186492 06/09/2010 CITY OF CARMEL, INDIANA VENDOR: 00352664 Page 1 of 1
F' ONE CIVIC SQUARE RELYCO SALES INC
I: CHECK AMOUNT: $514.40
121 BROADWAY
CARMEL, INDIANA 46032
DOVER NH 03820 CHECK NUMBER: 186492
OM
CHECK DATE: 6/9/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1701 4230000 628218 514.40 LASER CHECKS
INVOICE
;TSWILYCO T 777 -7359 D
(603) 742
Invoice Number: 628218
F (603) 742 -9993 Invoice Date: 5/27/2010
E info @relyco.com Purchase Order#: C.Sheeks
www.relyco.com Terms: 1% 10 Net 30 Days
Bill To: 005081 Ship To: 005081
CITY OF CARMEL CLERK TREASURER CITY OF CARMEL CLERK TREASURER
One Civic Square One Civic Square
Camel IN 46032 -2584 Carmel IN 46032 -2584
Attention: Cindy Sheeks
Item Number Description
Qty Ordered Qty Shipped Qty To Whse Shipping Status Unit Price Extended
04517 BLUE LASER CHECK BOTTOM
i 10.00 M 10.00 M 0.00 M 10 -UPS2 5/25/2010 $45.00 $450.00
Your Relyco Account Representative is: Jennifer Corrado, jcorrado@relyco.com (603) 516 -3641
Please update your records to reflect our new remittance
address, 121 Broadway, Dover, NH 03820. Thank you.
Sub Total $450.00
Sales Tax $0.00
You may deduct $4.50 from this invoice Shipping Handling $64.40
if paid by check, not credit card on or before 6/06/2010
Invoice Total $514.40
V /SA rRI
il� S
Payable in US Funds
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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))
'I �CS
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
IN SUM OF
ON ACCOUNT OF APPROPRIATION FOR
N-
(DD DA
Board Members
Po# or INVOICE NO. ACCT# /TITLE AMOUNT
DEPT. I 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
�a
20
Signature
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund