172620 05/13/2009 ,r CITY OF CARMEL, INDIANA VENDOR: 00351469 Page 1 of 1
ONE CIVIC SQUARE XEROX CORP
CARMEL, INDIANA 46032 PO BOX 802555 CHECK AMOUNT: $1,641.78
CHICAGO IL 60680 -2555
CHECK NUMBER: 172620
CHECK DATE: 5/13/2009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMO UNT DESCRIPTION
1301 4353004 040128424 274.98 COPIER
1180 4353004 040128466 582.05 COPIER
601 5023990 040128468 490.46 OTHER EXPENSES
651 5023990 040128468 294.29 OTHER EXPENSES
XEROX CAPITAL 2.774 TO ORDER SUPPLIES NO PO REQ X @rOX ®�D
S E R V I C E S L L C CALL OUR TOLL Purchase Order Number
FREE NUMBER
P'O BOX 660502 1 -800 -822 -2200
DALLAS TX Special Reference
75266 -0501 VINOOOOOX -000
L Contract Number
4 Z.. 0 Telephone888- 435 -6333 NET 30 DAYS
Z. Please Direct Inquiries To:: Terms Of Payment
H Ship To /Installed At: Bill To:
L CARMEL CITY COURT 05 -01 -09
a+ ONE CIVIC SQUARE Invoice Date
CARMEL I N 040128424
0 46032 Invoice Number
a.r
305567166
Customer Number
DC430 430W /DADFIDUP,2TR SER.# UHG- 031217
AMOUNT
BASE CHARGE APRIL
274.98
METER CRU KIT SER.# CRU32METR INCL
DC432/40 CTCH TRAY SER.# DC32CT INCL
SUB TOTAL 274.98
0
U
TOTAL 274.98
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 ACCOUNTS PAYABLE VOUCHER City Form No. 201 (Rev. 1995)
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.
SSS Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
v 9 o go 1,2 8 c 17q. 5,f
Total 7 78
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 NO.
ALLOWED 20
T- IN SUM OF
0 sss
ON ACCOUNT OF APPROPRIATION FOR
Board Members
PO# or INVOICE NO. ACCT #!TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
O ya X30 .p l 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
PY 2
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
XEROX CAPITAL 3420 THE EASY WAY TO ORDER SUPPLIES 510994 xerox ®j
SERVICES, L L C CALL OUR TOLL Purchase Order Number
PO BOX 660502 1-800- 8 22 2200
DALLAS TX Special Reference
75266 -0501
E Contract Number
c Telephone888- 435 -6333 PAYABLE UPON RECEIPT
4► Please Direct Inquiries To: Terms Of Payment
�r Ship To /Installed At: Bill To:
L CITY OF CARMEL CITY OF CARMEL 05 -01 -09
v WATER AND SEWER WATER AND SEWER Invoice Date
E' UTILITY UTILITY 040128468
0 760 3RD AVE SW 760 3RD AVE SW Invoice Number
CARMEL IN CARMEL IN 713281426
46032 46032 Customer Number
V
W7655P WC 7655 COP PRNTR SER.# VDR- 557581
AMO.UN -T_
BASE CHARGE MAY
476.84
METER READ METER READ NET COPIES
METER USAGE 03 -21 -09 TO 04 -22 -09
TOTAL BLACK 139821 163949 24128
TOTAL COLOR 26915 28998 2083
METER CHARGES
V TOTAL BLACK 24128
BLACK BILLABLE PRINTS 24128 .006000 144.77
::k. TOTAL COLOR 2083
LESS PRINT ALLOWANCE 250
COLOR BILLABLE PRINTS 1833 .089000 163.14
_N FT__P.RIN -T CHARGE 307.91
w
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 of service rendered, by whom, rates per day, number of units,
price per unit, etc.
Payee
343004
XEROX CORP Purchase Order No.
PO BOX 802555 Terms
CHICAGO, IL 60680 Due Date 5/4/2009
Invoice Invoice nC?c�rin +i„►,
Date Number (or note attached invoice(s) or bill(s)) Amount
5/4/2009 040128468 $294.29
r
hereby certify that the attached invoice(s), or bill(s) is (are) true and
:orrect and I have audited same in accordance with IC 5- 11- 10 -1.6
,171 I
Date Officer
VOUCHER 095580 WARRANT ALLOWED
343004 IN SUM OF
XEROX CORP
PO BOX 802555
CHICAGO, IL 60680
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
f1
PO INV ACCT AMOUNT Audit Trail Code
040128468 01- 7360 -07 $294.29
C
Voucher Total $294.29
Cost distribution ledger classification if
claim paid under vehicle highway fund
ll
XEROX CAPITAL 3420 THE EASY WAY TO ORDER SUPPLIES 510994 �y
S E R V I C E S L L C CALL OUR TOLL Purchase Order Number
PO BOX 660502 1-800 822-2200
DALLAS TX Special Reference
75266 -0501
E Contract Number
O Telephone 888- 435 -6333 PAYABLE UPON RECEIPT
Please Direct Inquiries To: 4k� Terms Of Payment
Ship To /Installed At: Bill To:
CITY OF CARMEL CITY OF CARMEL 05 01 09
WATER AND SEWER WATER AND SEWER Invoice Date
E UTILITY UTILITY 040128468
0 760 3RD AVE SW 760 3RD AVE SW Invoice Number
IA CARMEL IN CARMEL IN 713281426
Z) 46032 46032 Customer Number
W7655P WC 7655 COP PRNTR SER.# VDR- 557581
AMOUNT
BASE CHARGE MAY
476.84
METER READ METER READ NET COPIES
METER USAGE 03 -21 -09 TO 04 -22 -09
TOTAL BLACK 139821 163949 24128
TOTAL COLOR 26915 28998 2083
METER CHARGES
V TOTAL BLACK 24128
BLACK BILLABLE PRINTS 24128 .006000 144.77
TOTAL COLOR 2083
LESS PRINT ALLOWANCE 250
COLOR BILLABLE PRINTS 1833 .089000 163.14
NET PRINT CHARGE 307.91
SINGLE LINE FAX KT SER.# FAXLINEI INCL
PROF FINISHER SER.# PROFNSHR INCL
PR /COPY /SCAN CNTRL SER.# SCANCTRLI INCL
SER.# TXC- 999999 INCL
SUB TOTAL 784.75
TOTAL 784.75
INVOICE FOR THE PERIODIC PAYMENT ON YOUR XEROX AGREEMENT
THIS AGREEMENT INCLUDES EQUIPMENT, MAINTENANCE AND SUPPLY CHARGES
TOTAL OF INVOICE MAY VARY ACCORDING TO METER USAGE BILLED
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 of service rendered, by whom, rates per day, number of units,
price per unit, etc.
Payee
350598
XEROX CORP Purchase Order No.
PO BOX 802555 Terms
CHICAGO, IL 60680 Due Date 5/4/2009
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
5/4/2009 040128468 $490.46
hereby certify that the attached invoice(s), or bill(s) is (are) true and
:orrect and I have audited same in accordance with IC 5- 11- 10 -1.6
Date Officer
VOUCHER 091781 WARRANT ALLOWED
50598 IN SUM OF
XEROX CORP
PO BOX 802555
CHICAGO, IL 60680
Carmel Water Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
040128468 01- 6360 -07 $490.46
V
u
Voucher Total $490.46
Cost distribution ledger classification if
claim paid under vehicle highway fund
XEROX CAPITAL 3419 THE EASY WAY NOT REQUIRED xerOX
TO
g CALL OUR SUPPLIES VV
OURTOLL Purchase Order Number
SERVICES, LLC
•v
PO BOX 660502 1 -822 zoo
DALLAS TX Special Reference
75266 -0501 DUMOOOOOX -000
E Contract Number
Q Telephone 888 -435 -6333 NET 30 DAYS
z Please Direct Inquiries To: Terms Of Payment
Ship To /Installed At: Bill To:
CITY OF CARMEL CITY OF CARMEL' 05 01 09
LAW OFFICE LAW OFFICE Invoice Date
1 CIVIC SQ 1 CIVIC SQ 040128466
,0 CARMEL IN CARMEL IN Invoice Number
46032 46032 711428953
V Customer Number
W7655P WC 7655 COP PRNTR SER.# VDR- 548166
AMOUNT
BASE CHARGE APRIL
453.76
METER READ METER READ NET COPIES
METER USAGE 03 -23 -09 TO 04 -20 -09
TOTAL BLACK 88883 94692 5809
TOTAL COLOR 20819 22456 1637
METER CHARGES
TOTAL BLACK 5809
.v LESS PRINT ALLOWANCE 5000
BLACK BILLABLE PRINTS 809 .006000 4.85
TOTAL COLOR 1637
Iv LESS PRINT ALLOWANCE 250
COLOR BILLABLE P R I N T S 1387 0 8 90 0.0__
C 0 INDIANA RETAIL TAX EXEMPT PAGE
it CERTIFICATE NO.003120155 002 0 o JL PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT
err 35- 60000972 U
ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES, A/P
CARMEL, INDIANA 46032 -2584 VOUCHER, DELIVERY MEMO, PACKING SLIPS,
SHIPPING LABELS AND ANY CORRESPONDENCE.
FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL 1997
PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION
•I/�,, SHIP
VENDOR /4AGQ-
f� Q �J�JC..S TO
CONFIRMATION BLANKET CONTRACT PAYMENTTERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
f�� r
5 0
Send Invoice To:
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
i 5 �3d -3od' PAYMENT g •43`
A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O.
NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND
`"'l•' VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED.
SHIPPING INSTRUCTIONS I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN
SHIP REPAID. THIS APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER.
C.O.D. SHIPMENTS CANNOT BE ACCEPTED.
ORDERED BY
PURCHASE ORDER NUMBER MUST APPEAR ON ALL
SHIPPING LABELS.
THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945 TITLE
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
2 0 1 CLERK- TREASURER l/
DOCUMENT CONTROL NO A.P. COPY SIGN AND RETURN TO CLERK'S OFFICE
VOUCHER NO. *ARk3ANT NO.
ALLOWED 20
IN THE SUM OF
X 53, -o.5'
ON ACCOUNT OF APPR PRIATION FOR
r
Board Members
PO# or INVOICE NO. ACCT #/TITLE AMOUNT
f I 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
i
20
gnature
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund