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206114 02/14/2012 CITY OF CARMEL, INDIANA VENDOR: 363971 Page 1 of 1 ONE CIVIC SQUARE A P C O CARMEL, INDIANA 46032 351 N WILLIAMSON BLVD CHECK AMOUNT: $92.00 DAYTONA BEACH FL 32114 CHECK NUMBER: 206114 CHECK DATE: 2/14/2012 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1115 R4350900 27696 92.00 2012 OBLIGATIONS ANNUAL DUES INVOICE co Federal ID Number 63- 046 -1885 APCO INTERNATIONAL INC. International 351 NORTH WILLAMSON BLVD. DAYTONA BEACH, FLORIDA 32114 APCO International 351 North Williamson Blvd. Daytona Beach, FL 32114 888- APC09 -1 -1 OR 386- 322 -2500 Janet Arnone Office Administrator Statement Date: 1!3112012 Carmel Clay Communications Center P.O. Number: 31 1St Ave NW Carmel, IN 46032 -1715 Bill Code: 308659 Total Amount Due: $506.00 You are being billed for: 2012 APCO Membership Dues Note: r Return invoice With remittance. Please indicate those individuals no longer with your organization by drawing a line through their name. Each new member requires a new application. Please complete the application on the back. Duplicate application as needed. Payment Donations: ff Check Check: Silent Key: MasterCard Card Visa Expiration Date: Sunshine Fund: Amex Cardholder's Name: Discover Cardholder's Signature: Please add this to your total amount due. Please retain a copy for your records and mail invoice with payment. MBR CAT. NAME DESCRIPTION AMOUNT DUE Primary Chapter Original Amt Amount Due AmountPaid Balance IN 592.00 $92.00 50.00 592.00 t i y s IN 569.00 $69.00 50.00 S69.00 14-3-5 Peggy fN S69.00 S69.00 50.00 569.00 96115 FULL Todd Luckoski 1N 592.00 $92.00 50.00 592.0 c FULL ar%' tWwrrrt iN 592.00 S92.00 50.00 S92.00 IN S92.001 S92.001 SO,001 S92.00 Total Amount Due: 0 Page 1 of I VOUCHER NO. WARRANT NO. ALLOWED 20 APCO International IN SUM OF 351 N. Williamson Blvd. Daytona Beach, FL 32114 $92.00 ON ACCOUNT OF APPROPRIATION FOR Carmel Clay Communications PO# Dept. INVOICE NO. ACCT /TiTLE AMOUNT Board Members Encumbered f` I hereby certify that the attached invoice(s), or 27696 I 43- 509.00 I $92.00 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 Wednesday, February 08, 2012 Director Title Cost distribution ledger classification if claim paid motor vehicle highway fund 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 Purchase Order No. Terms Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) 01/31/12 $92.00 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