190744 10/13/2010 CITY OF CARMEL, INDIANA VENDOR: 093000 Page 1 of 1
ONE CIVIC SQUARE FEDEX
CARMEL, INDIANA 46032 PO BOX 94515 CHECK AMOUNT: $21.99
PALATINE IL 60094 -4515
CHECK NUMBER: 190744
CHECK DATE: 10/13/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1160 4350900 7- 232 -92416 21.99 OTHER CONT SERVICES
F Invoice Number Invoice Da te Account Number Page
1 7-232-92416 Sep 22, 2010 4 of 4
FedEx Express Shipment Detail By Reference (Original)
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Fuel Surcharge Fehihas'appli'ad aiu'el's'urch'arge of this shipment- X:
Distance Based Pricing, Zone 4
Package age sent from: 30312 zip code
FedEx has audited this shipmentfor correct packages, weight, and service. Any changes made are reflected in the invoice amount,
We calculated your charges based on a dimensional weight of 13.01bs, 20"x 14'x9 divided by 194.
Automation USAB Sende Rec*pien
Tracking ID 872876676101 NANCY HECK NANCY HECK
Service Type FedEx Express Saver CITY OF CARMEL CITY OF CARMEL
Package Type Customer Packaging 1 civic SO ONE CIVIC SO
Zone 04 CARMEL IN 46032-2584 US CARMEL IN 46032 US
Packages 1
Actual Weight 5.0 lbs, 2.3 kgs
Rate 1911-1!
Delivered Sep 14, 2010 13:42
Svc Area A2 Transportation Charge 2055
Signed by E.BASS Fuel Surcharge 1.44 2=
FedEx Use 025310825100071711_ Total Charge Uso $21.99
NO REFERENCE INFORMATION Reference Subtotal USO $21.99
Total FedEx Express USD $21.99
5 049 0
1265-01-00-0034325-"1-0084681
FVXA-52� Invoice Number Invoice Da F
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FedEx Express Shipment Summary By Reference
Fed ExExpr Express Shipments pnjOr (Original
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No REFERENCE INFORMATION 1 13.0 20.55 1.44 21.99
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Total This Invoice USD $21.99
1265.01.00. 0034325 -000 0084681
Invoice Number Invoice Date
1of4
FedEx Tax 10: 71- 0427007
Billing Address: Shipping Address:
CITY OF CARMEUMAYOR'S OFC CITY OF CARMEL
JENNY CHASTAIN 1 CIVIC SQ
1 CIVIC SQ CARMEL IN 46032 -2584 Invoice Questions?
Contact FedEx Revenue Services
CARMEL IN 46032 -2584 Phone: (800) 622 -1147 M -Sa 7 -6 (CST)
Fax: (800) 548 -3020
Invoice Summary Sep 22, 209Q
Internet: www.fedex.com
FedEx Express Services FedEx Nevus!
Transportation Charges 20.55 Hold at FedEx Location is now available for FedEx
Special Handling Charges 1.44 Express® and FedEx Ground® shipments. Request the
Total Charges USD $21.99 service on fedex.com whenever you or your customers
TOTAL THIS INVOICE USD 21,99 want to pick up a package at a more convenient time
and place. FedEx Ground® shipments can be picked up
at more than 1,700 FedEx Office locations. With this free
Other discounts may apply. service, you can save money by avoiding
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For more information, go to fedex.com/holdit.
invoice Number Invoice Date Acc ®unt Number Pa 2e
7- 232 -92416 Sep 22 2010 2ofI
Adjustment Request
Fax to (800) 5 -30
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 www.fedex.com or calling
800.622.1147. Please use multiple forms for additional requests.
Please complete all fields in black ink.
I I I I I I Date
Re uestor I I I I I Name 1 1 1 1 1 1 1 I I I I I I 1 WW I W/ W
o: q 1 1.
Phone I I I I I I I I I I I I I Fax
E-mail Address
Address Yes, f wantto update account contact with the above information.
Tracking Number Bill to Account S Amount
J I I I I I I I I I I I i I I W
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11llIIII11111111 111111lIII llllll
I I I I 1 1 1 I I I I I I I I I I I I
I IIII111111111111 IlillllllI Illill
ADR Address Correction INW Incorrect Weight OVS Oversize Surcharge For all Service failures or other
u DVC Declared Value INS Incorrect Service RSU Residential Delivery surcharges please use our web
a IAN Invalid Acct# OCF Grd Pick -up Fee PNO Pwrshp Not Delivered site www.fedox.com or call
OCS Up Pick -up Fee SDR Saturday Delivery 18001 622 -1147
Rerate information only (round to nearest inch)
Tracking Number Code Amount LBS L W H
s I 1 1 I 1 1 1 1 f l l I I I I f I I I I I I I I I I I I I WWW WIWJ x WWI x L I I 41, I I I I I I L l l l l l l l l l l l l l i l l l l
I I I I 1 I II I I IX I I I l 1
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I I I I I I I I I I I I I I J I I I I I I I I I I I I WI I I I X I I x1 I I
I I I I I I I I I I I I I I I II-I I I f I I I I LWWI I I X I 11 1 X 1 I I I
VOUCHER NO. WARRANT NO.
ALLOWED 20
FedEx
IN SUM OF
PO Box 94515
Palatine, IL 60094 -4515
$21.99
ON ACCOUNT OF APPROPRIATION FOR
Mayor's Office
PO# Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Members
1160 7- 232 -92416 43- 509.00 $21.99 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, October 08, 2010
4 ayor
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))
09/22/10 7- 232 -92416 $21.99
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