173608 06/10/2009 CITY OF CARMEL, INDIANA VENDOR: 353840 Page 1 of 1
ONE CIVIC SQUARE XYBIX SYSTEMS INC
CARMEL, INDIANA 46032 8207 SOUTHPARK CIRCLE CHECK AMOUNT: $222.00
LITTLETON CO 80120 CHECK NUMBER: 173608
CHECK DATE: 6/10/2009
D EPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1115 4350000 11654 222.00 EQUIPMENT REPAIRS M
f
X bix Systems, Inc.
4 Phone: 303 683 -5656
y y Fax: 303 683 -5454
8207 Southpark Circle KY
sf Invoice: 11654
Littleton CO 80120.
a
INVOICE Page: 1 of 1
Date. 5/20/2009
Sold To: Ship To:
Todd Luckoski
Carmel Clay Comm Center Carmel Clay Comm Center
31 1 st Ave N. W. 31 1 st Ave N.W.
Carmel IN 46032 Carmel IN 46032
USA
Fax: 317 571 -2585
PO Number: LOI Luckoski, Todd Terms: NET 30
Sales Rep: DAVE BERGLUND Ordered: 5/14/2009 Ship Via: UPS -NEXT DAY
Packing Slip: 1545 Ship Date: 5/20/2009
LEne Quantity Part Number /Description Revision Unit Price Ext Price`
1 1.00 11279 187.00000 EA 187.00
Line Ref. 1 Task Light Jolt Huron
:2 1.00 Other A 0.00000 EA 0.00
Line Ref. 2 Other Charges Services
Line (2) Miscellaneous Charges
f
3 Description Amount
10.) Freight Non Taxable 35.00
t
PavmentSchealule j Total: 222.00
Due Date Amount',
1 6/19/2009 222.00
Total 222.00:
ARForm:001:00
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
Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
05/20/09 I 11654 I I $222.00
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
V NO. WARRANT NO.
ALLOWED 20
XYBIX Systems
IN SUM OF
8207 SouthPark Circle
Littleton, Co 80120
$222.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel Clay Communications
PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members
1115 11654 43- 500.00 $222.00 1 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
Monday, June 08, 2009
Dire
Titie
Cost distribution ledger classification if
claim paid motor vehicle highway fund