177130 09/15/2009 CITY OF CARMEL, INDIANA VENDOR: 357200 Page 1 of 1
ONE CIVIC SQUARE CANNON IV, INC
CARMEL, INDIANA 46032 PO BOX 697
CHECK AMOUNT: $1,009.63
INDIANAPOLIS IN 46206 -0697
CHECK NUMBER: 177130
CHECK DATE: 9/15/2009
DEPARTM ACCOUNT PO NU MBER INVOICE NUMBE AM OUNT DESCRIPTION
1202 4230200 21147 INV178372 925.25 PLOTTER SUPPLIES
1202 4230200 INV178490 84.38 OFFICE SUPPLIES
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A INVOICE
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Invoice No: INV178372
950 Dorman Street Indianapolis, IN 46202 -3544 Date: 8/17/2009
P: 317 951 0500 F: 317 951 0600 Account No: C008
Bill To: City of Carmel Ship To: City of Carmel
Attn: Terry Crockett Attn: Terry Krueskamp /P0:21147
Three Civic Square Three Civic Square
CARMEL, IN 46032 CARMEL, IN 46032
"""i "=y gr F a E a.. „t-. m 3.+ v- °arF• -n '"ta` z'sv tax xc
Order No ��P+O�_ ^IVumlier"� Ship Metlod����'; r P,ayment�Terms�� Payment Due
5014264 2 Best Way Net 30 Days 9/16/200
Mark Benefiel
Stii #a��BkO� k �'aiUMi: WWI �Disc� t ms' Amoun
„I Description Serial Nom p
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C5081A HP #90 Yellow Value Pack (20000 yield 1.0 1.0 0.0 EA $231.67 $231.67
C5080A HP #90 Magenta Value Pack (20000 1.0 1.0 0.0 EA $231.67 $231.67
yield
C5079A HP #90 Cyan Value Pack (20000 yield 1.0 1.0 0.0 EA $231.67 $231.67
C5078A HP #90 Black Value Pack (20000 yield 1.0 1.0 0.0 EA $219.70 $219.70
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PLEASE REMIT ALL PAYMENTS TO: Subtotal $914.71
CANNON IV, INC.
P.O. BOX 697 Discount $0.00
INDIANAPOLIS, IN 46206 -0697 Freight $104
Sales Tax
Past due amounts are subject to a Finance Charge of Invoice Total $925.25
1 1/2% per month (18% APR). Balance Due $925.25
Page 1 of 1
INVOICE
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Invoice No: INV178490
950 Dorman Street Indianapolis, IN 46202 -3544 Date: 8/18/2009
P: 317 951 -0500 F: 317 951 -0600 Account No: 5712414
Bill To: City Of Carmel Ship To City Of Carmel
One Civic Square Attn: Terry Krueskamp
Carmel, IN 46032 Three Civic Square
USA Carmel, IN 46032
USA
Sales;OrderNo .�P O.Number 3 Ship Method y Y
50142126 Terry K UPS Ground Net 30 Days 9/17/2009
s r x I�$a12S rse Olt;'
aw.
Mark Benefiel
-Yi a s `SFii <BkO U�M'£ Price Disc Amount
No�Descrption� y Sepal No Order p r
h 9• =%s: ,t asp, r ^:��>efi�� �r ..F aw".z�e�t, 1 1 4
3092401 -4 24x150 24# Premium Coated Inklet 1.0 1.0 0.0 CTN /4 $76.43 $76.43
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PLEASE REMIT ALL PAYMENTS TO: Subtotal $76.43
CANNON IV, INC.
P.O. BOX 697 Discount $0.00
INDIANAPOLIS, IN 46206 -0697 Freight $7.95
Sales Tax $0.00
Past due amounts are subject to a Finance Charge of Invoice Total $84.38
1 1/2% per month (18% APR). Balance Due $84.38
Page 1 of 1
Prescribed by State 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
Cannon IV In Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
08 17/nO IN]\/17A'l Toner 03/ i 3/0 INV17 8 4 0 Pr $925.25
Total $1,009. 3
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 IMI JAJnA WARRANT NO.
Cannon IV, nc ALLOWED 20
OX 6,91 IN SUM OF
India napNis, IN 46 ?nF_nF97
$1,009.63
ON ACCOUNT OF APPROPRIATION FOR
GENERAL FUND
1202 Information Systems
Board Members
PO# or INVOICE NO. ACCT #/TITLE AMOUNT I hereby certify that the attached invoice(s), or
final INV178372 302 $925. 25 bill(s) is (are) true and correct and that the
materials or services itemized thereon for
U which charge is made were ordered and
received except
20
rLatu�
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund