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166034 11/13/2008 CITY OF CARMEL, INDIANA VENDOR: 357004 Page 1 of 1 ONE CIVIC SQUARE KONICA MINOLTA BUSINESS SOLUTIONS CHECK AMOUNT: $192.39 !a CARMEL, INDIANA 46032 13847 COLLECTIONS cElvreR oRlve CHICAGO IL 60693 CHECK NUMBER: 166034 CHECK DATE: 11/13/2008 D EPARTMENT ACCOUNT P O NUM INV NUMBE AMOU DESCRIPTION 1201 4- 351501 18234 211196393 192.39 SERVICE AGREEMENT h lnvolce Number: 211196393 please Remit To: 23 KONICA MINOLTA BUS SOLUTIONS Invoice Date: 10/31/2008 USA INC Page I of 1 KONICA MINOLTA DEPT. CH 19188 PALATINE, IL 60055 -9188 `Subject to E.O. 112478 and the regulations of the Secretary or Labor on Affirnwtive For Billing Inquiries Call: 317- 870 -7000 Action and Equal ur0- INVOICE CORPORATE DUNS NS No. No. 0 00.170.7322 FEDERAL DUNS No. 62- 657 -8041 Bill To: Ship To: CITY OF CARMEL CITY OF CARMEL I CIVIC SQ ATTN HR CARMEL IN 46032 1 CIVIC SQ CARMEL IN 46032 Purchase Order Nbr Delivery Nbr Sales Order Nbr Date Account Nbr Shelly Lingeibaugh 44307055 01/07/2008 148154 148154 Cartons Tot Weight Carrier Shipping Point Terms of Payment Comments 32.000 NET 30 DAYS Quantity Quantity Quantity Ordered Back Ordered .Material Nbr Description Shipped Unit Net Price Amount 7670932802 Per Copy Charge -B &W 192.39 Copies Overage Charge C353 A02EO 10001347 10/31/2008 76,402 09/30/2008 58,912 Usage 17,490 Tot Usage 17,490 Allowance 0 Overage 17,490 0.01100 TOTAL NBR OF UNITS TOTAL AMT 192.39 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 Konica Minolta Business Solutions Purchase Order No. Terms Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) W31 /08 2111963913 Per Copy Charge-BOV Overage Charge $192.39 Total l 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 N( rtt W VARRANT NO. ut ALLOWED 20 Elonica Minolta Business Solutions IN SUM OF 13847 Collections Center Drive Ghicago, 1L 60693 $192.3 ON ACCOUNT OF APPROPRIATION FOR GENERAL FUND 1201 Human Resources Board Members or INVOICE NO. ACCT #/TITLE AMOUNT DEPT, I hereb y Y certif that the attached invoice(s), or 18234 bill(s) is (are) true and correct and that the partial 211196393 515 -01 39 materials or services itemized thereon for which charge is made were ordered and received except 20 Sign re Title Cost distribution ledger classification if claim paid motor vehicle highway fund