168084 01/21/2009 CITY OF CARMEL, INDIANA VENDOR: 205575 Page 1 of 1
ONE CIVIC SQUARE KONICA MINOTLA BUSINESS SOLUTIOSECK AMOUNT: $38.32
CARMEL, INDIANA 46032 PO BOX 7247 -0322
PHILADELPHIA PA 19170 -0322
CHECK NUMBER: 168084
CHECK DATE: 1/21/2009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1201 R4351501 18234 211537666 38.32 SERVICE AGREEMENT
Invoice Number: 211537666 W Please Remit to: 23
KONICA MINOLTA BUSINESS SOLUTIONS
Invoice Date: 12/31/2008 USA INC
Page 1 of 1 DEPT. CH 19188
Subject to E.O. 112478 and the regulations
KONICA MINOLTA PALATINE IL 60055 -9188
of the Secretaq of Labor on Affirmative For Billing Inquiries Call: 317 870 -7000
Action and Equal Opporturnity n
CORPORATE DUNS No. 00 -170 -7322 /�caN�"� I N tl ®I C C
L
FEDERAL DUNS No. 62- 657 -8041 t J
B Ship To:
Bill To:
CITY OF CARMEL �0 CITY OF CARMEL
1 CIVIC SQ ATTN HR
CARMEL IN 46032 1 CIVIC SQ
i CARMEL IN 46032
Purchase Order Nbr Delivery Nbr Sales Order Nbr Date Account Nbr
Shelly Lingelbaugh 44307055 01/07/2008 148154 1 148154
Cartons Tot Weight Carrier Shipping Point Terms of Payment Comments
32.000 NET 30 DAYS
Quantity Quantity Quantity
Ordered BackOrdered Material Nbr Description Shipped Unit Net Price Amount
7670932802 Per Copy Charge -B &W 38.32
Copies Overage Charge
C353
A02EO 10001347
12/30/2008 88,276
11/28/2008 84,792
Usage 3,484
Tot Usage 3,484
Allowance 0
Overage 3,484
0.01100
TOTAL NBR OF UNITS
TOTAL AMT 38.32
PrescribedPy §tate 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
Konica Minolta Business Solutions Purchase Order No.
Terms
i'
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
er Go
Overage Charge $38.32
Total
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 NO. WARRANT
S ;ba 01116/09
ALLOWED 20
Konica Minolta Business olutions
IN SUM OF
13847 Collections Center Drive
Chicago, IL 60693
$38.32
ON ACCOUNT OF APPROPRIATION FOR
GENERAL FUND
1201 Human Resources
Board Members
PO# or
DEPT INVOICE NO. ACCT #/TITLE AMOUNT I hereby certify that the attached invoice(s), or
bill(s) is (are) true and correct and that the
32 materials or services itemized thereon for
which charge is made were ordered and
received except
20
�igtaatur
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund