186225 06/09/2010 CITY OF CARMEL, INDIANA VENDOR: 033825 Page 1 of 1
ONE CIVIC SQUARE CDW GOVERNMENT INC
y i CHECK AMOUNT: $169.16
CARMEL, INDIANA 46032 75 REMITTANCE DR
SUITE 1515 CHECK NUMBER: 186225
CHICAGO IL 60675 -1515
CHECK DATE: 6/9/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1115 4230200 STD5073 169.16 OFFICE SUPPLIES
nr The Right Technology. INV OICE ICE NUMBER INVOICE TERMS DUE D ATE
�.0 Right Away. 05(2612010 STD5073 NET 30 Days- Govt/State -Local 06/25/201
VISIT CDWG ON THE INTERNET
OUR PART NO. DESCRIPTION CITY CITY OTY UNIT PRICE TOTAL
ORQ SHIP B10
640640 PANASONIC 9.4GB DUD -RAM 3X 20 20 $7.9 $159.8
Manufacture Part Number: LM- HB94LU
ACH INFORMATION: THE NORTHERN TRUST ROUTING NO.: 071000152
50 SOUTH LASALLE STREET ACCOUNT NAME: CDW GOVERNMENT
CHICAGO, IL 60675 ACCOUNT NO.: 91057
HAVE QUESTIONS ABOUT YOUR ACCOUNT? PLEASE EMAIL U AT: credit@cdvv,com
ORDER A SHIP VIA PURCHASE ORDER NO. CUSTOMER NO. PRODUCT
05/26/2010 UPS Ground (1- 2 day) 26872 1674420 SUBTOTAL $159'80
SALESPERSON SHIP TO:
BART HECKMAN CITY OFCARMEL SALES ORDER NUMBER SHIPPING $9.36
312 705 9572 TERRY CROCKETT SALES
barthec cdw com 3 CIVIC SO TTG5750 TAX $0.00
g CARMEL IN 46032.2584
INVOICE
AMOUNT $169.16
CDW GOVERNMENT AN ILLINOIS CORPORATION FEIN 36- 4230110
IIIIIIIIlIIIIIIIIlIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIllllllllllllllllllllllllllfllllllll AMOUNT Du $169.16
I
CDW Government "CDW -G") Terms and Conditions of Sale
The Righf TechrwlugY.
Rigl:1 Awey. r
'f 11 'F'V It NIS AND CO.ND3T ill NS \Rfi i,lAt Ii Ely 10rI'1i1/SF: C.O N "1'111, \'3 ?[III F;REIN .1 11 'fkl V. �1 flf)Il'111 ��:11. PricinK Fnfurm:J ian; A: ails hlFily Ui,wlaimer
Tf:R51S AND CONIII'I'IONS CON''I'AINFO IN 1111; "1'LRNI1 AND C:ON'DI'1'IONS" LINK 1T W\5'W,COW,(:UM SOI,, risen e, the nxhn to conk, nti ,hare Is Is i x:ng. P"Jtcts iltd Senrce Inc, daq, b I n x i mired
IN( „ORPORXIE[I IIFli RV RVFLRF:NCF:.:5N 'I'b;RMS NO'I OI: FI N'F:ll 11FH1,1N AkE UF.FFNIl11 At r. etsnnging nnrkn canJ'tions Product disttrnhn uifo P,1d 1st Fact urea price chnnge.
_selpp .r price
\5'\V 55,(: OSV.CO AF. ANT ,%DDI'1'PON.AL OR UIFNERE, \'I' 'II: R,51,S OR (.011M TIONJ IN AN FORM elmngo, and er t ad+'ert'i ECnlrn[s. All rn�Ill' -s ur subject ru Product nvuikn4il ily and the uT Pcrs
a'ai lubili ly „n net lu
i)EREUIlS'full I "CUS'ICINO'.R ")ARK IIERERYRKI:MI:R'10 RE: M,5'fF.R1,51. A I.Ell 11(N. :\NI) penirn h.5 s' Sellercunrw[curare,lre ih,lI+s 113u•nhlc t.. tiJfll(_;I+Iner ss. rd, rs.It _..rliccs arc he',g
:NotICEOk'b1;..It:(�OON'ru'flf E%l AN11RCIECI N 01 IS RF.HPI'll OIvEN. pen'ornleJ one lime and mbirrl: its husks,mi±' pro,idcd by Seller arc for plxonine purposes-
Ell' .5C(:F,PT'I,N(.. OE1,1 \'FHl' OF TIIE PHOP4IC'fs OR fill' ENCACING'1'111, (Al ArVILIA1'I IIIIIFEP I.imi taboo of Fiulsility
ON 'I'llK INVOICE, SfATTEMF„N''I' OP WORK OR O'FIIF:R COW' W)CUMEN'I'A'1'ION "Nt:LI.L R "1 'IO UNDER NO C1R('11NIbf AN'C ES AND N'OM1 '111E FAILURE OF ESSI N'I'IAI, P0ftl OF
PROVIDE, PROMR.1' OR PF.RF(FRM OR PROCURE AN'S SERS'ICF J. (.IiFfO NIF;H .ICREY:S lO RE. ROVNO ANV REMEM SET FOR'UI IIERFIN• WILL SELLP;R, 1TS AFFILIATES OR I'T3 OR mEI Ii SI.PPLIERS,
R \,5NU.5(:(;EYI,c TIIESh.IE;RiM4• \N'U CONISI'rlb'NS 11- .NLk'�S Cllti'OIi\IF:K.SNO SF.I,I.N:H Ii AVE s3C \F,DA vLRCONI'HACTONS (/R AGEN'T'S II F: LIABLE 411 R: {.1) ANY INC,Il1 FN 1 �\I„ IN'I11R}: C'1', 3PF.CI:O..
ILIA V% IF A" F f.All:N 1" poll "IE PHfIV ISION' OF I'ROfIt:( "1' OR ITRFORMANCF OF SERVICES, LN' Pl1N173%E OR CONSVi F: FIAL DAMACI:. 1\ AXE)I,NC: lint NI FI LIMII FR) '111 LOSS OF PROFITS,
5V311(:11 CASE T'OI• SEP.ARA FE ACRFF,511:N I' Spa LL CONT,llN. IFUSINi SS. RVVr.' OR SAVINGS. E\'EN IF SE1.LA:It }L\S REEN ADVISED (A: t HE POSSI IIILI I'FF., OF
SUCII I1,WIAI Ins OH 7F gE"_II I)"IA(;" ARE O'1'11ENWISE FORESEEABLE. IN FACR ('ASE'„ H'Illf 11 1:R
Irulnrr1un11nfonn Rinse,56am'I'Ile unJ (:en'Itlixn. A C; LAI NI FOR ANN' I F LIAliI1,1'fl' IS 1'l IISF.II 111'(1:\ RREACIt OF C(1 N'1 HAC1', 5NI.N'IV.
l'hne )rim, a d tond so ,st'tma n b'nd rat u,mruel h,l„ee, Cuslo ner a d Stllrr n d me relei.ed to he e n as either 1'KCII( ENCE, S Rl[A LIAMA I 1 OR 0 I l l F i t '1111,1511\' OF LIABIJA VVI (ill A.NY' f I,AIMS. DEMANOS OR
'I'rrms and f td" s" or lli s ".lcrccros ,t'. C ,more, ac oep,s,hese I ran, ¢rd Co.d l s by making a puchase from or .5f'111I:NS All;'O NN1' CUS'I'UAI F:R RY ANY "'1111 Rt5 PA R'E'1'(I(:! ANY LOSS (5N CLO 51 ARISING OIcT OF OR
pia, ,gar, order ss,h Sell rror sN,pp ngn 4•Iler't Websie fthe'S'le "1 II rays reyuesing pnrJ n,(lhe"P,oduc,s "i or IN C(INN U:IION \5'1'111 (;US 'I ONE E R'S I n€ PLLM EN'FXI ION' OF ANY CONCLUSIONS OR
rnyay rig Sellers o rurfnmt or p—,ve on) S 5s(a This und¢11 capJnlrrd.arms ire domed h.sae'r) Hli('ONI At EN El IONS R1'SF'.I.I.FH OR I'I'S,% Fit ldAIES BASED() N. RFSII LIA NO VROSL A RiNI SC O I IT OF
OR 0 'I'f1ERlvISk; HEI.,S'3'IiD '1 0 'I'll K I'NOO1 J' OR SFRY1f,ES: OR (0) AA}' UN. \VAI LARILI'f5' OF T114
C ,.IUr ter n_ a puchase orals, fu arhnit s[rxl' p poses onK. Addto u, dilk—, co
le r and nmdinrns PROOkic: I'Fil FI INV. OR ANY LOS' 1', DA,51 A C 1•: U OR(:O R R Ir PI 111UTA 0 R S0F'1'WA R E. I,N' tI E: ES'f:N''1'
•uata nnEi such pnrchasc order ill 0r null and,u'd Phis Ag« ne, includ rig lln-ICr n u+nt +nedin [hr Perms and OF:5N1 "I.IARII.II}'INCI;RHF:O BY SELLER OR AN'1'UFI'!'S, \FF'11.1,YfE;S, ARE I�:N'1'IItF: I,L51i1L1'T5'OF
(onJ' lion,' Ilnl ul ww.v..J.: wm wl rch Co Co ukrl ,tinges nnd ag t entry ld he1. n h+ rcli once nmins SF; 1.1,. F;H ANO ITS ,S Fl. LI,vfLS FOR IYAN1AGEN FRCPSI ANY ("list' W'll: \T'S(lE VFR 55'11,1, NO-1 EXCEED [he entire Indrrstind r got Ih.I artier svirl esl' -ct to the —1— uou[a:nrd here„'u d s pt ,des and pf nits enhrclY FII F: LESSER UF:IAS'I'31E R(l 1, I.AR AN7r.1L'
a an "f YAlll !il' CUS'I'OMI:H FOR '1'llh: YNU IIU C "FCS} GIVI,NC RISE;
d all prior rommnninuion.and nwlrmponmcuns ugrn•n,ents a,,d unJersl;mJings, uhethcr mvl, arineu_elecnonic or 'f0'1'IIE CLAIM OR'I'HE SPECIVIC-MA5TC1,S GIVING RISE 10 I'll E,CLAINI; OR (11) S50,0110.011.
mplied, fany. between the parties ,11t1, respn -I to the subjnl ntaRCt b—of.
(1nfidernisl lnfn rm .,[inn
C;;.seruing Lw.e Each Pnn, anticipates shut ii nr be necessary to pro,EJ, paces, ro inf'nraurtion of n confidential nature of such pany, h,
'I'I ECSF_'ft li Nl,S
AND CONIIIIIOiNS. ANY S'I'A "li! #O:NTS UP WORK. I'I HE' SI:RVK FS ill- 1117.1 )NOER AND ANY Al orn Ill p,n (ill, „Fi rlerred to as"C- fidenlol ltlur nnli:ni Ill. the other pany,., Ih. perf..... n,c of lh,,
SMLI: OI' PRODUC'TS HERCUNI)1 R WILL, BE GOVERNIiD R5' I ilk' LAU'S Ill 'I'I I1,. S "I'rkI V OF ILLINOIS. Agree, en and ml., Slater A N,rsk. "Cunf[d snfal I,Fer nation" n trot nxdon nr data n oral 11"'In e ur
5p11'IEOUT" RI:Gr1RO 1'O CONFLI(:1S OIL LAWS RL'LLS AN AIMI'KA'110N', EM"1iRC.I_M FN "I OF_AIN w h t Em rose. t, n, g par k ar lm. -Sw,.4 knn' i, pmp6el y rnnfdc„tW and wh'r.h is dr,iL h.w
\RNIIRAI'IO.N OR I,I f1OA "PION MU, fit' RIMU6ll'f I: XCLUSI VELI' IN' COON COUNTY 11.1- LAOIS, AND pate ,at r t wish Ili, Ag,olo e or whfch [h, rcee ,ins ps n h+ ac—1 I r n cannon n with rh s Aeat i,,l.
C IISIO, \dI k LONSI; \1S 'CO I'IIF:JURI51J1 C'I'tO.� Uf '1111" F IXIRAI, ANO SI I COL�ftTS LO(',hT1:I> IFIFRPI N, ncluding hul not ,unite! to fh, s and sonJitis,ns „re h Stnlevnen ri W,,,k. C„ol d-6A 1, Mandan w'll nol Include
S L'13A1 f1S u Ills: JURISUl C3'I C] fllF.liffrF \NO 55'AIVLS ML RIC111' 'fit CHANGL VENUE ('I I(151fSK in R,nnn'or ,yh ch_ (a! br ,u knn,wr u 11 c pu6l'e them }I n wl M the rcee, ns
I UR1'I 141, C0N'SI.MS 'f(i TI11: 1 \LRCISF OP I'f.HSONAL iIj RISOIC'I'ION' nY ANY SU[ t�Ol:k'F WII11 pany. nr hero ,es k u. 1,, �c1l,-i y pun, li, t a 0,tol parry ha,� the righl o dtscl t,e I, c,d Inom" no obl m-, of
ItI:SPi:C' f'f \'Y Slil "I!I'ROCI:F; I)1 E,cept in 0, case 10- In nst oJe aaya aria ,st ng pulv
—fd- 1.111, oohed lEd, —1— n to the arypl .able f a„unnn or lcl is w&ro, Jeolly de k,p Jh
lion g rid of ihcse ferns a,d Cotolk ,s n c tear uric 11) tearnR,r the sr use of nhon ,r 'fhe righl, and Cmpk srha,n,I newes oflhc ro nog p r ly ,h, Ill— un t- s, t,, I n Ito 'I. the P, 6,nhle.
rune) e`er pea, dcd Seller i Idcr ri ere "Ic' t t'o.nl t'a,s •Ire cum, ilo +c arr „dd'tlon Io nnd do not I mn n, prejudice Cnptid 1 Ion on ,h< ld b<,I Hy id sr labeled as t dl di,closing pnn. the Inn, of disalus are ,r ns
y other right 0r renscdy uveilabil so Ia or in cyuitc. pram plR• [hrn•utln xs passible, h"e" ,failure io to idenlilj or L,1,0 such C lnr fde n liaE Inl'orn,aliun wiil not be e,'ide' c
shat such infarmat i,nl 'I, Il, cm Jldnni,Il or prco -whlc-
1'rtle; Ri,A ur I.nsv
If Cr r p« „-ides SdIll 111h 01 .,,her .vic— a w e
rat der than a arr r drat regularly F.& h pany agars to hold the uiher pnnv's C-Fid —frill Iona ,i�n cnwid —ml (or u period of sloe, years h,lluwing the
si,'ps I<,r s.11,•e, lak w I' duos an d ask tl Ic s- damage during +htpn e.. to front
Sellec to ('usrt,mrr i ntran del s s' dm, of d': I 1 w do s. i i w le .t s ian r d” n, u I olds its ow t Confdr tial C r uRnn ul like kind bra
the •r IF 0.13. Origin, f igl:t a,l lcat3. 1 -nr all „the, sh pnenl,. Idle In I'n'ducts and r sl of h'. d n c due to axe no less I .,able d,gr f 'a Ll sc rc of lbc 1 r p,', Co, fide., n1 Inf,,r ,h oo .,[B ben dticd f(o ,rig
a
,hip pus from S01cr to Cusomer open deii w the xp,65,j duslinarinn W.O.R. Do tinoliun. freight prepaid nnd n (hose individuals +vbo ore purliefpain& in h, patCrmnnca of Ile, Agr, meat ar rtes applirlbic Slt .i rat of Work and
addedi. Net +ichsan ding the for repine line to "'fissure ,rill r n, +s oh the apph,,bie hcensnrls), and i'ustomca's righs, cad Iv kr,s such Conftdenial Infhrn 6- for purpn..s ul'providing or rc.liv'Ir,a the Prmluch pr Su..n- or olh—ke in
a;o n
therein are c+r;lained is fie license ugrcemrm belwecn such Iinnsortzl ur,d Cu,rotate_ A purchase money security interest is nth this Agrc ...I nr the applicable Stalemen, ,f'WorF', or Ell) to ill husine.s. legal and Imanciat adv ,u each
ncd In the I'mducls to secure pay n n full. Customer uuthorins Seller 1., rile a an
fincing ,I ens rOlwing suc11 onfrdemin! hates. Ench pany u Sere, use not to :uiy C m
oniiden[ia1 Infornlion of lh an
the ocl py fur a In page usher
sc ulty ins e_t and, fnyxt:.ed. (t. +ner t s1 "h mcotd S[ h p rich,, t .0 it) i Isrel 1. i auks. ,hall the b, sines, 1, 1 es cometptaied by III s i,rcc of nod the nppikble Stu,tmem Work i p ,the wrt1e
ofa pany, theusher par, +g ill either alum or emrify the d,wlnrctkm, ofth, (:n fid,m, ul 1 n faro,hliun of t he other pan).
Pa)tn nl
OMa's are n„I b'nhe dutg [pro Seller i mfr aceepteJ by Seller Cu.lr n cs to pa, the tot, I porchn.e pr ,c Por the PrnJucts Ef n Frig p,,", ny is 7uirrd by la,v vle o-regulata,n. r rrsgr LueA in y judi I Ininihtren,e pr.t.rdngor b u
plus stet ppi,sg�oo t c,ICnl shipping is n prepaid by C'.us ark including alnpping charges Thal :r o Mild to S cllcr u ose
grnntontal or rigulunay —1h, ily, lo diselase Cnnf denial I,lfonnal ion .1 Oh, r„ Ilur party, Ihng pan gi
y 'ill st the
sull'fusing C carrier nccunot o or her. T-- rpaymentx within Seller'ssnle dk,r,rion. 1. ,d,,, wsdr dischningpany pr�mptnotice.1 l, request ao thin the di.closioe pay mu) seek nn npprop,• receivi
Hall pr-6,c order,similar
ticrviccs boinp performed pnrsulan to n Staremenl of \Sark, C�stor" iil 1'.. for the Services in 6, anwuuls and in p"'hNn'l msasun, anti Hill use ,cronn.hle eIrtor,, In ohl.ir, confidential. 1r ,tmont of liw Confidential Inl'ormatinn 50
a,dan kite a y pn)m schcJ ale net fool, in Ills applicable SOlement A Work. 11 no ryay m SehWldc is pmvideJ, disclosed,
C sE will pay for [Ill Sall— as in, owed by Seller. In, .1... xre due and Il nitltin Isle time period spaoi fled nn the
u-i I the Jule of in "oi", strhj,'lt u coniioaing credit apprc„rf by Sc11cr. Seller nr any of 'i I Alf o„ 11-non Vri,flrges
""I f at Scllu my 's. ,n( ar
e. SeElc gay sac e s narmcl, for panral sh p ,lc rs and Seller 1,, ohlnin Seller's p cr
nhcc Cusunn ;lolled canna ('O11 rr IScl lions 0 566.55 C, 4r'Mk o wil et
c Lnstome, for all of it, Services d,scr bed in a Smtnn eta M 55'u.1 n a,iy port o, ,hrnsf i. •.r ogre c iykrknrr 12c1m1y1PS ri d_� n. Gastonia must n,n[fy COW Ch,lo er R u1 :ln, d,,,aged Products +ash ten 1101
pa)� o all Rnsi -J�c se the I—, ,t' n•-
n o and uhnlF perc ent 1 L nth 5 °hl per el the highesl n 1ait,,"I hY
s days of recd pr.
luu_ lu rsem of a pa+•mcnt r cleFault. C:uston:er +,ill he responsible far ill of Sdo,", ends ofco*,lioa, I ,,ling, but not
looted rt ns(, fling fccs and "nR," es ties_ In addiliun, if payments nee nnl nuked a, des crihed ¢have_ Seller Arbitru don
r.sers rs
Ohl n}ifi ms uspe rid Scrvl,rs until puynlrnt kI-li, id. An, claim, dispute. 0 (,0 -her i ,Most rore.
ton o mherwI,, +het her prnr�isf ing. Prvseot nr fu mud
ncluding, but nol limited I. m any. --on law. mention .id wid cqukahle alalln s! aI n Cram o relutiuc w [11
k:slmn Sxles Produc[s, the Serltces, die iniealrrclal±an or applic:nion of Ih,s,: 'I'crtns and Crl,,diliorn or ¢ray Stoic man o f Work or the
If this Iransarlion iI :011.•. an 'I r an of items (including, hilt n n rim Red i<I aOn+nloditiati xftw,re nr Iechnologyl, su bjecl to hrexch. lenni ,lnlien o s �lidity Ihe,_Il the rrlalionships Insult from these 'Perms rd Conditions or n v SI—th rni of
the Ey,ao Ad '',memo I2cguly ons SlIch it—1, wcr exported Fon II c I, aired Stales by Sclicr it a, toed whh the U'ork Omdudinli. the fill p,nuitred by pp1i,,btc In+ ester nslnps with third port hl, as t
i;s pon Adn, ,'s ,anon R—lmions UVvc t n,. to t led Slntrs law s p olnbil,d. hen lr l or C.I krs or any of its Affil[a,c� odven'srr g or t kel ly En +3l.cf a ,li,, "1 WILL 131: RE.SU I U UPO\
flu' I'.I.ECI'I OIN pi ANl pF sFI,1.I;R. CUS'I'OMI:H UK '1'111: 7'I IIKO P,SR'll6S LN' \'OL1TD, KX(,,Usi VI:LY A \'1)
\5'n ere okras FINALLY BY BINDIN(: AIiREIRAIION. f arhitraliun is chosen, i[ will K co nductr'd purvu tart q, the Roll of the
Cus,nn,cr undcrsnnd: Item ticRc+ is not the manul'acturo of the Produns purchased by Cn.,to—1 h.•rennder and the ,ny American Arbimnion As u larion. If nHkh ti.sn is chosen b, ;my party P [;r a i'h hi neither Seller nor Cu,lnmcr
amiss ollircd arc Ibnse of the n nu0icinrcr, not Seller or 4, A1T,liatrs. In pn hlling IIIe E'roduns_ Cusrmner is relying w,P ha.e the right la litigate ohm (:lain, in coon orm In.-:a iur.- -trial on that Claim orto gnu, ge in ore- orbhml tun discovery,
at then n t,ctunr s spes'finn'u ,Iv gad not 1 -i ,y hie sp. 'Rcahons photographs o othn .cep as pas 'Jed fir n 14c nppfcahL a..'tral n dts or by aEreemem of the pa e.' vol Further, Ctninmer wait
ru ,s s n ail em,, r es
III .s(rylions rcpnsenting Ili, Pneluns Ihal mn} be p,o,•i &d by Scllcr ur its Aflilintes, sI:1.1.FR AND IIS AML1ATF,S not ha,e the right In I, turd..., n a r'rpre enlnike pr member or nay class of claimaa0 pexlainiii._ to nnv (,:,aim.
Iil.kl'I I' I;XPI2 -SSIY OISCL.UM ALL WARRA..V11FS EYNIVAR fXPW:5S OR INIPLII;O, RITA'IEU 'f0 Nols+iihs[nndia g ro,.h,iceoflu., pro,', ncludd n these Tartu.,nd C—ditons the arhitralion agree.. ell ins, bye., ao
I•H IOI ;CTS. I,N CI OI:SG, HUT NOT 11511 I1;0 TO. ANT WARRANTY (11' 'IY'ItiL ACCURACY- ,Ito. Federal Arb,n It on Al. Ill U.S.0 1 1 -16). l he orb uiioon fl eke plea clus rely m Clocaga III' x Am
CI C'llA \T;1 RI Li'I'1' OH h1IN111 I "OR A PAIi I'K pUHI'OSE WAKRAN I1 OF .,NON I N FR I NG SII_NF_ OR b „irlg ill risdic non may' enter 11dg ,l ent nn Ilse ,",rid rendered by the ur h'".1"o, t_ L 1, puny tr dill bear I,, own ens,
ANY WARRA1YlY KFLATING W 1111RD PARTS SERVIC:E!.S, I ItE DISCLAIMER CON'i AINF1) IN THIS of any le rrpr,;:c ids non ar ra,earch rcydred w <n npine :vbo ndiun 'dole rs dtr of mly arbrt.......
VOUCHER NO. WARRAN NO.
ALLOWED 20
CDW Government, Inc
IN SUM OF
75 Remittance Drive, Ste 1515
Chicago, IL 60675
$169.16
ON ACCOUNT OF APPROPRIATION FOR
Carmel Clay Communications
PO# l Dept. INVOICE NO. ACCT #!TITLE AMOUNT Board Members
1115 STD5073 42- 302.00 $169.16 1 hereby certify that the attached invoice(s), or
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
Friday, June 04, 2010
Director
Title
Cost distribution ledger classification if
claim paid motor 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 service rendered, by
whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc.
Payee
Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
05/26/10 I STD5073 I $169.16
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