205687 01/26/2012 CITY OF CARMEL, INDIANA VENDOR: 360611 Page 1 of 1
ONE CIVIC SQUARE BANK OF NEW YORK MELLON
I FINANCIAL CONTROL BILLING DEPT
PO BOX 19446 CHECK AMOUNT: $1,500.00
CARMEL, INDIANA 46032
CHECK NUMBER: 205687
NEWARK NJ 07195 -0445
CHECK DATE: 1126/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1150 4354002 252- 1599053 1,500.00 TRUSTEE FEES
DOR 69�
BNY Mr1.I.ON INVOICE
CORPORATE TRUST
The Bank of New York Mellon
Trust Company, N.A.
000041 RBFRSDOI
CARMCL CITY INDIANA Invoice Number: 252- 1599053
ATTN DIANA CORDRAY Account Number: CARMRED04
CLERK TREASURER
CITY HALL I CIVIC SQUARE Invoice Date: 29 Dec
CARMCL, IN 46032 Cycle Date: 31- Dec -11
Administrator: Perette Russell
Center Name: Indianapolis Muni
Phone Number: 317- 637 -7771
Currency: USD
CITY OF CARMCL INDIANA REDEVELOPMENT AUTHORITY COUNTY OPTION INCOME TAX LEASE RENTAL
REVENUE REFUNDING BONDS SERIES 2004
Q uantity Rate Proration Subtotal Total
Flat
Administration Fee 1,500.00
For the period: December 31, 2011 to December 30, 2012
Invoice Total: 1,500.00
Satisfied To Date: 0.00
Balance Due 1,500.00
Terns: Payable upon receipt. Please reference the invoice and account number with your remittance.
Our Tax ID Number is 95- 3571558. Please fax Taxpayer Certification requests to (732) 667 -9576.
Check Payment Instructions: Wire Payment Instructions:
The Bank of New York Mellon The Bank of New York Mellon
Financial Control Billing Department ABA 9 021000018
P.O. Box 19445A Account. GLA 4 111 -565
Newark, NJ 07195 -0445 For fui her credit: TAS 4 016760
Please enclose billing stub. Please reference Invoice Niunbcr: 252 1599053
Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No. 207 (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
L N ✓1 I F Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached inv ices) or bill(s))
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
VOUCHER NO. WARRANT NO.
Vo�—ALLOWED 20
IN SUM OF
ON ACCOUNT OF APPROPRIATION FOR
-?�p
Board Members
PO# or INVOICE NO. ACCT #!TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
I ObZ 1 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
Signature
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund