174123 06/24/2009 CITY OF CARMEL, INDIANA VENDOR: 00352741 Page 1 of 1
ONE CIVIC SQUARE XEROX CORP
CARMEL, INDIANA 46032 PO BOX 827181 CHECK AMOUNT: $144.95
7
PHILADELPHIA PA 19182 -181
e� CHECK NUMBER: 174123
CHECK DATE: 6/24/2009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
209 R4353004 17868 040706565 144.95 COPIER FEES
XEROX CAPITAL 1567 THE EASY WAY
TO CALL E OUR U ES xerox
SERVICES, LLC TOLL Purchase Order Number
O
PO BOX 660502 1-800 -822B zoo
DALLAS TX Special Reference
r 75266 -0501 VINOOOOOX -000
Contract Number
C Telephone888 435 -6333 PAYABLE UPON RECEIPT
4z. Please Direct Inquiries To: A� Terms Of Payment
Ship To /Installed At: Bill To:
CITY OF CARMEL 06 -01 -09
Q) C I T Y LAW OFF. Invoice Date
ELAINE BASS 040706565
1 CIVIC SQUAR E Invoice Number
V) CARMEL IN 976584607
46032 Customer Number
V
DC425AC DIGITAL COPIER SER.# EYC- 017353
AMOUNT
BASE CHARGE JUNE
144.95
METER CRU KIT SER.# CRU32METR INCL
DC432/40 CTCH TRAY SER.# DC32CT INCL
SUB TOTAL 144.95
aJ
U
j TOTAL 144.95
C
INVOICE FOR THE PERIODIC PAYMENT ON YOUR XEROX AGREEMENT
THIS AGREEMENT INCLUDES EQUIPMENT, MAINTENANCE AND SUPPLY CHARGES
XEROX FEDERAL IDENTIFICATION #16- 0468020
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
Xerox Corporation
Purchase Order No. /Z 9 0 p
c
P. O. Box 827181
Terms
Philadelphia, PA 19182 -7181
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
6 -9 -09 040706565 DC425AC Digital Copier, Ser. #EYE 017353 $144.95
Per the attached invoice
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
X6 Corporation IN SUM OF
P. O. Box 827181
Philadelphia, PA 19182 -7181
$144.95
ON ACCOUNT OF APPROPRIATION FOR
DEFERRAL FUND (Law)
430 -53004 Copier
Board Members
PO# or INVOICE NO. ACCT #/TITLE AMOUNT
I hereby certify that the attached invoice(s), or
17868 040706565 $144.95 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
20 O 9
nature
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund