179654 11/24/2009 CITY OF CARMEL, INDIANA VENDOR: 093000 Page 1 of 1
ONE CIVIC SQUARE FEDEX
CARMEL, INDIANA 46032 PO BOX 94515 CHECK AMOUNT: $9.56
PALATINE IL 60094 -4515 CHECK NUMBER: 179654
CHECK DATE: 11/2412009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMB AMOU DESCRIPTION
1202 4342100 938780084 9.56 POSTAGE
F ed Ex. I Invoice Number Invoice Date
1 of
FedEx Tax ID: 71- 0427007
Billing Address: Shipper Address:
CITY OF CARMEL/MAYOR'S OFC CITY OF CARMEL
JENNY CHASTAIN 1 CIVIC SG Invoice Questions?
1 CIVIC SO. CARMEL IN 46032 -2584 Contact FedEx Revenue Services
CARMEL IN 46032 -2584 Phone: (800) 622 -1147 M -Sa 7 -6 (CST)
Fax: (800) 548 -3020
Invoice Summary Nov 04, 2009 Internet: www,fedex.com
FedEx Ground Services
Transportation Charges 4.82
Other Handling Charges 17.74
Total Charges US0 $22.56
TOTAL THIS INVOICE USD
Other discounts may apply.
wp Invoice Number Invoice Date
2 of 4
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.
J' Re uestor Name I I I I I I I I I I I I I I I I I I I I I I I I I I I I Date W W W
a> Phone I l l l WWW V I I I Fax
E -mail Address W Yes, I wanito update account contact with the above information.
Tracking Number Bill to Account Amount
e 1111111111111111 IIIIIIIIII IIIIII
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C
ADR Address Correction INW Incorrect Weight OVS Oversize Surcharge For all Service failures or other
o DVC Declared Value INS Incorrect Service RSU Residential Delivery surcharges please use our web
e IAN Invalid Acct OCF Grd Pick -up Fee PND Pwrshp Not Delivered site www.fedex.com or call
OCS Exp Pick -up Fee SDR Saturday Delivery '800f 622 -1147
Rerate information only (round to nearest inch)
Tracking Number Code Amount LSS L W H
`e` I I I I I i l l l! I I I I I I I I I I I I I I I W I I I II I I I I I I I I
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F ecE x. I Invoice Number Invoice Date F Number 's, page
1 9-387-80084 Nov 04, 2009 3 of 4
FedEx Ground Shipment Summary By Reference
FedEx Ground Shipments (Original)
T
:i M45
I I I
r
TRIPP
Charges �,r Ch
Information Systems 1 4 4.82 4.74 9.56
Tfat 1 r
FedEx Ground Miscellaneous Charges
Handlin -Rot:
Wit Z
A'
U a ge
jar
A lternate Address Pickup 10127 1 13.00
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1. w.......
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Total This lflvoice USD _42mr
MET
22P
01 3798 712
on
Invoice Number Invoice Date [:Account Number Page
9-387-80084 N ov 04, 2009 4 of 4
FedEx Ground Shipment Detail By Reference (Original►
PJA 1
-.1
wom-ro�m''-
Tracking 10 161 629310000144 Sender Recipient Transportation Charge 4-82
Service Type Direct Sign, Ppd CITY OF CARMEL C/O LIHILSOLUTIONS Fuel Surcharge 0.19,
Zone 02 1 civic SO CHECK POINT SOFTWARE TECHNOLO Declared Value 4.55
Packages I CARMEL IN 46032-2584 2450 SPIEGEL DR Total Charge USD $9.56
Rated Weight 4lbs STE A
Declared Value USD 700.00 GROVEPORT OH 43125-912073
Delivered Oct28,2009
Information Systems Reference Subtotal USD $9.56
FedEx Ground Miscellaneous Charges USD $13-00
(see summary section)
Total FedEx Ground USD $272.56
'L P. ,r-"
Fed Gr00fid:Aftern a te A
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dd
Pickup Date Alternate Address Tracking ID Ch
Oct 27, 2009 TERRY N. CROCKETT 161 629310000144 13.00
CITY OF CARMEL
THREE CIVIC SQUARE
Front reception desk
CARM IN 46032 US
Ct
�0 P9
Prescribe; by Slate Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No. 201 (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.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
11/04/09 9- 387 -80084 Shipping 9.56
Total $9.56
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 Ng /09 WARRANT NO.
ALLOWED 20
FedEx IN SUM OF
PO Box 94515
Palatine, IL 60094
$9.56
ON ACCOUNT OF APPROPRIATION FOR
General Fund
1202 Information Systems
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
1202 9- 387 -80084 421 $9.56 materials or services itemized thereon for
which charge is made were ordered and
received except
20
�S gnatur
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund