192951 12/15/2010 CITY OF CARMEL, INDIANA VENDOR: 00352741 Page 1 of 1
d ONE CIVIC SQUARE XEROX CORP
CARMEL, INDIANA 46032 PO ROX 827181 CHECK AMOUNT: $152.13
PHILADELPHIA PA 19182 -7181
CHECK NUMBER: 192951
CHECK DATE: 12/15/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMB AMOUNT DESCRIPTION
209 4353004 051795353 152.13 COPIER
r te..
XEROX CORPORATION 3295 THE EASY WAY Xerox
TO ORDER SUPPLIES VE
PO BOX 660502 CALL OUR TOLL Purchase Order Number
DALLAS TX t -800 822 -2200
75266 -0501 Special Reference
VINOOOOOX -000
Contract Number
Q Telephone8$8 435 -6333 PAYABLE UPON RECEIPT
C Please Direct Inquiries To: 46. Terms Of Payment
Ship To /Installed At: Bill To:
L CITY OF CARMEL 12 -01 -10
Q) CITY LAW OFF. Invoice Date
ELAINE BASS 051795353
1 CIVIC SQUARE Invoice Number
CARMEL IN 976584507
V
46032 Customer Number
DC425AC DIGITAL COPIER SER.# EYC- 017353
AMOUNT
BASE CHARGE DECEMBER
152.13
METER CRU KIT SER.# CRU32METR INCL
DC432/40 CTCH TRAY SER.# DC32CT INCL
SUB TOTAL 152.13
v
TOTAL 152.13
C
ti
INVOICE FOR THE PERIODIC PAYMENT ON YOUR XEROX AGREEMENT
THIS AGREEMENT INCLUDES EQUIPMENT, MAINTENANCE AND SUPPLY CHARGES
XEROX FEDERAL IDENTIFICATION #16- 0468020
Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Farm No. 201 (Rev. 1995)
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
Xerox Corporation I n/ r
Purchase Order No. r� I `�(.l�
P. O. Box 827181
Terms
Philadelphia, PA 19182 -7181
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
12 -7 -10 051795353 DC425AC Digital Copier Ser. EYE 017353 $152.13
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
XPrnx C.arpnratinn IN SUM OF
P.O. Box 827181
Philadelphia, PA 19182 -7181
$152.13
ON ACCOUNT OF APPROPRIATION FOR
DEFERRAL FEE FUND 209
430 -53004 Copier
Board Members
PO# or INVOICE NO. ACCT #/TITLE AMOUNT
p I hereby certify that the attached invoice(s), or
21196 051795353 $152.13 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
7 20 /O
nature
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund