172621 05/13/2009 CITY OF CARMEL, INDIANA VENDOR: 00352741 Page 1 of 1
ONE CIVIC SQUARE XEROX CORP
CHECK AMOUNT: $289.90
CARMEL, INDIANA 46032 Po BOX a271e1
�yi >oy PHILADELPHIA PA 19182 -7181 CHECK NUMBER: 172621
CHECK DATE: 5!9312009
DEPARTMENT r ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTI
209 R4353004 17868 039876975 144.95 COPIER FEES
209 R4353004 17868 040128470 144,95 COPIER FEES
XERGIX CAPITAL 94 THE EASY WAY SIGNED XOA Xerox
0 TO Purchase Order Number
:SERVICES L L C FREE NUMBER
PO BOX 660502 1-8 -822 -2200
4-j DALLAS TX Special Reference
Q 75266 -0501 VINOOOOOX -000
Contract Number
Q Telephone888 -435 -6333 PAYABLE UPON RECEIPT
z Please Direct Inquiries To: -w Terms Of Payment
Ship To /Installed At: Bill To:
CITY OF CARMEL 05 0
CITY LAW OFF. Date
ELAINE BASS 040128470
1 CIVIC SQUARE Invoice Number
a CARMEL IN 9 7658 46 07 6 Nuber
V 46032
DC425AC DIGITAL COPIER SER.# EYC- 017353
AMOUNT
BASE CHARGE MAY
144.95
METER CRU KIT SER.# CRU32METR INCL
DC432/40 CTCH TRAY SER.# DC32CT INCL
SUB TOTAL 144.95
�J
U
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 ACCOUNTS PAYABLE VOUCHER City Form No. 201 (Rev. 1995)
9ti 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 n p/
Purchase Order No.
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))
5 -4 -09 040128470 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
Xerox Corporation IN SUM OF
P. p. Box 827181
Ph iladelphia, PA 19182
$144.95
ON ACCOUNT OF APPROPRIATION FOR
DEFERRAL FUND (Law)
430 -53004 Copier
Board Members
PO# or INVOICE NO. ACCT #/TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or 040128470 7T4T95— 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 Q
i nature
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund
XEROX CAPITAL 1 p 1 B THE EASY WAY xerox
SIGNED XOA
TO ORDER SUPPLIES .f'
SERVICES, LLC CALL OUR TOLL Purchase Order Number
PO BOX 660502 1- 800 822
DALLAS TX
Special Reference
75266 -0501 VINOOOOOX -000
Contract Number
O
Telephone8 8 8-43 5 —63 3 3 PAYABLE UPON RECEIPT
Please Direct Inquiries To: Terms Of Payment
Ship TO /Installed At: Bill To:
CITY OF CARMEL 04 18 -09
C I T Y LAW OFF. Invoice Date
E ELAINE BASS 039876975
Q 1 CIVIC SQUARE Invoice Number
CARMEL IN 976584607
V 46032 Customer Number
DC425AC DIGITAL COPIER SER.# EYC- 017353
AMOUNT
BASE CHARGE APRIL
144.95
METER USAGE 12 -30 -08 TO 03 -30 -09
METER 1 150725 157835 7110
PRINT CHARGES
METER 1 PRINTS 7110
LESS ALLOWANCE 12000
V NET BILLABLE PRINTS 0 .015700 .00
•o TOTAL EXCESS PRINT CHARGES .00
METER CRU KIT SER.# CRU32METR INCL
C DC432/40 CTCH TRAY SER.# DC32CT INCL
SUB TOTAL 144.95
TOTAL 144.95
FINAL INVOICE FOR PERIOD ENDING 03 -30 -09
CONTRACT RENEWED TO 03 -30 -10
AT THE TIME OF BILLING, NO VALID METER READ WAS AVAILABLE,
SO METER USAGE WAS ESTIMATED. ANY OVERAGE /UNDERAGE WILL BE
ADJUSTED OP! NEXT METER INVOICE. PLEASE VISIT OUR WEBSITE
AT WWW.XEROX.COM TO SUBMIT YOUR NEXT METER READ.
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 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
Xerox Corporation
Purchase Order No. D
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))
5 -4 -09 03987697 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
Xerox Corporation IN SUM OF
P. O. Box 827181
P P A 19182 -71
$144.95
ON ACCOUNT OF APPROPRIATION FOR
DEFERRAL FUND (Law)
430 -53004 Copier
Board Members
Po# or INVOICE NO. ACCT /TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
039876975 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
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund