178360 10/14/2009 CITY OF CARMEL, INDIANA VENDOR: 00352664 Page 1 of 1
ONE CIVIC SQUARE RELYCO SALES INC
CARMEL, INDIANA 46032 121 BROADWAY CHECK AMOUNT: $450.20
DOVER NH 03820
CHECK NUMBER: 178360
CHECK DATE: 10/14/2009
DEPARTMENT ACCOUNT PO N INVOICE NUMBER AMOUNT DESCRIPTION
1701 4230200 618466 450.20 OFFICE SUPPLIES
INVOICE
��L 73 (V 1 Broadway Dover Invoice Number: 618466
T (800) 777 -7359 (603) 7 742 -0992-099 9 Invoice Date: 9/30/2009
F (603) 74
E info @relyco.c om Purchase Order#: C. Sheeks
lyco.c
www.relyco.com Terms: 1% 10 Net 30 Days
0,11 To: 005081 Ship To: 005081
CITY OF CARMEL CLERK TREASURER CITY OF CARMEL CLERK TREASURER
One Civic Square One Civic Square
Carmel IN 46032 -2584 Carmel IN 46032 -2584
Attention: Cindy Sheeks
Item Number Description
Qty Ordered Qty Shipped Qty To Whse Shipping Status Unit Price Extended]
02- 81136 -001 HP 4250/4350 TROY SECURE HY MICR TONER
1.00 EA 1.00 EA 0.00 EA 1 -UPSGR 9/30/2009 $437.00 $437.00
Your Relyco Account Representative is: Jennifer Corrado, jcorrado@relyco.com (603) 516 -3641
Our office has relocated to 121 Broadway, Dover, NH 03820. Please
update your records. Thank you.
Sub Total $437.00
Sales Tax $0.00
You may deduct $4.37 from this invoice Shipping Handling $13.20'
if paid by check, not credit card on or before 10/10/2009
c Invoice Total $450.20
VISA t�� '1�Fx1�£it�
c.:JEy
Payable in US Funds
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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))
�J
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.
ALLOWED 20
V IN SUM OF
PA
ON ACCOUNT OF APPROPRIATION FOR
-ty� 44qu
Board Members
POP or INVOICE NO. ACCT #/TITLE AMOUNT
DEPT I hereby certify that the attached invoice(s), or
101 &4(o Z 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
a
Signature
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund