179180 11/11/2009 CITY OF CARMEL, INDIANA VENDOR: 362651 Page 1 of 1
h ONE CIVIC SQUARE DE LADE LANDEN
CARMEL. INDIANA 46032 PO BOX 41602 CHECK AMOUNT: $88.00
PHILADELPHIA PA 1 91 01 -1 602
,o CHECK NUMBER: 179180
CHECK DATE: 11/11/2009
D EPARTMENT ACCOUNT PO NU MBER INVOICE NUMBER AMOUNT DESCRIPTION
:1160 4353004 3753439 88.00 COPIER
Keep l vwet portion far your records P iaase return upperrartian with your payment
lrrvoice�Date Invoice, Number _/�►ccount P m
07
DE LAGS LANDEN 10/24/2009 3753439 3898
PO BOX 41602
PHILADELPHIA, PA 19101 -1602
PeriocJ ofPerformance, v Contract Number;
10115/2009 1111412009
Impor tant Message
Message
If this is your f irs t inv it may include interim rent or prior period rentals in the payment amount.
See Reverse for Important Information
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PAYMENT $8800 $0.00 $88 00
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Ma8e1Model pa serial Number Asset Number; �R gcontract:Number�lli P rnentAmount �saleslUse-Tax 1 yQTOtaGAmnunt
V i �d`,'3 1, f-"t
e
ONMINIC20X IOFDO130001271 24954963 1 2 4954983 $88.00 $0.00 $88.00
sset' Location: 1'CIVIC SQ CARMEL HAMILTON IN'46032- 7569`United States
IMIDI O TANT REMINDER, Enclose remittance slip witil your check and send it to the address on reverse
side to ensure accurate and timely processirg of year payment. for prompi review and handling, please
send other correspondence and notices separately to the attention of, Custcmer Service DE LAGS ILAN
111 OLD EAGLE SCHOOL Rte, WAYNE, PA 19037 -1453_
Fur g(°neral account information 24 hours a day, 7 days a week, visit our Neba to xwip�k lessncai,. �,;t r. om...
Please remit payments at least 5 business days prior to clue date.
Please be sure to record your Invoice or Account Number on the check.
Explanation of Charges:
?t i s important to us that you un;ierstand the char es on your invoice Please refer to this guide as
assistance
11'-CUWENI'ATIUN FEE
C
A Ur'f' t ;2 charge ISSf SS£. {j on fhs new Cr�,3(:9aGtE`.ill`a. }is fee i J =E''rS 4'.' :1t3;".r J Lra. t7l -1,4s c ?3 ?:9 F)'•t1F>
1NSltPfiNCE ICHA E
A cba g.e duo a,sl h hill -ng frerlod a� the result of the equiolnent br €,7g insured by '.ho lessor gxnst N. risks of toss or
3. PAYME- r<11
Arnrourrt due E j's i Nking pelio 111 lac- GoCl;ance `Jln the terms of the Contra
4. I.-A E CIHPJRGiF
l SSt�Ssed w. "en a pay ment 1 not received Sly its J ue zlS pr'(wii ?ed by tht
iris. s! >sed voher a Paymen E:> not 3'E:%eived by "S Le dat6, as Iwovided by th contrud+
AX
Th e "Ox is due inq ie ce vv,� h the tax taw. of 1 C Si <tY'e"S" "",4I6-TE 45 IQ'C a'�T. r gU'us?i,X1S 2aDow
ta cal vUSiofTtar =mac fvice nu r€ bcr me. ltioned :oE',k"V"'.
r lessor as owner of the, £;quip 3S as5E�Ssad and paa,+S property tax to the apptOpricliC- tfaX €ng authority on z10 ai1� ,aa3
ti Per the le <Uc comract, the Lessee has agreed to reirnburt >e the Lessor for al` property taxes paid can their behalf pius;
reasorlable a< mirlistrative costs, ror questions about taxes stall: Oistoaner =ervlce number mant'cnod blow,
As=s�.�ssed each tine a ciaeck is return�� for any reason.
3. �'£Opy F
Assessp,d w the Lessee rs;7uesls an addiflonal copy of tie arltract
10. AC,COUN S i A` 1:F -41 NT
Ovaruiev'4 of lt"lor invoice; for bYl'kC ;lo payment Vvras receNed at the °.1,+ ?e the current invoice `a nrinted,
L
C orrespondence Address:
C'LlstCfrler S'e ^rice, DE LAGE LA.NDEN 1111 OLD EAGLE SCHOOL RD, WAYN PA 19037 -1453 or call,
8001.736 -0220
Please send all written enquires to the address indicated above. Please do not send checks to the address
as this will delay the pasting of payments to yoUr account.
Peescribed by State Board of Accounts City Form No. 201 (Rev. 1995)
ACCOUNTS PAYABLE VOUCHER
11/9/09 CITY OF CARMEL
:;4n 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 Lae 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))
10724/0 3753439 Copier monthly lease 10/15/09-11Z14/09 $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.
u�'n /nom a 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
3753439 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
/j 20
"I'Signatuce
Cost distribution ledger classification if /Title
claim paid motor vehicle highway fund