177649 09/29/2009 CITY OF CARMEL, INDIANA VENDOR: 093000 'Page 1 of 1
ONE CIVIC SQUARE FEDEX
CARMEL, INDIANA 46032 PO BOX 94515 CHECK AMOUNT: $20.78
PALATINE IL 60094 -0515
CHECK NUMBER: 177649
CHECK DATE: 912912009
DEP ART M ENT ACC OUNT P O NUMBER INVOICE NUMBER AMOUNT DESCR IPTION
1205 4342100 933239724 20.78 POSTAGE
J IV& ke F Invoice Dumber Invoice Date
1 of 4
FedEx Tax ID: 71- 0427007
Billing Address: Shipping Address:
CITY OF CARMEUMAYOR'S OFC CITY OF CARMEL
JENNY CHASTAIN 1 CIVIC SCI Invoice Questions?
1 CIVIC SCI 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 Sep 16, 2009 Internet: www.fedex.com
FedEx Express Services
Transportation Charges 15.70
Special Handling Charges 5.08
Total Charges USD $20.78
TOTAL THIS INVOICE USD $20.78
Other discounts may apply.
vv. Invoice Number Invoice Date Account Numb—e7--N Page
9- 332 -39724 Sep 16, 2009 -7 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 wwwJedex.com or calling
800.622.1147. Please use multiple forms for additional requests.
Please complete all fields in black ink.
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Phone I I! 1 I I I I I I I I I Fax
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Tracking Number Bill to Account Amount
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ADR Address Correction INW Incorrect Weight DVS oversize Surcharge For all Service failures or other
C DVC Declared Value INS Incorrect Service RSU Residential Delivery surcharges please use our web
e w
IAN Invalid Acct DCF Grd Pick -up Fee PND Pwrshp Not Delivered site ww.fedex.com or call
DCS Exp Pick -up Fee SDI; Saturday Delivery (800) 622 -1147
Rerate information only (round to nearest inch)
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FedE I Invoice Number Invoice Date
3 of 4
FedEx Express Shipment Summary By Reference
Fed Ex Express Shipments (original)
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NO REFERENCE INFORMATION 1 1.0 15.70 5.08 20.78
t al:k d1t ess 1....:...; >:::::$3 ,7Q.::: ::;:.:;:.'Sva18.::::::::::<:::;
fit xpt.:....:.:::::::::::::.::.......:::::::::::::.............::....................................................................................................................
Total This Invoice USD $20.78
013791 212
F ed Ex. I Invoice Number Invoice Date
-4 of 4
FedEx Express Shipment Detail By Reference (Original)
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Fuel Surcharge FedExhas applied a fuel surcharge of 5.50% to this shipment.
Distance Based Pricing, Zone 7
Automation USAB Sender Recipient
Tracking 10 861994324052 SHELLY LINGELBAUGH CRM KLARVING
Service Type FedEx 20ay CITY OF CARMEL 2218 FORADY AVE
Package Type FedEx Pak 1 civic SO CARLSBAD CA 92008 US
Zone 07 CARMEL IN 46032-2584 US
Packages I
Rated Weight 1.0 lbs, 0.5 kgs
Delivered Sep 10, 2009 09:43 Transportation Charge 15.70
Svc Area Al Fuel Surcharge 1.08
Signed by G.COTTON Courier Pickup Charge 4.00
FedEx Use 025210475/0006090/ Total Charge USD S20.78
NO REFERENCE INFORMATION Reference Subtotal USD $20.78
Total FedEx Express USD $20.78
Prescribed by State 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))
0-9116/09 9 332 39 ght Package $20.78
Total
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 N ARRANT NO.
FedE ALLOWED 20
IN SUM OF
P.O. Box 94515
��T 7
IL 60094-45i5
$20.78
ON ACCOUNT OF APPROPRIATION FOR
GENERALFUND
$1,202.00
Board Members
P n INVOICE NO. ACCT #/TITLE AMOUNT I hereby certify that the attached invoice(s), or
bill(s) is (are) true and correct and that the
1205 9- 332 -39724 421 20 78 materials or services itemized thereon for
which charge is made were ordered and
received except
20
n Si a re
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund