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188254 08/03/2010 CITY OF CARMEL, INDIANA VENDOR: 003000 Page 1 of 1 ONE CIVIC SQUARE BOYCE INC CHECK AMOUNT: $160.59 CARMEL, INDIANA 46032 P.O. Box 669 DALEVILLE IN 47334 -0669 CHECK NUMBER: 188254 CHECK DATE: 8/3/2010 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1115 4230000 0400639IN 160.59 OFFICIAL FORMS Paae 1 of 1 Boyce Forms Systems 800 -382 -8702 Invoice Boyce P.O. Box 669 317- 664 -7400 (Ph) Daleville, IN 47334 -0669 317 -664 -7401 (Fx) 0400639 -IN 7/27/2010 B S I CARMEL CLAY COMMUNICATIONS CTR H CARMEL CLAY COMMUNICATIONS CTR L 31 1STAVE NW I 31 1STAVE NW L CARMEL, tN 46032 P ATTN: JANET CARMEL, IN 46032 T T O O CUSTOMER ICUSTOMER P01 TERMS I SALES ORDER ORDER DATEI SALESMAN I SHIP VIA FOB 0765470 JANET Net 10 0078968 07/13/10 0007 UPS -COM ITEM DESCRIPTION UM I ORDERED I SHIPPED 1BACKORDERED1 UNIT PRICE 1EXTENDED PRICE FM352 -2 -BK BK 3.00 3.00 0.00 154.90 352 GEN RCPTS 2PT 3 -ON BK, WHITE /CANARY, #15400 15849 S1145 U3045 Net Invoice Less Discount Freight Sales Tax Invoice Total Less Deposit Invoice Balance 154.90 0.00 5.69 0.00 160.59 0.00 160.59 VO UCHER NO. WARRANT NO. ALLOWED 20 Boye,e Forms /Systems IN SUM OF P.O. Box 669 Daleville, IN 47334 $160.59 ON ACCOUNT OF APPROPRIATION FOR Carmel Clay Communications PO# Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Members 1115 0400639 -IN 42- 300.00 $160.59 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, July 30, 2010 4* 'O e 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)) 07/27/10 I 0400639 -IN I $160.59 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