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206843 02/28/2012 CITY OF CARMEL, INDIANA VENDOR: 00350735 Page 1 of 1 t ONE CIVIC SQUARE BOB VANVOORST CARMEL, INDIANA 46032 23402 MULE BARN ROAD CHECK AMOUNT: $666.27 SHERIDAN IN 46069 CHECK NUMBER: 206843 CHECK DATE: 2/28/2012 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1120 4237000 666.27 REPAIR PARTS M MALGOLITE I nvoice lighting efficiency simplified Remit To Address: e 1918 Raymond Drive MC 105650 2/20/2012 IN413659 Northbrook, IL 60062 800 527 -5777 1 q Carmel Fire Dept Carmel Fire Dept 2 Civic Square 2 Civic Square Carmel IN 46032 Carmel IN 46032 Bob CC Bob CIA /CC 2/20/2012 i tle .r i PPD /ADD Monterey Park, CA 286783815071301 Email M 22 Custom 60 Custom Diffuser Clear Prism 18 33.58 604.44 Acrylic Freight Est. Shipping Charge 1 61.83 61.83 NOTE Thank you for your credit card 1 0.00 0.00 order. Subtotal 666.27 Shipping Cost (Fed Ex Ground) 0.00 Total $666.27 Amount Paid 666.27 All damages /shortage must be reported within 7 days to be considered for a credit. All Return Requests must be submitted in writing. Please pay by this invoice and include your Customer and Invoice number to insure proper posting of your payment to your account. Thank you for your prompt payment! Payment Due Date New Balance Past Due Amount Minimum Payment 03105112 $ $0.00 $ Account nurnber Make your check payable to: Chase Card Services. Please write amount enclosed. New address or e-mail? Print on back. 42668410825258800000250000146641000000000000002 ROBERT VANVOORST II 'I 1r11r11 1111 1111111111'I 111 1 11 11 1 11 1 11 1 111 1 1 1111 1 1 1 1 11 1 LEANNA K VANVOORST 23402 MULEBARN RD CARDMEMBER SERVICE SHERIDAN IN 46069 -8718 PO BOX 94014 PALATINE IL 60094 -4014 rr1111rr1111 mill 111111111 CHASE d f reedo m Manage your account online: Customer Service Additional contact www.chase.com/creditcards 1- 8400 9452000 information on back ACCOUNT SUMMARY PAYMENT INFORMATION Account Number: 4266 8410 8252 5880 New Balance $ payment $49 3years $1,761 (Savings =$448) If you would like information about credit counseling services, call 1- 866 -797 -2885. CHASE FREEDOM REWARDS SUMMARY Previous Points Balance As a Chase Checking sM customer, you earn more cash back for all your spending! You get 1 point for every $1 you spend, plus you will receive 10% bonus points per $1 spent and 10 bonus points on every purchase. Redeeming your points for cash back is easy! You can receive a check, statement credit, or even direct deposit into your Chase Checking account. ACCOUNT ACTIVITY Date of Transaction Merchant Name or Transaction Description Amount PAYMENTS AND OTHER CREDITS 01111 REDEMPTION CREDIT 129.25 01111 Payment Thank You 500.00 ()1117 Pavment Thank You 350.00 Statement Date, 01/09/12 02/08/12 Account Number: 4266 8410 8252 5880 Page 2 of 4 9 ACCOUNT ACTIVITY CONTINUED Date of Transaction Merchant Name or Transaction Description Amount MALCOLITE 800- 527 -5777 1L 666.27 2012 Totals Ye o-Date Total fees charged in 2012 $3.00 Total interest charged in 2012 $0.00 Year -to -date totals reflect all charges minus any refunds applied to your account. INTEREST CHARGES Your Annual Percentage Rate (APR) is the annual interest rate on your account. Annual Balance Balance Percentage Subject To Interest Type Rate (APR) Interest Rate Charges PURCHASES Purchases 12.24% (v) 0- -0- CASH ADVANCES Cash advances 19.24% (v) -0- -0- BALANCE TRANSFERS Balance transfers 12.24% (v) -0- -0- OVERI]RAFTS Overdrafts 19.24% (v) $6.55 -0- (v) Variable Rate 31 Days in Billing Period Please see Information About Your Account section for the Calculation of Balance Subject to Interest Rate, Annual Renewal Notice, How to Avoid Interest on Purchases, and other important information, as applicable. VOUCHER NO. WARRA NO. ALLOWED 20 Bob VanVoorst IN SUM OF $666.27 ON ACCOUNT OF APPROPRIATION FOR Carmel Fire Department PO# Dept. INVOICE NO. ACCT #/TITLE I AMOUNT Board Members 1120 I I 42- 370.00 I $666.27 1 hereby certify that the attached invoice(s), or 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 FEB 2 4 2012 Fire Chief 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)) $666.27 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