMEL, INDIANA 46032 PO Box 41602
PHILADELPHIA PA 19101 -1602 CHECK NUMBER: 183256
CHECK DATE: 3/1612010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1160 4353004 5031217 136.00 COPIER
Keep lower portion for your records Piease return upper portion with your payment
Invoice Datelri'vgice Numb "er Ace ountrX a
AM
KONICA LEASING A PROGR OF DE 02/20/2010 5031217 073388
98
LAGS L ANDEN ]FINANCIAL SERVICES Ear' kc y �E3
€d,.,. bw -.l
PC? BOX 41602
f'HLLADE:L.PHIA, PA 19101 1602', Period H of Performan'ce,' �,Contract�NumbeA� I t
0211512010— 03/14/2010 25021065
Important Messages
If this is your first in voice, it may include interim rent or prior period rentals in the payment amount.
See Reverse for Important Information
h .vi0i k+Otafl$' -t
In V°'- 'e s .N`i,m°�,� �G
k� €x1�' Pa `nient Ai �o,unta s S616s1Use�Tax� a Total;Amount
PAYMENT $61.00 1 $0.00 $61.00
DOCUMENTATION FEE $75.00 $0.00 $75.00
€3
Billed this Inoice� a�, �FS�� "w Po
s
h b N A t 9 h f2 p
Assetleta�ls m
*Make! Mgdel a Senal Number +Asset Number ContractiMumber Payment Am SaleslUse Tai 4 g lTataLAmaunt
�EMt '`X{; 3 .a s
6NMINIC20 OFDO130029 25021065_1 25021065 $61.0 $0 0 $61.00
4
5sel Cocationr Y:CIVIC.SQ`.CAF2MEL'HAMILTON IN:46D32- 7569.Unitetl,States -r M'Z
IIMIPO TANT R EMINDER; Enclose remittance slip with yoUr check and send it to the address c n reverse.
s to ensure acv #,state and flimely processing of your payment, For promIx, review and handling, please
se is other correspon er"Ice avid notices separately to the attention of: Customer Service KOMCA L A I C
A PROGRAM OF DE LA GE EA DEN FINANCIAL SERVICES 1111 OLD EAGLE SCHOOL RD, WAY E,
IAA 10087 -1453.
For gene'a! accoun infori nation 24 hours a day, 7 days a vieek, visit ourwo—Atsit?
Please remit payments at least 5 business clays prier to due cute.
Please be sure to record your Invoice or Account Number on the check.
Exp l a n a tion of C harges.
I! is important to us that you understand the charges can your invoice. Please refer to this guide as
ass °st�;°sr 4t \Brf FEE
A erne tirne ';barge assesse:j on the nevv transactions. T his fee covers `he cost of UCC filings and other documentahori uosts,
INSURANCE CHARGE
A charge due each billing period as the result of the equipmen' being it ured by the lessor against all risks of loss or damage.
3. PAYMENT
Arno €rnt d,je* &ate N lli nc period in cca'3?'{ anize v,( the tern of the ct'i!?l!act.
fTE- CHARGE
5; LATE PEE
Assc-ssed when a paynner;[ is not received by its dui: dale, as provided by tE-, cor3hact.
VV
The saiesJuse tax is due in accoidance with the tax laws of the state(s) inhere the equipment is located. For gijestions abort
tam—, ca;i the Customer Service number mentioned below.
RROPE Y T AX
Tt�o lessor, as owner of the egUipment, is assessed and pays pr;aperty tax to the appropriate taxing aLdhority or, �in annual
basis. Per the iease contract, the Lessee: has agreed to reimbi -Irse the Lessor for all property taxes paid on their behalf Pius
reasonable administrative costs, nor questions about taxis cal[. Custorner Service nurnber rnentic,ned beio v.
8. RETURNED CHECK FEE
Assessed eac€, time a check is retuned for any reason.
9. COPY FEE
r %ssFssed wuher, the L essee requests an adrfitionai copy of the contract.
FJ- ACCOUNT STAT i-WFNT
Overview of prior invoices for which no paymen( was received at the time the c rre rl invoice was printed
Crar respa nce Address:
Customer SerOce, KONICA- LEASING A PROGRAM OF DE LAGP LAND EN FfNANCIAL ERViC s 1111
0Li, EAGLE SCHOOL RID, WAYN PA 1 9087 -1 453 or call: 800-736-0220
Please send all written en Mires to the address indicated above. Please do coot send checks; to the address
as this will delays the posting of payments to your account.
Prescribed by','wte Board of Accounts City Form No. 201 (Rev. 1995)
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
3/15/10
An invoice or bill to be properly itemized must show: kind of service, where performed, dates service rendered, by
whom, rates er day, number of hours, rate per hour, number of units, price per unit, etc.
Payee
Konica Leasing /De Lage Landen Purchase Order No.
P. 0. Box 41602 Terms
Philadelphia PA 19101 Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
2/20/10 5031217 Copier1printer lease $136.00
Total $136.00
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.
20
Clerk- Treasurer
VOUCHER NO. WARRANT NO.
_3/15/10
ALLOWED 20
Konica Leasing /De Lage IN SUM OF
P. 0. q��a 02
Philadelphia PA 19101
136.00
ON ACCOUNT OF APPROPRIATION FOR
1160- Mayor 4353004
C
Board Members
PO# or INVOICE NO. ACCT #/TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
5031217 4353004 $136.00 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
3/15 20 10
1 Signa re
Cost distribution ledger classification if -1 Title
claim paid motor vehicle highway fund