177119 09/15/2009 CITY OF CARMEL, INDIANA VENDOR: 356389 Page 1 of 1
ONE CIVIC SQUARE BLACK BOX RESALE SERVICES CHECK AMOUNT: $102.00
CARMEL, INDIANA 46032 SOS
O 12-0976
CHECK NUMBER: 177119
MINNEAPOLIS MN 55486 -0976
CHECK DATE: 9/15/2009
DEPARTMENT A CCOUNT PO NU MBER I NVOI CE NUMBER AMO DESCRIPTI
1110 4239099 4015893 102.00 OTHER MISCELLANOUS
.r�
V
4@rr: BLACK BOX
RESALE SERVICES INVOICE
Vibes Technologies, Inc.
BILL TO: 116124
For billing questions, please call
CITY OF CARMEL 877 214 -4661
CARMEL CLAY COMM CTR /TODD LUCKOSKI
31 1ST AVE NW 4015893
CARMEL IN 46032 Order 999365129
UNITED STATES Invoice Date 08/3112009
PON 8-
Antount:Due 102.00
SHIP TO: 116124 US lliillar
CITY OF CARMEL NET 30 FROM INVOICE DATE
CARMEL CLAY COMM CTR /TODD LUCKOSKI
31 1sT AVE NW REMIT PAYMENT TO:
CARMEL, IN 46032 Black Box Resale Services
SDS 12 -0976
PO BOX 86
Minneapolis, MN 55486 -0976
Line Adj Identifier Description Quantity Unit Amt Net Amount
1 FREIGHT FREIGHT AND HANDLING 1 7.00 7.00
2 XM9516B BUSINESS SET W /CALL ID DIG 1 95.00 95.00
Subtotal. .102:..0
Total Amount Due s: 1o2 o0
i 1
i
Original
Presrrjied by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No. 201 (Rev. 1995)
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
Black Box Resale S er vic es Purchase Order No.
SDS 12 -0976
Terms
PO Box 86
Mi nneapolis, MN 55486 -0976 Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
9/14/2009 4015893 payment for garage phone 102.00
Total
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
VOI,)CHER NO. WARRANT NO.
ALLOWED 20
IN SUM OF
Black Box Resale Services
SDS 12 -0976
PO Box 86
Minneapolis, MN 55486 -0976
102.00
ON ACCOUNT OF APPROPRIATION FOR
police general fund
Board Members
PO# or
DEPT INVOICE NO. ACCT #/TITLE AMOUNT I hereby certify that the attached invoice(s), or
1110 4015893 390 -99 102.00 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
Sept 14, 2009
i nature
tTsst Chief of Police
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund