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174124 06/24/2009 CITY OF CARMEL, INDIANA VENDOR: 343004 Page 1 of 1 ONE CIVIC SQUARE XEROX CORP 's 0 CARMEL, INDIANA 46032 PO BOX 827598 CHECK AMOUNT: $26.27 PHILADELPHIA PA 19182 -7598 CHECK NUMBER: 174124 CHECK DATE: 6124/2009 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION '1110 4230200 21019 106706012 26.27 BUSINESS CARD STOCK t`� 305569055 106706012 06/09/09 xerox XEROX C A P I T A L D o t e Customer No. Invoice No. Invoice Date SERVICES, LLC 21019 06/05/09 PO BOX 6 6 0 5 0 2 Purchase Order No. Date GSA Contract No. DALLAS, TX C283824 06/08/09 75266 Xerox Order No. Date Processed Registration No. R O Telephone 888 -435 -6333 NET 30 DAYS I Direct Billing Inquiries To: -0 Special Reference No. Tax Terms of Sale G I�1 Ship To Bill To N CARMEL POLICE DEPT. CARMEL POLICE DEPT DL505599 A 3 CIVIC SQUARE Master Order No. L TIM ZELLLERS CARMEL IN 3 CIVIC SQUARE 46032 -7570 Bill Code of CARMEL IN V 46032 -0000 CALLER:TIM ZELLERS 317- 571 -2562 R E M A R K s Quantity Quantity Reorder No. Description Ordered Shipped Unit Price Amount AGREEMENT GRJ10 003R12321 PREMIUM BUSINESS CARD 20 1 26.27 26.27 INVOICE TOTAL $26.27 4i U d TO ORDER SUPPLIES CALL TOLL FREE 1 -800- 822 -2200 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 X erox Corporation Purchase Order No. O J p P .0. Box 827598 Terms Philadelphia, PA 19182 -7598 Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) 619/09 10670612 payment for business card stock 26.27 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. f ALLOWED 20 Xerox Corporation IN SUM OF P.O. Box 827598 Philadelphia, PA 19182 -7598 26.27 ON ACCOUNT OF APPROPRIATION FOR polic g eneral fund Board Members Po# or INVOICE NO. ACCT /TITLE AMOUNT voice(s), or 9 DEPT. I hereby certify that the attached in oZ1Ol4P 106706012 302 26.27 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 ,Tune 16 20 09 Signature Chief of Police Title Cost distribution ledger classification if claim paid motor vehicle highway fund