HomeMy WebLinkAbout197864 05/27/2011 CITY OF CARMEL, INDIANA VENDOR: 359662 Page 1 of 1
ONE CIVIC SQUARE A T T
=1 CHECK AMOUNT: $1,365.23
CARMEL, INDIANA 46032 Po aox eioo
'tirtvch'ie;:a AURORA IL 60507 -8100 CHECK NUMBER: 197864
CHECK DATE: 512712011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1091 4344000 317815176305 126.13 31781517630544
1125 4344000 317816030805 184.54 31781603081593
1110 4351501 317M26200705 491.92 317M2620073696
601 5023990 317RO6039405 562.64 317RO603945861
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MAY 2 3 2011
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CARMEL CLAY PARKS Account Number 317 815 -1763 054 4
1411 E 116TH ST Billing Date May 16, 2011
CARMEL, IN 46032 -3455 Web Site att.com
Invoice Number 317815176305
Apr 17, 2011 May 16, 2011
Bill -At -A- Glance Billing Summary
Previous Bill 126.07 Billing Questions? Visit att,com /billing
Payment Received 4 -27 -Thank Plans and Services 126,13
126.07 CR 1- 800 -480 -8088
You! Repair Service:
Adjustments 0.00 1- 800 727 -2273
Total of Current Charges 126.13
Balance 0.00
Local Services provided by AT &T Illinois,
Current Charges 126.13 AT &T Indiana, AT &T Michigan, AT &T Ohio
or AT &T Wisconsin based upon the
Total Amount Due $126.13 service address location.
2006 AT &T Knowledge Ventures. All rights
Amount Due in Full by Jun 6, 2011 reserved.
News You Can Use Summary
PREVENT DISCONNECT
CARRIER INFO
CALL BEFORE YOU DIG!
See "News You Can Use" for additional
information.
Plans and Services
Monthly Service May 16 thru Jun 15
Charges for 317 815 -1763
Monthly Charges 58,52
Charges for 317 815 -1874
Monthly Charges 58 52
Total Monthly Service 117.04
Surcharges and Other Fees
9 -1 -1 Emergency System
Billed for Hamilton County 4 00
Federal Universal Service Fee 3. 08
IN Universal Service Surcharge 42
IN Utility Receipt Surcharge 1.53
Telecommunications Relay Service 06
Total Surcharges and Other Fees 9
Total Plans and Services 126.
News You Can Use
PREVENT DISCONNECT.
Thank you for being a valued customer. It is important to inform you
that all charges must be paid each month to keep your account current
and prevent collection activities. In addition, please be aware that
https: /www.att.com/ view /viewFulIBill. doview ?reportActionEvent= A_VIEW_VFB 5/23/2011
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we are required to inform you of certain charges that MUST be paid in
order to prevent interruption of basic local service. These charges
are already included in the Total Amount Due and are $126.13.
If you don't agree with the amount due, you should dispute the portion
you disagree with before the payment due date.
CARRIER INFO.
Qwest Communications Corp,, or a company that resells their service,
is your long distance and local toll carrier.
CALL BEFORE YOU DIG!.
Always call 811 before you begin an excavation project so all utilities
can be identified and marked. Dig with care. Damages are avoided
when safe digging procedures are followed. CALL 811 BEFORE YOU DIG!
https: /www.att.com/ view /viewFullBill .doview ?reportActionEvent= A_VIEW VFB 5/23/2011
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice of 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.
359662 AT &T Terms
P.O. Box 8100 Date Due
Aurora, IL 60507 -8100
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
5/16111 317815176305 DTS Alarm West Conf room, MDF 126.13
31781517630544
Total 126.13
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
Voucher No Warrant No.
359662 AT &T Allowed 20
P.O. Box 8100
Aurora, IL 60507 -8100
In Sum of
126.13
ON ACCOUNT OF APPROPRIATION FOR
109 Monon Center
PO# or INVOICE NO. ACCT #!TITLE AMOUNT Board Members
Dept
1091 317815176305 4344000 126.13 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
23 -May 2011
Q mw"
Signature
126.13 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund
AT &T Page 1 of 5
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CARMEL CLAY Account Number 317 816 -0308 159 3
1411 E 116TH ST Billing Date May 16, 2011
CARMEL, IN 46032 -3455 Web Site att.com
Invoice Number 317816030805
Apr 17, 2011 May 16, 2011
Bill -At -A- Glance Billing Summary
Previous dill 177.45 Eilling�Questions? Visit
Payment Received 4 -27 Thank Plans and Services 163.68
177.45 CR 1- 800 -480 -8088
You! Repair Service:
Adjustments 0.00 1-800- 727 -2273
AT &T Long Distance 20.86
Balance 0.00 1- 800 480 -8088
Current Charges 184.54 Total of Current Charges 184.54
Local Services provided by AT &T Illinois,
Total Amount Due $184.54 AT &T Indiana, AT &T Michigan, AT &T Ohio
or AT &T Wisconsin based upon the
Amount Due in Full by Sun 6, 2011 service address location.
2006 AT &T Knowledge Ventures. All rights
reserved.
Amount if Paid After Jun 6, 2011 $186.85
News You Can Use Summary 0,? 1 1 t'
PREVENT DISCONNECT MAY CARRIER.INFO M Fa AY 3 2 01 1
CALL BEFORE YOU DIG!
See "Neves You Can Use" for additional
information. BY
AT &T Benefits
Total AT &T Savings 206.00
Plans and Services
Monthly Service May 16 thru Jun 15
Charges for 317 816 -0308
Monthly Charges 11.02
Sus Local Calling Unlimited B 30.00
Indiv Msg Business Hunting Ln
Unlimited Local Usage
Calling Name Display
Caller Identification
By choosing Bus Local Calling Unlimited B,
you are saving $51.50 over the cost of the same
services purchased separately.
Charges for 317 816 -0312
Monthly Charges 5.52
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AT &T Page 2 of 5
Bus Local Calling Unlimited B 30.00
Indiv Msg Business Hunting Ln
Unlimited Local Usage
Calling Name Display
Caller Identification
By choosing Bus Local Calling Unlimited B,
you are saving $51.50 over the cast of the same
services purchased separately.
Charges for 317 816 -0314
Monthly Charges 5.52
Bus Local Calling Unlimited B 30.00
Indiv Msg Business Hunting Ln
Unlimited Local Usage
Calling Name Display
Caller Identification
By choosing Bus Local Calling Unlimited B,
you are saving $51.50 over the cost of the same
services purchased separately.
Charges for 317 816 -0345
Monthly Charges 5.52
Bus Local Calling Unlimited B 30.00
Indiv Msg Business Hunting Ln
Unlimited Local Usage
Calling Name Display
Caller Identification
By choosing Bus Local Calling Unlimited B,
you are saving $51.50 over the cost of the same
services purchased separately.
Total Monthly Service 147.58
Local Calls
Call(s) Charged to 317 816 -0308
Unlimited Local Usage Plan Summary
216 Call(s) billed at no charge per call .00
Total Call(s) Charged to 317 816 -0308 .00
Call(s) Charged to 317 816 -0312
Unlimited Local Usage Plan Summary
117 Call(s) billed at no charge per call .00
Total Call(s) Charged to 317 816 -0312 .00
Call(s) Charged to 317 816 -0314
Unlimited Local Usage Plan Summary
111 Call(s) billed at no charge per call .00
Total Call(s) Charged to 317 816 -0314 .00
Total Local Calls .00
Surcharges and Other Fees
9 -1 -1 Emergency System
Billed for Hamilton County 8.00
Federal Universal Service Fee 6.16
IN Universal Service Surcharge .27
IN Utility receipt Surcharge 1.55
Telecommunications Relay Service .12
Total Surcharges and Other Fees 16.10
Total Plans and Services 163.68
AT &T Long Distance
Message Regarding Terms Conditions:
To view your Terms Conditions for AT &T Long
Distance, access www.att.coin /servicepublications
or call 1- 888 -225 -8530 to have a copy mailed.
Invoice Summary
(as of May 03, 2011)
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AT &T Page 3 of 5
Current Charges
Service Charges 10.00
Credits and Adjustments .00
Call Charges 8.77
Surcharges and Other Fees 2.09
Taxes .00
Total Invoice Summary 20.86
Service Charges
Monthly Service Charges
Type of Service Period Qty
2 -01. BUS BOT 200MIN II lY 05/02 -06/01 1 10.00
Total Monthly Service Charges 10.00
Total Service Charges 10.00
Call Charges Apr 2nd thru May 1st
Calls for 317- 816 -0308
Domestic
No. A Date Time Place Called Number Code Min Amount
2 -02 4 -04 1206P LEWISTON ID 208 305 -7739 D 4:39 .00
2 -03 4 -05 1102A WSEVENTH I OH 513 345 -6878 D 1:15 .00
2 -04 4 -05 1224P SAN ANGELO TX 325 223 -9300 D 11:08 .00
2 -05 4 -05 234P DAYTON OH 937 241 -7064 D 0:35 .00
2 -06 4 -05 238P DAYTON OH 937 241 -7064 D 3:46 .00
2 -07 4 -06 1040A WHEATLAND OK 405 745 -1586 D 0:40 .00
2 -08 4 -06 1142A MINNEAPOLS MN 612 414 -6161 D 0:45 .00
2 -09 4 -07 1219P SAN ANGELO TX 325 223 -9300 D 92:23 .00
2 -10 4-11 938A PLAINFIELD IN 317 272 -6728 D 0:30 .00
2 -11 4 -11 154P SAN ANGELO TX 325 223 -9300 D 16:42 .00
2 -12 4 -12 916A LIZTON IN 317 994 -5487 D 1:55 .00
2 -13 4 -13 805A FERGUSON MO 314 595 -0100 D 5:55 -00
2 -14 4 -13 1147A SOUTH BEND IN 574 344 -8076 D 8:11 .00
2 -15 4 -13 137P SOUTH BEND IN 574 229 -8780 D 9:02 .00
2 -16 4 -14 938A PLAINFIELD IN 317 839 -0520 D 3:03 .15
2 -17 4 -14 959A SAN ANGELO TX 325 223 -9300 D 8:20 .42
2 -18 4 -15 157P GREENFIELD IN 317 586 -3634 D 1:34 .08
2 -19 4 -19 1254P GREENFIELD IN 317 596 -3634 D 0:30 .03
2 -20 4 -25 934A FAIRLAND IN 317 835 -2445 D 1:22 .07
2 -21 4 -25 1125A NAPERVILLE IL 630 961 -4291 D 18:42 .94
2--22 4 -26 843A LIZTON IN 317 994 -5487 D 1:11 .06
2 -23 4 -28 502P NORTHRIDGE CA 818 428 -5436 D 1:00 .05
2 -24 4 -29 115P ENGLEWOOD CO 303 549 -9034 D 0:52 .04
Subtotal Domestic Calls for 317 -816 -0308 1.84
Total Domestic Calls for 317 -816 -0308 1.84
Total Calls for 317 816 -0308 1.84
Calls for 317- 816 -0312
Domestic
No. a Date Time Place Called Number Code Min Amount
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AT &T Page 4 of 5
2 -25 4 -04 1258P MINNEAPOLS MN 952 882 -4661 D 0:44 .00
2 -26 4 -05 540P WSEVENTH I OH 513 345 -6878 D 0:30 .00
2 -27 4 -07 1224? BLOOMINGTN IN 812 325 7993 D 0:30 .00
2 -28 4 -08 2162 AMARILLO TX 806 342 -1638 D 1:05 .00
2 -29 4 -11 900A WSEVENTH I OH 513 345 -6878 D 11:10 .00
2 -30 4--12 919A LIZTON IN 317 994 -5487 D 0:57 .00
2 -31 4 -13 1154A LAS VEGAS NV 702 321 -3999 D 0:44 .00
2 -32 4 -13 224P CHICAGO IL 312 641 -6759 D 28:56BP 29
2 -33 4 -18 1218P SOUTH BEND IN 574 344 -8076 D 2:06 .11
2 -34 4 -20 1251P SAN ANGELO TX 325 223 9300 0 61:49 3.09
2 -35 4 -20 450P MONTICELLO IN 574 870 -6532 D 2:43 .14
2 -36 4 -25 449P CICERO IN 317 376 -0829 D 1:07 .06
3 -01 4 -26 927A LAFAYETTE IN 765 490 -2077 D 0:40 .03
3 -02 4 -26 3402 SHELBYVL IN 317 512 -1195 D 1:03 .05
3 -03 4 -27 2142 SAN ANGELO TX 325 223 -9300 D 47:01 2.35
3 -04 4 -28 151P CINCINNATI OH 513 313 -3516 D 0:48 .04
BP Call continued beyond plan minutes
Subtotal Domestic Calls for 317- 816 -0312 6.16
Total Domestic Calls for 317- 816 -0312 6.16
Total Calls for 317 -816 -0312 6.16
Calls for 317- 816 -0314
Domestic
No. A Date Time Place Called Number Code Min Amount
3 -05 3 -31 503P CICERO IN 317 385 -0936 D 2:35 .13
3--06 4 -01 946A ANDERSON IN '765 621 -7107 D 5:28 .27
3 -07 4 -04 1250P WALKERTON IN 574 586 -3400 D 1:37 .00
3 -08 4 -11 928A KOKOMO IN 765 438 -0692 D 0:44 .00
3 -09 4 -12 253P CHICAGO IL 312 641 -6759 D 1:26 .00
3 -10 4 -19 1250P COVINGTON KY 859 982 -0579 D 0:46 .04
3 -11 4 -21 1212P PLAINFIELD IN 317 839 -0520 D 1:30 .08
3 -12 4 -22 1009A SAN ANGELO TX 325 223 -9300 D 0:57 .05
3 -13 4 -25 117P NAPERVILLE IL 630 961 -4291 D 1:19 .07
3 -14 4 -26 152P LIZTON IN 317 994 -5487 D 2:30 .13
Subtotal Domestic Calls for 317 -816 -0314 •77
Total Domestic Calls for 317 816 -0314 •77
Total Calls for 317 816 -0314 •77
Total Call Charges 8.77
Surcharges and Other Fees
3 -15. Fed Universal Service Fund 1.79
3 -16. Federal Regulatory Fee
3 -17. IN Universal Service Surcharge .02
3 -18. IN Utility Receipts Tax Recovery
Total Surcharges and Other Fees 2.09
Taxes
3 -19. Federal .00
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AT &T Page 5 of 5
3 -20. State .00
3 -21. Municipal .00
3 -22. Non Home State .00
Total Taxes .00
Total Invoice Charges 20.86
Key for Calling Codes:
A Anytime B Collect C Calling Card
D Day E Evening F Call Forwarding
H Third Number I Special Intrastate L Late Night
M Multiple Rate Period N Night/Weekend
O Operator Completed Dial Rates Apply P Person to Person
R Standard Overseas S Station to Station T Discount Overseas
X Conference Y Economy Overseas 3 Three Way
Total AT &T Long Distance 20.86
News You Can Use
PREVENT DISCONNECT.
Thank you for being a valued customer. It is important to inform you
that all charges must be paid each month to keep your account current
and prevent collection activities. In addition, please�be awvare that
we are required to inform you of certain charges that MUST be paid in
order to prevent interruption of basic local service. These charges
are already included in the Total Amount Due and are $117.52.
If you don't agree with the amount due, you should dispute the portion
you disagree with before the payment due date.
CARRIER INFO.
AT &T Long Distance, or a company that resells their service,
is your long distance and local toll carrier.
CALL BEFORE YOU DIG!.
Always call 811 before you begin an excavation project so all utilities
can be identified and marked. Dig with care. Damages are avoided
when safe digging procedures are followed. CALL 811 BEFORE YOU DIG!
https: /www.att.com/ view /viewFullBill. doview ?reportActionEvent= A_VIEW_VFB 5/23/2011
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice of 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.
359662 AT &T Terms
PO Box 8100 Date Due
Aurora, IL 60507 -8100
Invoice invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
5116111 317816030805 Adm. Office 184.54
Acct# 31781603081593
Total 184.54
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
Voucher No. Warrant No.
359662 AT &T Allowed 20
PO Box 8100
Aurora, IL 60507 -8100
In Sum of
184.54
ON ACCOUNT OF APPROPRIATION FOR
101 General Fund
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1125 317816030805 4344000 184.54 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
23 -May 2011
Signature
184.54 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund
CITY OF CARMEL Page I of 1
POLICE DEPT Account Number 317 M26 -2007 369 6
3 CWIC So Billing Date May 7, 2011
CARMEL, IN 46032 -7570
at &t web Site att.com
T Invoice Number 317M26200705
MOnthN Statem
Apr 8 May 7, 2011
Previous Bill 491.92 Itemized Charges an Credits
No Da te Descr iption___
Payment Received 4 -27 Thank You! 491.92CR Services for 012 635 -1289
CKT 12.HCFM.000572..SUV
Adjustments .00 CARMEL CLAY COMM C TR
311STAVNW
Balance .00 CARMEL, IN
01 -D CKTNCGS.659747..NB
Current Charges 491,92 1 05 -01 FR 1.536M ACCESS LINK .00
Service date: 05/01/11 05/31/11
Total Amount Due $491.92 2 05 -01 FR 1.536M PORT 491.92
Service date: 05/01111-05/31/11
Total for CKT 12.HCFM.000572..SUV 491.92
Amount Due in Full by May 31, 2011 Total Services for 012 035 -1289 491.92
Total Itemized Charges and Credits 491.92
Total AT &T Advanced Solutions 491.92
Biffing Questions? Visit att.com /billing
AT &T Advanced Solutions 491.92
1- 800 972 -7826 PREVENT DISCONNECT
Thank you for being a valued customer. It is important to inform you
Total of Current Charges 491.92 that all charges must be paid each month to keep your accomlt current
and prevent collection activities. In addition, please he aware that
we are required to inform you of certain charges that MUST be paid in
order to prevent interruption of basic local service. These charges
are already included in the Total Amount Due and are $.00.
If you don't agree with the amount due, you should dispute the portion
You disagree with before the payment due date.
CALL BEFORE YOU DIG!
Always call 811 before you begin an excavation project so all utilities
can be identified and marked. Dig with care. Damages are avoided
when safe digging procedures are followed. CALL 811 BEFORE YOU DIG!
PREVENT DISCONNECT CALL BEFORE YOU DIG!
See "News You Can Use" for additional information.
Local Services provided by AT &T Illinois, AT &T Indiana. AT &T Michigan,
AT &T Ohio or AT &T Wisconsin based upon the service address location.
Primed on ReaYClable Paper
Return bottom portion with your check in the enclosed envelope. GO GREEN Enroll in paperless billing.
b."1.- .�lAlll
VOUCHER NO. WARRANT NO.
ALLOWED 20
AT &T
IN SUM OF
P.O. Box 8100
Aurora„ IL 60507 -8100
$491.92
ON ACCOUNT OF APPROPRIATION FOR
Carmel Police Department
PO# Dept. INVOICE NO. ACCT #!TITLE AMOUNT
Board Members
1110 317M26200705 43- 515_01 $491.92 I 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, May 19, 2011
Chief of Police
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
hrescrihed by State Board of Accounts City Form No. 20 (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))
05/07/11 317M26200705 monthly payment $491.92
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
CITY OF CARMEL Page 1 of 1
3450 W 131 ST ST Account Number 317 R06 -0394 586 1
CARMEL, IN 46074 -8261 Billing Date May 1, 2011
s
Web Site att.com
(3t&t Invoice dumber 317RO6039405
Monthly Statement
Apr 2 -May 1, 2011
Previous Bill 562.64 Monthl Service Ma 1 tbru Ma 31
Monthly Charges 525.30
Payment Received 4 -27 Thank You! 562.64CR
Surchar and Other Fees
Adjustments .00 9 -1 -1 Emergency Syatein
Billed for Hamilton County 2.00
Balance .00 Federal Universal Service Fee 10.01
FCC Compiex Line Port f=ederal Charge 15.53
Current Charges 562.64 IN Universal Service Surcharge 1.99
IN Utility Receipt Surcharge 7.12
Total Amount Due $562.64 Telecommunications Relay Service .69
Total Surcharges and Other Fees 37.34
Amount Due in Full,by May 23, 2011 Total Plans and Services 562.64
PREVENT DISCONNECT
Billing Questions? Visit att.com /billing
Thank you for being a valued customer. It is important to inform you
Plans and Services 562.64 that all charges must he pair) each month to keep your account current
1- 800 480 -8088 and prevent collection activities. In addition, please be aware that
Repair Service: we are required to inform you of certain charges that MUST he paid in
1 -800 -727 -2273 order to prevent interruption of basic local service. These charges
are already included in the Total Amount Due and are $562.64.
Total of Current Charges 562.64 It you don't agree with the amount due, you should dispute the portion
you disagree with before the payment due date.
CALL BEFORE YOU DIG!
Always call 811 before you begin an excavation project so all utilities
can be identified and marked. Dig with care. Damages are avoided
t when safe digging procedures are followed. CALL 811 BEFORE YOU BIG!
PREVENT DISCONNECT CALL BEFORE YOU DIG!
See "News You Can Use" for additional information.
Local Services provided by AT &T Illinois, AT &T Indiana, AT &T Michigan,
AT &T Ohio or AT &T Wisconsin based upon the service address location.
Printed on Recyclable Paper
Return bottom portion with your check in the enclosed envelope. GO GREEN Enroll in paperless billing. �N
VOUCHER 111111 WARRANT ALLOWED
359662 IN SUM OF
AT T 8100
PO BOX 8100 WATER
pPERAnONS
AURORA, IL 60507
Carmel Water Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
317R060394@ 01- 6360 -06 $562.64
Voucher Total $562.64
Cost distribution ledger classification if
claim paid under 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 of service rendered, by whom, rates per day, number of units,
price per unit, etc.
Payee
359662
AT T 8100 Purchase Order No.
PO BOX 8100 Terms
AURORA, IL 60507 Due Date 5/10/2011
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
5/10/2011 3178060394: $562.64
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
Date Officer