174817 07/22/2009 CITY OF CARMEL, INDIANA VENDOR: 362651 Page 1 of 1
ONE CIVIC SQUARE DE LAGE LANDEN
CARMEL, INDIANA 46032 PO BOX 41602 CHECK AMOUNT: $88.OD
PHILADELPHIA PA 19101.1602
CHECK NUMBER: 174817
CHECK DATE: 7/22/2009
DEPARTMENT------. ACC OUNT PO NU MBER INVOI NUMBER AMOUNT DE SCRIPTION
1160 4353004 2515512 88.00 COPIER
�4
Keep tower portion for your records Please return upper portion with your payment
DE LAGS LANI7EN InVOice Dat
PO BOX 41602 e InVOrce Number'' �Accountt y 5
a �"NZ
06/2012.009 2515512 73898
PHILADELPHIA, PA 19101 -1602 pg' ,.r, I
Periid ofPerformance Contract'Number
%K sa�
06/15/2009— 07114/2009 24954963
I mportant Messages
If this is your first in v o ice, it may include interim rent or prior period rentals in the payment amount.
See Reverse for Important Information
4lnvalce QetallS a a
LA, .F J,: Y`, 5 T `u'�s:Nn F91- aA,l ,,i'm n w"� k ha ui..
Descri` "lion U r �Pa v SaCesl,Use Tax t E Total Arna "u'nt 7
PAYMENT $88.00 1 $0.00 1 $88 00
LATE FEE $4.40 1 $0.00 1
z°Iw', �a,� s �L CI 1 M 57 pl 'ji; k s w. 6�-
Total Belted this Period ,$92:40
gror�
1 e...�aka a.. >s
t €Y G� 3 s d.?dg�' d pi »a'" P� k'd
:AsseDeta�ls..:, b�ti� °,e
rr
Makel�Motle1 Seiial Number I� Contract
Asset Number° e r Numberp' ;Wa 99 Paym t Amount SaleslUse TaM Total Amounk
l,�x t,.:�.� 1�clt� �'.e,. -:p°, :`cae.� �k`*�t?'...5"ax N s�k� .����'W'. x=�.',�
ONMINIC20X IOFDQ130001271 249549631 1 24954963 1 $88,001 $0.001 $88.00
sset Location: 1,CIVIC:SO':CARMELHAMILTON IN.46032- 7569 -UMted :States a =.r
JIVI O t A T REMINDER. Enclose remittance slip with your check and send it to the addre;'s on reverse
side tc emsure accu ~ate and tin;ely processing of your payment. For prai'rpt review and handli;ncq, ple'3Se
send other co: respondence and notices separately to the attention o'. Customer Ser ice DE LAGS IA DE
1 11 e OLD FAGL.F SCI i001- RD, WAYNE, PA 19087- 1453.
Igor general a:. information 24 hours a day, 7 days a week, visit our t��e� site vl�.i sseedi�uct c��rn.
Please remit payments at mast 5 business days prior to due date.
Please be sure to record your Invoice or Account Number on the check.
Explanation of lures;
It is important to LIS that you understand the c1arges on your invoice. Please refer to this guide as
assistance.
1. Ut;CU ENTA710NrEi=
A one time charge assessed on the new transactions. This fee covers the cost of UCC filings and e °her documentation costs.
2. INSURANCE C HARGF
a charge due each billing period as the result of the equipment being insured by the essor against ail risks of loss or drarnage.
3. PAY fV EN-1
Amount due each biving period in accordance with ttae terms of the contract.
4. LA fr CI
assessed w hen a paynient is not received by its dose date, as provided by the contract
F. LnTL FE
t'? Sesc'ed wh"""?n a pa" 7 ira,t iG not received by itc date is provided by th*3 contra,
The sales?use tax is due in accordance with the tax laws of the, states) .where the equipment is located. For qu sUone� a jou!
taxes call the 1 -(800) 488-0844.
',�'�I l't.1 r� ERE TAY
The lessor, as owner of the equipment_ is assessed and pays properly tax to the appropriate taxing authority on an annual
basis. Per the lease contract, the Lessee has agreed to reimburse the Lessor for all property taxes paid on their behalf plus
reasonable administrative costs For questions about taxes call: 1 -(800) 483-0844.
8. RETURNED CHECK FEE
assessed each time a check is returned for any reason.
0. C{JP's FEE
Assessed wrien the Lessee requests an additional copy of the contract,
10. ACCOUNTS A I t MENT
Overviews of prior invoices for which no payment was received at the time the current invoice was printed.
Correspondence Address:
Customer Service, DE LADE LANDEN 1111 OLD EAGLE SCHOOL. RD, WAYNE, PA 19087 -1453 or call:
800- 736 -0220
Please send all written enquires to the address indicated above, Please do not send checks to the address
as this will delay the posting of payments to your account.
1:.
4
00053823/00139055
@nt`�'W�j n. A? w -c:. .�?1 C ,,,�f�ahM..t s�a�.`'-.x��, i� a 4 G r
.w
Invoice °Number FU €)ue gate, E x5 Amount;lnvo€ced fly, v
�.m. M 'BalanceDUe s,
2173042 06/15/2009 $92 -40 $92.40
j Total Balance Due for Pr>IOr,,.B�iled, lnvaICe °a
E 3
@�FC.Gdnt�RIndtlCeChdP P Q @'td,1 5v"m,A��`�„`,__ �.f��.� sa. ���a ��€1.x..a. i' i h�,'��sr* SIP
Past Due Past Duey E Past3Due� Past Due�€�Past Due3 rte' ILate�Fee 4Finance¢Charge',
Invoke Number§ s Invoice„ €a: lnvolce Due, qnvalce Balance 1nvolce l?a meet, t 5'V R s a �ff fi Rrt
x De'scn lon z a Date �;,5ub ect tfl`Late a
p €s: Date I N
t
Char
t
F.«P,: r
2173042 A Q6115/2009 88.00 4.40
PrescribAt by State Board of Accounts City Form No. 201 (Rev. 1995)
ACCOUNTS PAYABLE VOUCHER
7/20/09 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
De Lage Landen Purchase Order No.
P. 0. Box 41602 Terms
Philadelphia, PA 19101 -1602 Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
6/20/09 2515512 Nancy Heck copier lease $88.00
Total $88.00
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
De Lage Landen IN SUM OF
P. 0. Box 41602
Philadelphia, PA 19101 -1602
88.00
ON ACCOUNT OF APPROPRIATION FOR
1160 Mayor 4353004
C opier
Board Members
PO# or INVOICE NO. ACCT /TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
2515512 4353004 $88.00 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
ign ure
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund