172287 05/13/2009 CITY OF CARMEL, INDIANA VENDOR: 362651 Page 1 of 1
ONE CIVIC SQUARE DE LAGE LANDEN CHECK AMOUNT: $88.00
CARMEL, INDIANA 46032 PO BOX 41602
i o 8o PHILADELPHIA PA 1 91 01 -1602 CHECK NUMBER: 172287
CHECK DATE: 5/13/2009
DEPARTM ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTI
1160 4353004 1771583 88.00 COPIER
I
Keep lower portion for your records Please return upper portion with your payment
In vor;ce D atej ,,In voice Number',
DE LAGS LANDEN 04/25/2009 1771583 73898
P.O. BOX 41602 �_�.a, ,.r *cR� ?.m k
PHILADELPHIA, PA 19101 -1602
Period of Performance p Contrac
04115/2009 00511412009 24954963
Imp Me
If this is your first invoice, it may include interim rent or prior period rentals in the payment amount.
See Reverse for Important Information
10oig Det lS ,I '_1Z x i!.. a; H 1 C w 1 ti .."'r A ;r ".i
Descri' tion
1
p
a Payment Amaunt A 'SaleslUse?Tax „a. �T Amount
PAYMENT $88.00 $0.00 $88.00
Total Bilied this Petod Q p
�D8U0`
Asset.Details
Makel Model Serial Number w Asset Number* Contract,Number Payment Amount SaleslUse Tax TofaI Amount
F S 4 E
DNMIWC20X IGFDO130001271 24954963 24954963 1 $88.0 so.og $88.00
Ass Location: 1 CIVIC SQ CARMEL HAMILTON IN 46032 -7569 United States
IMPORTANT REM|NDER. Enclose remittance slip with your check and send it to the address on reverse
side to ensure accurate and timely pronpyoing ofyourpayment, For prompt review and hund|inA, p|omoe
send other correspondence and notices separately to the attention of: Customer Service DE LA8E LANDEN
1111 OLD EAGLE SCHOOL RD, VVAYNE.P/\18OO7-1453.
For general account information 24 hours a day, 7 days a week, visit our vvebsitevmxxwiesoee��nec�conn
Please remit payments atleast 5 business days prior ha due date. r
Please he sure tm record your Invoice or Account Number on the check.
Explanation ofCh
it is important to LIS that You understand the charges or) your invoice. Please refer to this guide as
DOCUMENTATION FEE
*o^aunec+o-ge assessed m "he ^ew�anaomunx. covers the cost v/uoom.nauonum-Le,u��momzuonooya
z, INSURANCE C!
Ac»arge ouueu&.ummob=nwgaa the result ofmeonv|nm=,ueino insured uy top lessor aoa/n�ao//oKuo,/oaoo,�Jamaoe.
3 PAYMENT
Amovn' due aa&mmnoFw//oum^ucomax*o*u^ the terms u/mecontract.
4. LATE 0 nA RGE
xoaus*uwxcn a paymen,ia ncurecsiveu by /t5du*usTe. is provided ov the oonoua
s �ArcreP
�s��ouodwxe, paymcnt/s not r*m/vaubyitonv--Cate. msnro"iueu uy the contract.
SX-ES/uSETAX
The oa|ax/unc lax iu uv* in accordance wkh the Tax iaen of the slate( x)whe, e mc anuip/nontis|c*sl� Fo,vuasbone acum
/ax:o call ma1(aon)4oa'ou«4
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xou.sper��*|eouo�on'm*��n:L*w^e haxaAwed�
�uyoosu|*aumivi�,mmvcosts- po, questions about tax«s^an 1'|0nO)zae ouw
o nsruFwso CHECK FEE
Ausamoedcochurn:a:hocaivmmmodfo/any mono^.
o, oopvpss
Asncaxcmwhco Ina Lessee /a=a,m^^auuuinna/cucvmo.aum/rIc,
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O,em=mv|on"r/nvnben 'or vvn|chnopayn`entmesrece/weda- the Umo the current |nvn|o:wa�nnoteu
Correspondence Address:
Customer Service, DE LAGE LANDEN 1111 OLD EAGLE SCHOOL RD, WAYNE. PA 19087-14,53 or call,'
Please send all written enquires to the address indicated above. Please do not send checks to the address
aa This m/i|| delay the posting of payments to your account
❑oa3oese /aooaaiis
it
m
Account =Stateent`'
.A?I
lnvoice�Ntfmber, kDue,Date`" =w �Amountlniioiced,
458828 04/1512009 $88.00 $88 00
x$88:00
Prescribed by State Board of Accounts City Form No. 201 (Rev. 1995)
ACCOUNTS PAYABLE VOUCHER
.5/11/09 CITY OF CARMEL
An invoice or bill to be properly itemized must show: kind of service, where performed, dates service rendered, by
v,ihom, 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))
4/25_/Oql 1771983 C opier e ea e
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
Copier
Board Members
Po# or. INVOICE NO. ACCT #!TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
1771583 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
ignature
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund