167613 01/07/2009 CITY OF CARMEL, INDIANA VENDOR: 093000 Page 1 of 1
ONE CIVIC SQUARE FEDEX
CHECK AMOUNT: $35.88
CARMEL, INDIANA 46032 PO Box 94515
PALATINE IL 60094 -4515
CHECK NUMBER: 167613
CHECK DATE: 1/7/2009
DEPARTMENT ACCOUNT PO NUMBER IN VOICE NUMBER AMOUNT DESCRIPTION
1205 4342100 9- 019 -18314 35.88 POSTAGE
Fed=7 Invoice Number Invoice Date Account Number Page
9 -019 -18314 Dec 17, 2008
l of 4
FedEx Tax 10: 71- 0427007
Billing Address: Shipping_Address:
CITY OF CARMEL/MAYOR'S OFC CITY OF CARMEL
JENNY CHASTAIN 1 CIVIC SO. 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 Dec 17, 2008 Internet: www.fedex.com
FedEx Express Services
Transportation Charges 23.20
Special Handling Charges 12.68
Total Charges USD $35.88
TOTAL THIS INVOICE USD $33.88
Other discounts may apply.
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F ed[ Invoice Number Invoice Date Account Number rage
9- 019 -18314 Dec 17, 2008 z of
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.
'I Please complete all fields in black ink.
Re Q 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 I L_W I W
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a Phone I I I I I I I_ I I! I I I Fax WLJW L 1 I
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E -mail Address Yes, I wantto update account contact with the above information.
Tracking Number Bill to Account Amount
e' 1 1 1 1 1 1 1 1 1 1 1 1 1 1) 1 1 1 1 1 1 1 1 1 1 I I L I I I I I
b IIIII11111111111 IIIIIIIIII Illllf
3 IIIIIIIIIIIIIIII IIIIIIIIII (11111
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1111111111111111 Illlllllll 111111
1111111111111111 1111111111 IIIIII
C DR
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
e IAN Invalid Acct OCF Gird Pick -up Fee PND Pwrshp Not Delivered site www.fedex.com or call
OCS Ex Pick -u p Fee SDR Saturday Delivery (800) 622 -1147
Rerate information only (round to nearest inch)
C; Tracking Number Code Amount LBS L W H
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ej' I I I I I I I I i I I l I I 1 I I I) I I I I I I I I I I LWWJ LW1W X 1 l I I X 1 i I I
I I __l I I I I I l i l l l l l l l l l l 1 1 1 1 1 W 1 1 i lI I I I i I I l X 1 I I I
I l l i l l l l l l 1 1 i l 1 1 I I I I l I I I I I I I WWWWWJX I I! I X I I I I
1 I l l l l l l l l l l l l l 1 1 1 1 1 1 1 1 1 1 I I I! WWJWWIX I I I L I 1
I I I I I 1 1 1! I I I I I I I I 1 1 1! 1 1 1 I W LWJ I I I I I I I I
FedE x. Invoice Number Invoice Date Account Number Page
9 -019 -18314 Dec 17, 2008 3 of 4
FedEx Express Shipment Summary By Reference
FedEx Express_ Shipments (Original)
Dated �pae�(
Ilfletgltit TranspQrtal€tvn F1aad(i�O #let Ch1Fax
�ieietetrce Stt� iertts #Iks Charges Gi�arges s±r dctsJO #h #M aUlm.,. Total Chetgas
Insurance Enrollment For 2 14.0 23.20 12.68 35.88
Total This Invoice USD $35.88
64183 V2
a> Invoice Number Invoice Date Account Number Page
9- 019 -18314 Dec 17, 2008 4 of 4
FedEx Express Shipment Detail By Reference 10riginal`
Prokei� u� lac 05 28 Cush Ref 1nsuanee Erlo�len Rif #2
Payerhl#sPer fie
Fuel Surcharge -FedEx has applied a fuel surcharge of 15.00% to this shipment
Distance Based Pricing, Zone 2
Fed Exhas audited this shipment for correct packages, weight, and service. Any changes made are reflected in the invoice amount.
Automation INET Sender Recipient
Tracking ID 796163591940 Shelly Lingelbaugh Kathy Madsen
Service Type FedEx 2Day City of Carmel Benefit Administrative Systems
Package Type Customer Packaging One Civic Square 17475 JOVANNA DR STE 16
Zone 02 CARMEL IN 46032 US HOMEWOOD IL 60430 US
Packages 1
Rated Weight 7.0lbs, 3.2 kgs
Delivered Dec 09, 2008 09:24 Transportation Charge 11.60
Svc Area A2 Fuel Surcharge 2.34
Signed by D- ARTHUR Courier Pickup Charge 4.00
FedEx Use 000000000/0005960% Total Charge USD 511 -94
Ptelcd fees 2Da8 Cust Rei Iflsurar►eenrc�llmenar Rer #2
Iw d Mayortlpptar
Fuel Surcharge FedEx has applied a fuel surcharge of 150% to this shipment.
Distance Based Pricing, Zone 2
FedEx has audited this shipment for correct packages, weight, and service. Any changes made are reflected in the invoice amount.
Automation INET Sender Recipient
Tracking ID 797160171651 Shelly Lingelbaugh Kathy Madsen
Service Type FedEx2Day City of Carmel Benefit Administrative Systems
Package Type Customer Packaging One Civic Square 17475 JOVANNA OR STE 1B
Zone 02 CARMEL IN 46032 US HOMEWOOD IL 60430 US
Packages 1
Rated Weight 7.0 Ibs, 3.2 kgs
Delivered Dec 09, 2008 0924 Transportation Charge 11.60
Svc Area A2 Courier Pickup Charge 4.00
Signed by D.ARTHUR Fuel Surcharge 2.34
FedEx Use 000000000/00059801_ Total Charge USO 517.94
Insurance Enrollment For Reference Subtotal USD $35.88
Total FedEx Express USD $35.88
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
F r-1 E) Purchase Order No.
Terms
Fq Date Due
4 Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
12/17/08 19-1b311 uVernight Shipping
Total $35.88
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 N0� �WARRA J�
FedEx ALLOWED 20
IN SUM OF
P.O. Box 94515
Palatine, it 60094
$3 5.88
ON ACCOUNT OF APPROPRIATION FOR
GENERALFUND
1205 Administration
Board Members
PO# or INVOICE NO. ACCT #/TITLE AMOUNT I hereby certify hat the attached invoice(s), or
DEPT: y y
bill(s) is (are) true and correct and that the
120 9- 019 -18314 421 88 materials or services itemized thereon for
which charge is made were ordered and
received except
20
a
natur
Tit e
Cost distribution ledger classification if
claim paid motor vehicle highway fund