178921 10/28/2009 CITY OF CARMEL, INDIANA VENDOR: 00352741 Page 1 of 1
ONE CIVIC SQUARE XEROX CORP
CARMEL, INDIANA 46032 CHECK AMOUNT: $148.40
PHILADELPHIA 19182 -7181
CHECK NUMBER: 178921
CHECK DATE: 10128/2009
D EPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
209 R4353004 17868 043479499 148.40 COPIER FEES
XEROX CAPITAL 2713 THE EASY WAY xe rox
TOCALLEOURSUPPLIES
SERVICES, LLC TOLL Purchase Order Number
FREE NUMBER
PO BOX 660502 1 -8 00- 822 -2200
DALLAS TX Special Reference
75266 -0501 VINOOOOOX -000
L Contract Number
Q Telephone888- 435 -6333 PAYABLE UPON RECEIPT
Please Direct Inquiries To: Terms Of Payment
H Ship To /Installed At: Bill To:
L CITY OF CARMEL 10 -02 -09
C I T Y LAW OFF. Invoice Date
ELAINE BASS 043479499
,0 1 CIVIC SQUARE Invoice Number
v1 CARMEL IN 976584607
V 46032 Customer Number
DC425AC DIGITAL COPIER SER.# EYC- 017353
AMOUNT
BASE CHARGE 10 -01 -09 TO 10 -30 -09
148.40
METER CRU KIT SER.# CRU32METR INCL
DC432/40 CTCH TRAY SER.# DC32CT INCL
SUB TOTAL 148.40
U_
.O TOTAL 148.40
G
CONTRACT EFFECTIVE DATE 04 -01 -09
INITIAL INVOICE
INITIAL METER READS METER 1 156791
INVOICE FOR THE PERIODIC PAYMENT ON YOUR XEROX AGREEMENT
THIS AGREEMENT INCLUDES EQUIPMENT, MAINTENANCE AND SUPPLY CHARGES
XEROX FEDERAL IDENTIFICATION #16- 0468020
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:easily viC; tie 'Nn it's n i o and cornamAnt way to save you th and money because it
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Xerox F edercal Identification -Wi 5 -0468020
t Y .r U t t .C6Ci! .:tF CURAi ION
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
Xerox Corporation
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))
1 -16 -09 043479499 DC432 40 CTCH TRAY, Ser. #DC32CT $148.40
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
Xe rox Corporation IN SUM OF
P. O. Box 827181
Philadelphia, PA 19182 -7181
$148.40
ON ACCOUNT OF APPROPRIATION FOR
DEFERRAL FUND (Law)
430 -53004 Copier
—X
00. D Board Members
Pte°# °r INVOICE NO. ACCT #/TITLE AMOUNT I hereby certify that the attached invoice(s), or
17868 043479499 148. 0 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 0Y
i nature
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund