162000 07/23/2008 CITY OF CARMEL, INDIANA VENDOR: 00350363 Page 1 of 1
ONE CIVIC SQUARE PETTY CASH
CHECK AMOUNT: $20.70
CARMEL, INDIANA 46032 C/O MAYOR'S OFFICE
C/O MAYOR'S OFFICE CHECK NUMBER: 162000
CHECK DATE: 7/23/2008
DEPART A CCOUNT PO N UMBE R INVOICE NUMBER AMOUNT DESCRIPTION
1160 4355100 20.70 PROMOTIONAL FUNDS
i
L: United States Postal Service®
I I C P 8 91, 9 8 8 5 4 5 U S Customs Declaration and Dispatch Note CP 72
IMPORTANT: This item/parcel may be opened officially. Please print in Englis%i and press firmly; you are
making multiple copies. See Privacy Notice and Instructions on the back of Page 6, Sender's Copy.
Sender's Name Senders Customs Insured Amount
Business Reference (If any)
G Street t/ i' Insured Fees (U.S. SDR Value
L-.
U.
3 Z.
city ii f E State IJO r i'J rl. ZIP +4®
Country
Addressee's Name r Importer's Reference Optional (If any)
t r t
Business l p, t (Tax code/VAT no. /Importer code)
Street
Importer's Telephone /Fax/E -mail (If known)
Postcode #f) city a1" StatelProvince C'
Country 1 1
Detailed Description of Contents (1) Qty. (2) Net Weight (3) Value (U.S. (5) For Commercial Senders Only
lbs. oz. HS Tariff Number (7) Country of Origin of Goods (8)
Check One (10) Total Gross Wt. (4) Total Value U.S. (6) Total Postage and Fees
0 /Priority Surface/Nonpriority
1 Y
Check One (11) Gift Commercial Sample Merchandise Explanation: Sender's Instructions in Case of Nondelivery Mailing Office Date Stamp
(17) Treat as Abandoned
Documents Returned Goods Other Return to Sender
Comments (12) (e.g., goods subject to quarantine, sanitary/phytosanitary inspection, or other restrictions) NOTE: Item is subject to return
charges at sender's expense.
License Number(s) (13) Certificate Number(s) (14) Invoice Number (15) ❑Redirect to Address Below:
I certify that the particulars given in this Date and Senders Signature (16)
customs declaration are correct and that
this item does not contain any dangerous
article prohibited by legislation or by
po stal or customs regulations. -<i' "f 1..�� "Z�•'
PS Form 2976 -A, October 2007 PSN: 7530-01-000-9834 Do not duplicate this form without USPS ®approval. 6 Sender's Copy
P PP
IMPORTANT: Save this receipt and present it when making an inquiry. Your tracking number appears under the barcode on the front of this form.
INSTRUCTIONS: Complete this form in English. You may add a translation of the contents in a language accepted in the destination county.
Complete in ink and press firmly so all information transfers to all copies.
Complete the declaration fully and legibly; otherwise, delay and inconvenience may result for the addressee. A false or misleading declaration may lead to a fine or to'seizure of.
the item.
Your goods may be subject to restrictions. It is your responsibility to inquire into import and export regulations, restrictions such as quarantine, pharmaceutical restrictions, etc.,
and to find out what documents, (commercial invoice, certificate of origin, health certificate, license, authorization for goods subject to quarantine such as plant, animal, or food
products, etc.), if any are required in the destination country.
1. Enter a detailed description of each article e.g., "men's cotton shirts." General descriptions e.g., "samples, food products" or "toiletries" are not permitted.
2. Enter the quantity of each article and the unit of measurement used.
3 4. In 3, enter the net weight of each article in pounds and ounces. In 4, enter the total weight of the package in pounds and ounces, including packaging, which
corresponds to the weight used to calculate the postage.
5 6. In 5, enter the value for each article. In 6, enter the total in U.S. dollars.
7 8. For commercial senders only: "Commercial item" means any good exported /imported in the course of a business transaction, whether or not it is sold for money Qr
exchanged. In 7, enter the 6 -digit HS tariff number (if known), which must be based on the Harmonized Commodity Description and Coding System developed by the
World Customs Organization. In 8, "Country of Origin (if known)" means the country where the good originated e.g., where produced /manufactured or assembled.
Senders of commercial items are advised to supply this information as it will assist Customs in processing the items.
9. Postal ServiceT clerk will enter the total amount of postage and fees.
10. Select mail handling method.
11. Check the box specifying the category of the item.
12. Provide details if the contents are subject to quarantine (plant, animal, food products, etc.) or other restrictions.
13, 14, 15. If your item is accompanied by a license or a certificate, enter the number. You should enclose an invoice for all commercial items.
16. Sign and date the form. Your signature and date confirm your liability for the item being mailed.
17. Check the box specifying instruction in case of nondelivery. Items returned to sender are subject to return charges at the sender's expense.
Insert the completed form into PS Form 2976 -E, Customs Declaration Envelope #CP 91. Enclose any commercial documents into the envelope. Do not fold form set or wrap
around the package. The entire barcode and all information must be visible. Remove the backing sheet and affix the envelope to the package on the address side.
PARCEL INDEMNITY COVERAGE: Indemnity for parcels is provided only in accordance with postal regulations in the Domestic Mail Manual (DMM and the International Mail
Manual (IMM Indemnity coverage is subject to both U.S. Postal Service@ regulations and the domestic regulations of the destination country. Indemnity coverage may be included
at no additional charge for uninsured parcel post and International Express Mail. Additional insurance is available to select countries. Indemnity for loss, damage, or missing contents
is limited to the lesser of the actual (depreciated) value of the contents, repair costs, the included indemnity, or the amount of insurance purchased. Claims for damage and missing
contents may be payable only to the addressee.
FILING CLAIMS: To initiate an inquiry for loss, damage or missing contents, call 800 222 -1811. International indemnity inquiries and claims for loss must be filed within the time limits
for the service purchased. All claims for damage or missing contents must be filed immediately and the article, container, packaging, and all contents received must be presented at
the destination Post Office"'. The original mailing receipt must be presented. Evidence of value, such as a sales receipt or repair estimate, must be submitted in support of all claims.
See IMM 920 and individual country listings in the IMM for complete regulations.
EXCEPTIONS: No coverage is provided for consequential losses, delay, concealed damage, spoilage of perishable items, articles improperly packaged, articles too fragile to
withstand normal handling in the mails, or prohibited articles. See the DMM and the IMM for the specific types of losses that are covered, the limitations on coverage, and conditions
of payment.
Important: Indemnity coverage is not paid for Express Mail International or uninsured parcel post items containing coins; banknotes; currency notes (including paper money);
securities of any kind payable to the bearer; traveler's checks; platinum, gold, silver (manufactured or not); precious stones; jewelry, including watches; and other valuable articles.
See the IMM for complete regulations.
Privacy Act Statement: Your information will be used to satisfy reporting requirements for customs purposes. Collection is authorized by 39 U.S.C. 401, 403, and 404. Providing the
information is voluntary, but if not provided, we may not process your transaction. We do not disclose your information to third parties without your consent, except to facilitate the
transaction, to act on your behalf or request, or as legally required. This includes the following limited circumstances: to a congressional office on your behalf; to financial entities
regarding financial transaction issues; to a USPS auditor; to entities, including law enforcement, as required by law or in legal proceedings; to contractors and other entities aiding us
to fulfill the service (service providers); and to domestic and international customs pursuant to federal law and agreements.
PS Form 2976-A, October 2007 PSN: 7530 -01- 000 -9834 Do not duplicate this form without USPS approval. Senders Copy (Reverse)
CAS
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CkRMEL RET9IL 3d
CARMEL, Indiana
400329898
1740350814-0095
�l/lO/2OOO (800)275-8777 01:25:42 PM
Co\as Receipt
Product 3dlB Un i1 Final
DesCrip[\on Qty Price Price
APO AE 09355 Zone-5 $10.55
Priority Mail
3 lb. 0.50 oz.
Delivery COnfir0d11OO Q0.65
Label 03070020000249001695
Customs Form CP8919883 5
ISOU8 PVI: 20
Total:
Paid by:
Cash $20.00
Change Due: -$8.80
Order 8td0p8 at USPS.CON/ShOp Or
Call 1-800-3td0p24. Go to
USPS.CO0/C\iCkD8h1p to print
s^�oping labels with postage. For
/''er 1OfO[0dtiOD call
/-300-ASK-U3PG.
B1ll#:1000500732083
Cl8rk:00 Y3
All sales final on stamps and pO3tdgB.
Refunds for guaranteed G8rYiC8S only.
Thank you for your business.
HELP U3 SERVE YOU BETTER
GO to: http://gX.gdllUp.CO0/pOO
TELL US ABOUT YOUR RECENT
POSTAL EXPERIENCE
YOUR OPINION COUNTS
CUOtON8r Copy
Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No. 207 (Rev. 1995)
7/21/08 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
Petty Cash Mayor Purchase Order No.
One Civic Square Terms
Carmel IN 46032 Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
7/16/08 Recei t Posta e $11.20
Total $11.20
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.
7/21/08
ALLOWED 20
'Petty Cash Mayors IN SUM OF
One Civic Square
Carmel IN 46032
11.20
ON ACCOUNT OF APPROPRIATION FOR
1160 Mayors 4355100
Promotional Funds
Board Members
Po# or INVOICE NO. ACCT #!TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
Receipt 4355100 $11.20 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
20
'1 Si ature
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund
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THANK li /l\ i'JV
HAVE A NME DAY
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Prescriber by State Board of Accounts City Form No. 201 (Rev. 1995)
ACCOUNTS PAYABLE VOUCHER
7/21/08 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
Petty Cash Mayor's Office Purchase Order No.
One Civic Square Terms.
Carmel IN 46032 Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
7/15/08 Recei t Melanie Lentz parking to attend IT class $4.00
Total $4.00
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
Clerk- Treasurer
VOUCHER NO. WARRANT NO.
7 17 1 1 8 ALLOWED 20
Petty Cash Mayor's Office IN SUM OF
One Civic Square
Carmel IN 46032
4.00
ON ACCOUNT OF APPROPRIATION FOR
1160 Mayors 4355100
Promotional Funds
Board Members
PO# or INVOICE NO. ACCT #!TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
Receip 4355100 $4.00 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
20
J� ignature
VJv �1�
Cost distribution ledger classification if
Title
claim paid motor vehicle highway fund
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Prescribed by State Board of Accounts City Form No. 201 (Rev. 1995)
ACCOUNTS PAYABLE VOUCHER
7/21/00 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
Petty Cash Mayor Purchase Order No.
One Civic Square Terms
Carmel IN 46032 Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
7/8/08 Recei t Parkin Nancy Heck for IUPUI computer class $5.50
Total $5.50
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.
7/21/08
ALLOWED 20
Petty Cash Mayors IN SUM OF
One Civic Square
Carmel IN 46032
5.50
ON ACCOUNT OF APPROPRIATION FOR
1160 Mayors 4355100
Promotional Fund
Board Members
Po# or INVOICE NO. ACCT #/TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
Recpipt 4155100 .$5,50 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
20
Si gnature
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund