192807 12/15/2010 CITY OF CARMEL, INDIANA VENDOR: 093000 Page 1 of 1
ONE CIVIC SQUARE FEDEX CHECK AMOUNT: $10.00
CARMEL, INDIANA 46032 PO BOX 94515
PALATINE IL 60094 -4515 CHECK NUMBER: 192807
CHECK DATE: 12115/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
911 4342100 7- 257 -04398 10.00 POSTAGE
4
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Invoice Number Invoice Date
1 of
PAST DUE FedEx Tax ID: 71- 0427007
Silting Address: Shipping Address:
CARMEL POLICE DEPT HCDTF CARMEL POLICE DEPT HCDTF
3 CIVIC SO. 3 CIVIC SU Invoice Questions?
CARMEL IN 46032 -2584 CARMEL IN 46032 -2584 Contact FedEx Revenue Services
Phone: (800) 622 -1147 M -Sa 7 -6 (CST)
Fax: (800) 548 -3020
Invoice Summary Oct 13, 2010
Internet: www.fedex.com
FedEx Express Services
Transportation Charges 85.20
Special Handling Charges 12.92
Credits /Payments -88.12
Total Charges USD $10.00
TOTAL THIS INVOICE USD $10.00
The amount due shown on the remittance advice reflects the invoice
balance due and includes only those items still outstanding. Any
payment which could be applied to a specific shipment has been
credited to the appropriate activity summary enclosed. Payments and/or
adjustments that could not be applied to a specific shipment have been
credited against the total amount due on this invoice.
Other discounts may apply.
Your Account is Past Due. Date of Notice: Dec 01, 2010. To prevent
further action, please remit your payment immediately. If payment has
been made, please disregard this notice.
Invoice Number Invoice Date
2 of 4
Adjustment Request
Fax to 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 vuwwJedex.com or calling
800.522.1147. Please use multiple forms for additional requests.
Please complete all fields in black ink.
Re uestor Date
Name 1 1 1 1 1 1 I I I I I I I I I I I I I I I I I
q 1 1
Phone I I I I L1JJ WWWW Fax# I I I I LWWW I L l I J
<J E mail Address Yes, I want to update aecount contactwith The abase intormauon.
Tracking Number Bill to Account Amount
I I! I I I I I I I I I I I 1 J I I I I I I I I I I I I I 1 I I I I I
I I I I I I l l j l l I i I I I I l I I
.I I I I I I I I I I I I! I I 1 I W
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III111.1111111111 IIIIIIIIII IIIIII
ADR Address Correction INW Incorrect Weight OVS Oversize Surcharge For all Service failures or other
a DVC Declared Value INS Incorrect Service RSU Residential Delivery surcharges please use our web
IAN Invalid Acct OCF Grd Pick -up Fee PNO Pwrshp "at Delivered site wwwr.fedox.com or call
OCS Exp Pick -up Fee SDR Saturday Delivery (800) 622-1147
Re rate information only (round to nearest inch)
C- Tracking Number Code Amount LBS L W H
I I 1 I I I LT I I I I I I I I I I I I I I I I 1 I I I I I1 -1 JX1 I IX1 I I
I I I I I I I I I I I I I I I I! 1 1 1 1 1 1 1 IWW� LWWI X X I WJ
X I I I! X I I I I
I I I I I I I I I I I I I I Il i t 1 1 I I I Xi I I
I I I L 1 1 1! 1 1 1 I I IW� 1 WJ X I I I I X I I I
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
Fed Ex Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
10/13/1 7--257 -04398 Balance Due on shipping charges 10.00
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
FedEx IN SUM OF
P.O. Box 94515
Palatine, IL 60094 -4515
10.00
ON ACCOUNT OF APPROPRIATION FOR
Project 2010 -911 Task 2010 -2
Board Members
Po# or INVOICE NO. ACCT #!TITLE AMOUNT
DEPT. I hereby certify that the attached invoices or
911 7- 257 -043 421 -00 10.00 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
12 8 2010
Major Signature
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund