187564 07/08/2010 CITY OF CARMEL, INDIANA VENDOR: 093000 Page 1 of 1
ONE CIVIC SQUARE FEDEX
CHECK AMOUNT: $208.45
PO BOX 94515
PALATINE IL 60094 -4515
CARMEL, INDIANA 46032
CHECK NUMBER: 187564
CHECK DATE: 7/8/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1160 4342100 7- 133 -06113 208.45 POSTAGE
F ecLK. Invoice Number Invoice Dote Account Number Page
7 =133 -06113 1 Jun 23 2010 1 of
FedEx Tax 10: 71- 0427007
Billing Address: Shopping Address:
CITY OF CARMEL/MAYOR'S OFC CITY OF CARMEL
JENNY CHASTAIN I CIVIC SQ Invoice Questions?
1 CIVIC SQ CARMEL IN 46032 -2584 Contact FedEx Revenue Services
CARMEL IN 46032 -2584 Phone: (800) 622 -1147 M -Sa 7 -6 (CST)
Fax: (800) 548 -3020
Invoice Summary Jun 23, 20'10 Internet: www.fedex.com
FedEx Express Services FedEx News!
Transportation Charges 1 B7.00 Better for you. Better for the environment. Choose
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Invoice Number Invoice Date Account Number Pag
7- 133 -06113 Jun 23 2010 2ota
Adjustment Request
Fax to D 548-3020
Use this form to fax requests for adjustments due to the reasons indicated below. Requests for adjustments
due to other reasons, including service failures, should be submitted by going to wwwJedox.com or calling
800.622.1147. Please use multiple forms for additional requests.
Please complete airfields in black ink.
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ADR Address Correction INW Incorrect Weight OVS Oversize Surcharge For all Service failures or other
DVC Declared Value IRIS Incorrect Service RSU Residential Delivery surcharges please use our web
IAN Invalid Acct OCF Gird Pick -up Fee PNO Pwrshp Not Delivered site wwwf.fedox.com or call
OCS Exp Pick -up Fee SDR Saturday Delivery 18001 622 -1147
Berate information only (round to nearest inch)
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4 of 4
FedEx Express Shipment Detail By Reference (Original)
At�py li tl>H 1111 t9i 10 t ilk »O PERENC 1 3
Fuel Surcharge FedEx has applied a fuel surcharge of 10.00% to this shipment.
Business Closed or Adult Recipient Unavailable Delivery Not Completed.
Distance Based Pricing, Zone 5
lst attempt Jun 15,2010at09:20AM.
Automation USAB f&nde Bficloin t
Tracking ID 870892512524 MICHELL KREMERY JIM BRAINARD
Service Type FedEx Priority Overnight CITY OF CARMEL CIO RENAISSANCE NY HOTEL
Package Type FedEx Box 1 CIVIC SO 130 EAST 5TJH ST
Zone 05 CARMEL IN 46032 -2584 US NEW YORK CITY NY 10022 US
Packages 1
Rated Weight 12.0lbs, 5.4 kgs
Declared Value USD 100.00
Detivared Jun 15, 201010:55 Transportation Charge 84.50_
Svc Area Al Fuel Surcharge 8.45
Signed by 6.GUTIERREZ Declared Value Charge 0.00
FedEx Use 016616686/0001552 Total Charge USD 59295
l4tf1:::::::::;.:::;::: ;iA 13fC tIFt1'QI.::..:.::.
Fuel Surcharge FedEx has applied a fuel surcharge of 10.00% to this shipment.
Distance Based Pricing, Zone 5
Package Delivered to Recipient Address -Release Authorized
Automation USAB Sfigd9i BSOJ@tttW
Tracking ID 870892512535 MICHELL KREMERY ROB DEROCKER
Service Type FedEx Priority Overnight CITY OF CARMEL DEVELOPMENT COUNSELL INTL
Package Type FedEx Box 1 CIVIC SO 3 WARNER LN
Zone 05 CARMEL IN 46032 -2584 US TARRYTOWN NY 10591 US
Packages 1
Rated Weight 17.0lbs, 7.7 kgs
Declared Value USD 100.00 Transportation Charge 102.50
Delivered Jun 15,2010 10:25 Residential Delivery 2.50
Svc Area A2 Fuel Surcharge 10.50
Signed by see above Declared Value Charge 0.00
FedEx Use 01661668OW1552/02 Total Charge USD $11350
NO REFERENCE INFORMATION Reference Subtotal USD $200.45
Total FedEx Express USD $205.45
1174 -01-0600 3 7 702.0 DD 1-009 3 76 U
recum. Invoice Number Invoice Da Account Number Page
7-138-06113 Jun 23, 2010 3 of 4
FedEx Express Shipment Summary By Reference
FedEx Express Shipments IOri ina11
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REFERENCE INFORMATION 2 29.6 187.00 21.45 208.45
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Total This Invoice USD $208.45
1174.01.00. 00377024 I- 0093750
VOUCHER NO WARRANT NO.
ALLOWED 20
Fed Ex
IN SUM OF
PO Box 94515
Palatine, IL 60094 -4515
$208.45
ON ACCOUNT OF APPROPRIATION FOR
Mayor's Office
PO# Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Members
1160 7- 133 -06113 43- 421.00 $208.45 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
Thursday, July 01, 2010
O
Mayor
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))
06/23/10 7- 133 -06113 $208.45
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