176513 08/19/2009 CITY OF CARMEL, INDIANA VENDOR: 00352741 Page 1 of 1
ONE CIVIC SQUARE XEROX CORP
CARMEL, INDIANA 46032 PO BOX 827181 CHECK AMOUNT: $144.95
PHILADELPHIA PA 19182 -7181
o CHECK NUMBER: 176513
CHECK DATE: 8/19/2009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
209 R4353004 17868 144.95 COPIER FEES
XEROX CAPITAL 2452 THE EASY WAY Xe�OX
TO ORDER SUPPLIES
SERVICES, L L C CALL OUR TOLL Purchase Order Number
FREE NUMBER
PO BOX 660502 1-8 822 2200
DALLAS TX Special Reference
75266 -0501 VINOOOOOX -000
Contract Number
0
Telephone 888- 435 -6333 PAYABLE UPON RECEIPT
4r' Please Direct Inquiries To: Terms Of Payment
Ship ToAnstalled At: Bill To:
v. CITY OF CARMEL 07 -18 -09
CITY LAW OFF. Invoice Date
ELAINE BASS 041703306
,Q 1 CIVIC SQUARE Invoice Number
vti CARMEL IN 976584607
V 46032 Customer Number
DC425AC DIGITAL COPIER SER.# EYC- 017353
AMOUNT
BASE CHARGE JULY
144.95
METER USAGE 03 -30 -09 TO 06 -23 -09
METER 1 152654 154433 1779
PRINT CHARGES
U METER 1 PRINTS 1779
LESS ALLOWANCE 11066
NET BILLABLE PRINTS 0 .015700 .00
TOTAL EXCESS PRINT CHARGES .00
METER CRU KIT SER.# CRU32METR INCL
DC432/40 CTCH TRAY SER.# DC32CT INCL
SUB TOTAL 144.95
TOTAL 144.95
ALLOWANCE PRORATED FOR 083 DAYS
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_BLLLED_
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. tS
F,'. O. Box 827181
Terms
Philadelphia, PA 19182 -7181
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
8 -6 -09 041703306 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
P— CQ[p� r> atioo IN SUM OF
P. O. Box 827181
Philadelphia, PA 19182 -7181
$144.95
ON ACCOUNT OF APPROPRIATION FOR
DEFERRAL FUND (Law)
430 -53004 Copier
7�— ��P Board Members
PO# or INVOICE NO. ACCT /TITLE AMOUNT I hereby certify that the attached invoice(s), or
17868 041703306 $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
20
!S i &66�naure
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund