178000 10/13/2009 CITY OF CARMEL, INDIANA VENDOR: 357004 Page 1 of 1
ONE CIVIC SQUARE KONICA MINOLTA BUSINESS SOLUTIOSECK AMOUNT: $25.33
CARMEL, INDIANA 46032 DEPT CH 19188
PALATINE IL 60055 -9188 CHECK NUMBER: 178000
CHECK DATE: 10/13/2009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
902 4353004 213063140 25.33 COPIER
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Invoice Number: 213063140 Please Remit To: RMS
KONICA MINOLTA BUSINESS SOLUTIONS
Invoice Date: 09/18/2009 USA INC
Page 1 of I DEPT. CH 19188
Subject to E.O. 112478 and the regulations
KONICA MINOLTA PALATINE, IL 60055 -9188
or the secretary or Labor on Affirmative For Billing Inquiries Call: 317 870 -7000
Action and Equal Opporturnity
CORPORATE DUNS No. 00 -170 -7322 INVOICE
FEDERAL DUNS No. 62- 657 -5041
B Ship To:
Bill To:
CITY OF CARMEL CITY OF CARMEL
I CIVIC SQ ATTN SHERRY MIELKE
CARMEL IN 46032 1 CIVIC SQ
OFC MAYOR'S
CARMEL IN 46032
Purchase Order Nbr Delivery Nbr Sales Order Nbr Date Account Nbr
JENNY CHASTAIN 443 _5 55 0_9 05/28/2009 148154 /124620
Cartons Tot Weight Carrier Shipping Point Terms of Payment Comments
53.000 NET 30 DAYS
Quantity Quantity Quantity
Ordered BackOrdered Material Nbr Description Shipped Unit Net Price Amount
7670932802 Per Copy Charge -B &W 25.33
Copies Overage Charge
C451
AOOK0I 0003953
09/09/2009 46,006
08/10/2009 43,703
Usage 2,303
Tot Usage 2,303
Allowance 0
Overage 2,303
0.01100
TOTAL NBB OF UNITS
TOTAL AMT 25.33
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Prescribed 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.
JJ
Payee
f v✓I1 Purchase Order No.
1
9 "'gl o /F'�F Terms
0 /G Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
Total 2 5 3j
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.
ALLOWED 20
IN SUM OF
s 2,5 33
ON ACCOUNT OF APPROPRIATION FOR
9e 3S 3,5v
Board Members
PO# or INVOICE NO. ACCT #/TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
got z�3a 3 y 3S3cx 2;3 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
200
Sign re
Director of Operations
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund