170173 03/18/2009 CITY OF CARMEL, INDIANA VENDOR: 00352741 Page 1 of 1
Q ONE CIVIC SQUARE XEROX CORP CHECK AMOUNT: $144.95
s` CARMEL, INDIANA 46032 PO BOX 827181
PHILADELPHIA PA 19182 -7181 CHECK NUMBER: 170173
CHECK DATE: 311812009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
209 R4353004 17868 038889870 144.95 COPIER FEES
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XEROX CAPITAL 1617 THE EASY WAY SIGNED XOA Xer ox
TO ORDER SUPPLIES
S E R V I C E S LLC CALL OUR TOLL Purchase Order Number
PO BOX 660502 1-800- 82282200
DALLAS TX Special Reference
75266 -0501 VINOOOOOX -000
Contract Number
Q Telephone888- 435 -6333 PAYABLE UPON RECEIPT
Please Direct Inquiries To: 4 k� Terms Of Payment
Ship To /Installed At: Bill To:
CITY OF CARMEL 03 01 -09
Q C I T Y LAW OFF. Invoice Date
ELAINE BASS 038889870
4.j 1 CIVIC SQUARE Invoice Number
CARMEL I N 976584607
V 46032 Customer Number
DC425AC DIGITAL COPIER SER.# EYC- 017353
AMOUNT
BASE CHARGE MARCH
144.95
METER CRU KIT SER.# CRU32METR INCL
DC432/40 CTCH TRAY SER.# DC32CT INCL
SUB TOTAL 144.95
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TOTAL 144.95
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INVOICE FOR THE PERIODIC PAYMENT ON YOUR XEROX AGREEMENT
THIS AGREEMENT INCLUDES EQUIPMENT, MAINTENANCE AND SUPPLY CHARGES
XEROX FEDERAL IDENTIFICATION #16- 0468020 I
VOUCHER NQ. R RANT NO.
ALLOWED 20
XPrnx nratiQn IN SUM OF
P. O. Box 827181
Philadelphia, PA 19182 -7181
$144.95
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ON ACCOUNT OF APPROPRIATION FOR
DEFERRAL FUND (Law)
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430 -53004 Copier
Jk Board Members
P.D
PO# or INVOICE NO. ACCT #/TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
17868 038889870 $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
200!'
ature
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund