155816 01/23/2008 CITY OF CARMEL, INDIANA VENDOR: 00353202 Page 1 of 1
ONE CIVIC SQUARE M/A COM INC CHECK AMOUNT: $20,000.00
CARMEL, INDIANA 46032 PO BOX 371536
PITTSBURG PA 15251 CHECK NUMBER: 155816
CHECK DATE: 1/23/2008
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1115 4351502 17498 90837021 20,000.00 EDACS FX AGREEMENT
t.
1*lease Rerrilt 70 I
Tyco Electronics MIA GOM
Po six 37���s
MIA -COM, Inc. Ptrisburllh 'PA F525t 75 3& l
1011 Pawtucket Boulevard Invoke
Lowell MA 01853
XX
REPEAT PRINTOUT
i3�iltrlt Address Account Ref 260 I>rafcarma�an
Carmel, City of Invoice Number 90837021
Carmel Clay Communications Center Invoice Date 01/09/2008
31 1st Avenue N.W. Purchase Order No. 17498
Carmel IN 46032 Purchase Order Date 01/09/2008
Sales Order Number 267463
$61pping :ACItIr4S5 A!cCOttnt I of 26067 Incoterms EXW Shippers Plant
Carmel, City of Payment Terms Net 30 Days
Carmel Clay Communications Center
31 1 st Avenue N.W.
Carmel IN 46032
RByer Address.: Accour►t Ref 260611 1 of 1
Carmel, City of For ali Invoice Issues, .Tease contact
Carmel Clay Communications Center WIN
31 1 st Avenue N.W. Telepone 7 €7 988 5206
Carmel IN 4 6032 SAX 507;
For' ali other sues
certaot your c€stomerl
SlrrtiiC@ repr�Sl~ntatlue
tn I e1~ ils
Currency
I #em Material Quantity Unit Price Amount
Description
0010 SSSV1C 1 EA 20,000.00 20,000.00
SERVICE,SW,ANNUAL,LVL 2 SGL SITE W /DISP per 1 EA
Subtotal 20,000.00
Tax Amount 0.00
Total Amount 20,000.00
he items above are sold for use in the U.S. only. Any export may require prior authorizatior by the U.S.
Gover ment. The purchaser solely is responsible for complyi g with all U.S. export licensing equirements.
A ttn: Janet Arnone (317) 571 -2586
illing Period: 1/01/08 12/31/08
A nnual renewal of Software FX agreement per Amendm nt dated 01/07/C8 and Purchas Order 17498
d ated 01/07/08.
oolzi
00156
C 0 f INDIANA RETAIL TAX EXEMPT PAGE
i ty Carmel CERTIFICATE NO. 003120155 002 0 �1 I' 1i PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 17458
35- 60000972
ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES, A/P
y CARMEL, INDIANA 46032 -2584 VOUCHER, DELIVERY MEMO, PACKING SLIPS,'
SHIPPING LABELS AND ANY CORRESPONDENCE.
FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL 1997
PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO, VENDOR NO. DESCRIPTION
117/2008
MIA -Com Carmel Clay Communications
SHIP 31 F i rst Av enue NW
VENDOR 221 Jefferson Ridge Parkway TO Carmel, IN 46032
Lynchburg, VA 24501 Phone: (317) 5'71 -2586
777 LVUNIT CONTRACT PAYMENT TERMS FREIGHT
OUANTITY 6 O RE F M EASU DESCRIPTION UNIT PRICE EXTENSION
Account 43-5 T 1 S;02
1 Each EDACS FX Agreement $20,000.00 $20,000.00
Sub Total: $20,OOO.00
44
A
Send Invoice To:
Carmel Clay Communications
31 First Avenue NW
Carmel, IN 46032
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT T PROJECT PROJECT ACCOUNT AMOUNT
Communications PAYMENT $20,000.00
A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O.
NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND
VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED.
SHIPPING INSTRUCTIONS I HEREBY CER�T IS AN UNOBLIGATED BALANCE IN
THIS APPROPRIAJION•SUFFICIENT TO PAY FOR THE ABOVE ORDER.
SHIP REPAID.f
C.O.D. SHIPMENTS CANNOT BE ACCEPTED. 'yf f.�.•r
PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY w
SHIPPING LABELS. O IL^ THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945 TITLE
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
CLERK TREASURER
DOCUMENT CONTROL NO 174 v. COPY SIGN AND RETURN TO CLERK'S OFFICE
VOUCHER NO. WARRANT NO.
ALLOWED 20
IN THE SUM OF
ON ACCOUNT.OF APPROPRIATION FOR
Board Members
PO# or INVOICE NO. ACCT /TITLE AMOUNT
,DEPT. 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
a
which charge is made were ordered and
received except
20
Signature
Title 4
Cost distribution ledger classification if
claim paid motor vehicle highway fund
VOUCI''ER'N'O. WARRANT NO.
ALLOWED 20
MIA -Com
IN SUM OF
221 Jefferson Ridge Parkway
Lynchburg, VA 24501
$20,000.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel Clay Communications
PO# Dept.# INVOICE NO. ACCT /TITLE AMOUNT Board Members
17498 90837021 43- 515.02 $20,000.00 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
Wednesday, January 16, 2008
Dir
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))
01/09/08 90837021 $20,000.00
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
Cleric- Treasurer