180045 12/08/2009 e:.�•, CITY OF CARMEL, INDIANA VENDOR: 362651 Page 1 of 1
Q� ONE CIVIC SQUARE DE LAGE LANDEN CHECK AMOUNT: $88.00
CARMEL, INDIANA 46032 PO BOX 41602
p h iohia PHILADELPHIA PA 19101 -1602 CHECK NUMBER: 180045
CHECK DATE: 1218!2009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1160 4353004 4135778 88.00 COPIER
i
Keep lower portion for your records Please return upper portion with your payment
Invoice Date' I nuotce_Number Acco
DE LAGS LANDEN
11/21/2009 4135778� 073898
PO BOX 41602�� y
PHILADELPHIA, PA 19101 -1602
Penod of Performance Y A Contract Number _4
11/15/2009- 12/14/2009 24954963
Import M es s ag e s
If this is you fir invoice, it may include interim rent or prior period rentals in the payment amount.
See Reverse for Important Information
::Invoice Details., f
pescription ,,,.r$ P,a ment Amount" .Sales /Use;Tax. Total Amount
PAYMENT $88.00 1 $0.00 1 $88.00
Total Billed this Period $88:00
..otal:'Balance Due 'for`Prior Billed ln` oices
Total k A $1,76.00
(Please see the following pages for details.)
'AssetDetails y
Make) Model Serial Number, g Asset Number, w.. Contract Number Payment Amount SaIesIUse Tax Total A unt
i
u...Z"z i a-
I
ONMIN /C20X IOFDO130001271 24954963 1 24954963 1 $88.001 $0.001 $88.00
ssel Location: 1 CIVIC So CARMEL,HAMILTON IN 46032 -7569 United States
IMPORTANT REMINDER: Enclose remittance slip with your check and send it to the address on reverse o
side to ensure accurate and timely processing of your payment. For prompt review and handling, please
send other correspondence and notices separately to the attention of: Customer Service DE LAGS LANDEN
111 OLD EAGLE SCHOOL RD, WAYNE, PA 19087 -1453.
For general account information 24 hours a day, 7 days a week, visit our website www.lesseedirect.com.
Please remit payments at least 5 business days prior to due date.
Please be sure io record your Invoice or Account Number on the check.
Explanation of Charges:
x
It is important to us that you understand the charges on your invoice. Please refer to this guide as
assistance.
1. GOCUMFNTA T ION FEE.
A one time charge assessed on the new transactions. This tee covers the cost of UCC filings and other documentation costs.
2. INSURANCE CHARGE.
A charge due each billing period as the result of the equipment being insured by the lessor against all risks of ioss or damage.
3. PAYMENT
Amount due each billing period in accordance vAth the terms of the contract.
4. LATE CHARGE.
Assessed+, hen a payment is riot received by its due date, as provided by the contract.
;i. LL i E FEE
Assessed when a payment is not received by its due date, as provided by the contract.
6. SALES/USE TAX
The salesiuse tax is due in accordance with the tax laws of the state(s) where the equipment is located. For ques9;ons abo�.rt
taxes call the Customer Service number mentioned below.
7. PROPERY TAX
The lessor, as owner of the equipment, is assessed and prays property tax to the appropriate taxing authority on an afnua'
basis. Per the lease contract. the Lessee l'os agreed to reimburse the Lessor for all property taxes paid on their behaif plus
reasonabie administrative costs. For questions about taxes call: Customer Service number mentioned below.
H. RETURNED CHECK FEE
Assessed each time a check is returned for any reason.
9. COP`! FEE
Assessed when the Lessee requests an additional copy of the contract.
10. ACCOUNT STATEMENT
Overview of prior invoices for which no payment was received at the firne the current invoice was printed.
Correspondence Address:
Customer Service DE LAGS 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.
00087981/001-10709
Y�CCAUfIf'- Stafement .r
°rImiceNumber. Due, Date" E3 eFtimountInvoiced k ME Due,_
3753439 1111512009 $88.00 $88.00
TotalfiBatance Due; =for,'PriorxSlled Irivaices, r se
i
Prescribed by State Board of Accounts City Form No. 201 (Rev. 1995)
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
12/7/09
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
Delage 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))
11/21/0 135778 CODier lea 88.00
Total 88.00
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. WAR_ RANT NO.
12/7/09
ALLOWED 20
Pelage 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
4 135778 4 $88 bills) is (are) true and correct and that the
materials or services itemized thereon for
which charge is made were ordered and
received except
20 [7
i J
s ignature
Cost distribution ledger classification if
Title
claim paid motor vehicle highway fund