180066 12/08/2009 CITY OF CARMEL, INDIANA VENDOR: 093000 Page 1 of 1
ONE CIVIC SQUARE FEDEX
CARMEL, INDIANA 46032 PO BOX 94515 CHECK AMOUNT: $3.75
PALATINE IL 60094 -4515
CHECK NUMBER: 180066
CHECK DATE: 1216!2009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1180 4230200 9- 372 -27683 3.75 OFFICE SUPPLIES
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FedE v x. I Invoice Dumber Invoice Date
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FedEx TaxID: 71- 0427007
Billing Address: Shipping Address:
CITY OF CARMEL /MAYOR'S OFC CITY OF CARMEL
JENNY CHASTAIN 1 CIVIC Sa
1 CIVIC SG CARMEL IN 46032 -2584 Invoice Questions?
Contact FedEx Revenue Services
CARMEL IN 46032 -2584 Phone: (800) 622 -1147 M -Sa 7 -6 (CST)
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Fax: (800) 548 -3020
Invoice Summary Oct 21, 2009 Internet: www.fedex.com
FedEx Express Services FedEx News!
Transportation Charges 172.95 FedEx International Wine Shipping to Canada THE
Special Handling Charges 12.97 WORLD IS YOUR VINEYARD Now licensed entities can
Total Charges USD $185.92 ship wine to businesses and consumers in Canada, with
FedEx Other Charges the FedEx® international wine shipping program. FedEx
Merchandise Sales 3.50 has been handling the wine industry's
Sales Tax 0.25 business -to- business and business -to- consumer U.S.
Total Charges USD $3.7 delivery needs for nearly 20 years. Now, you can get
that same time definite service, reliability and expertise
TOTAL THIS INVOICE USD $189.67 for shipping wine directly to international consumers in
Alberta, British Columbia and Ontario, Canada. Visit
Other discounts may apply. fedex.com /wineshipping to learn more.
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F ed E m Invoice Number Invoice Date
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Adjustment Request
Fax to (800) 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 www.fedex.com or calling
800.622.1147. Please use multiple forms for additional requests.
Please complete all fields in black ink.
Re uestor Name 1 1 1 1 1 1 1 1 1 1 1 L I I! I I I I I I I I I I I I Date W W W
a Phone I! I I 1 1 I I I I I I I Fax I 11 1 1 1 1 1 1 1 __1 I
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E -mail Address Yes, I wantto update account contactwith the above information.
Tracking Number Bill to Account Amount
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ADR Address Correction INW Incorrect Weight OVS Oversize Surcharge For all Service failures or other
U DVC Declared Value INS Incorrect Service RSU Residential Delivery surcharges please use our web
a IAN Invalid Acct QCF Grd Pick -up Fee PND Pwrshp Not Delivered site www.fedex.com or call
OCS Exp Pick -up Fee SDR Saturday Delivery (8001622 -1147
Rerate information only (round to nearest inch)
Tracking Number Code Amount LBS L W H
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I J I i I f I I I! I I I I I 1 I I I I I I I I I W W--L -1 WJ—J x I 11 I x 11 I
F eda Invoice Number Invoice Date
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FedEx Express Shipment Detail By Reference (Original)
[huppedvf# ref ,2QQ £ttsi del 9 EFERE UMFtII�1t Tlf-N
P htpel. Ae;
Fuel Surcharge FedEx has applied a fuel surcharge of 1.50% to this shipment
Distance Based Pricing, Zone 6
Undeliverable Package.
Automation USAB Sender Recipient
Tracking ID 870099034219 DOUGLAS HANEY DOUGLAS HANEY
Service Type FedEx Standard Overnight CITY OF CARMEL HILTON MIAMI DOWNTOWN
Package Type Customer Packaging 1 CIVIC SO 1601 BISCYNE BLVD
Zone 06 CARMEL IN 46032 -2584 US MIAMI FL 33132 US
Packages 1
Rated Weight 44.0lbs, 20.0 kgs
Delivered Oct 15, 200915:55 Transportation Charger 172.95
'Svc Area A2 Fuel Surcharge 12.91
FedEx Use 02881429110001371 /14 Total Charge USD $185.9
NO REFERENCE INFORMATION Reference Subtotal USD 2
Total FedEx Express USD 92
FedEx Other Charges Detail
Ti asast�on�# gZ€t54A63A Transaf r¢ C3ota6er t, 200 Transacttvr� Typo AIEeransftse dales
.Purchaser: DOUGLAS HANEY Description Quanti Unit Price Total Charge
Purchase Location: Retail Box- 14xl4x14 1 3.50 3.50
530 E CARMEL DR Sales Tax 0.25
CARMEL, IN 46032 Total USD 3.75
Merchandise Sales Subtotal USD 3.75
Total Other Charges USD 3.75
d E g Invoice Number Invoice Date Account Number Page
9- 372 -27683 Oct 21, 2009 3 Of
FedEx Express Shipment Summary By Reference
FedEx Express Shipments (Original)
RnCel sp�i
Werght ;Trans urtattvn Hand Fm 1Ret ax
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Reference Shipments 1bs Cha rues, Ghargas r�drts /O ber 1t i$jr .a Total Cf;aroes:
NO REFERENCE INFORMATION 1 44.0 172.95 12.97 185.92
a�afedxpres. :Q:,.....::::$ $8532
FedEx Other Charges Summary
pfnber
Tray #fan f#ai#
telEns
urges Sale Tax ....l)�ecvunts sTotal
Merchandise Sales
10115 1 3.50 0.25 3.75
Merchandise Sales Subtotal $3.75
vtat:atfeerarges X1125 X375:
Total This Invoice USD $189.67
014209212
Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No. 261 (Rev. 1995)
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
FedEx
Purchase Order No.
P. O. Box 94515
Terms
Palatine, IL 60094 -4515
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
12 -7 -09 Mailing container per the attached Invoice No. 9- 372 -27683 $3.75
TOTAL: Total $3.75
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.
ALLOWED 20
IN SUM OF
P. O. Box 94515
Palatine, IL 6009 -451
$3.75
ON ACCOUNT OF APPROPRIATION FOR
Department of Law
420 -30200 Office Supplies
Board Members
Poo# or INVOICE NO. ACCT #/TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
1180 -372 -27683 3.75 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
✓1l�fT�� 20
ignature
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund