170292 04/01/2009 CITY OF CARMEL, INDIANA VENDOR: 360390 Page 1 of 1
ONE CIVIC SQUARE AMERICAN TECHNOLOGY SOLUTIONS CHECK AMOUNT: $400.00
CARMEL, INDIANA 46032 ACCOUNTS RECEIVABLE
1212 S NAPER BLVD SUITE 119 -201 CHECK NUMBER: 170292
NAPERVILLE IL 60540
CHECK DATE: 4/1/2009
DE PARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1701 4351502 10055 -10 400.00 SOFTWARE MAINT CONTRA
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ERIC-�N TEC.HNOLOCY ft�i.1iTIONS
J 1212 S. Naper Blvd
Suite 119 -201 a
Naperville, IL 60540
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Client City of Carmel Invoice 10055 -10
Diana Cordray
One Civic Square Invoice Date: 3/17/2009
Carmel, IN 46032 PO
Phone: 630 548 -1970
Fax: 630 839 -7252
Qty Description Unit Price Cost
1 SSA W -2 Electronic Filing Fee for a single EIN 250.00 250.00
1 SSA W -2 Electronic State Filing (Indiana) 150.00 150.00
Balance Due: $400.00
Payment Due Upon Receipt
Please make check payable to: American Technology Solutions, Corp.
1212 S. Naper Blvd.
Suite 119 -201
Naperville, IL 60540
Thank You! We truly appreciate your business.
Prescribed by F 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
Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
Total
I 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
JD
IN SUM OF
j al� S rbV
qu), a
ON ACCOUNT OF APPROPRIATION FOR
(�%32, [StJ MW, ,J-
Board Members
Po# or INVOICE NO. ACCT #!TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
�f b GjQZ 400,00 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
20
Signature
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund