HomeMy WebLinkAbout168594 02/04/2009 CITY OF CARMEL, INDIANA VENDOR: 00353202 Page 1 of 1
ONE CIVIC SQUARE M/A COM INC CHECK AMOUNT: $20,000.00
CARMEL, INDIANA 46032 PO BOX 371536
PITTSBURG PA 15251 CHECK NUMBER: 168594
CHECK DATE: 2/4/2009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1115 4351502 18419 90954702 20,000.00 EDACS FX AGREEMENT
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Tyco Electronics CDtIA, Enc
:ii x 371536
MIA -COM, Inc. Wireless Network Pats #04 PA E525t 7536
Solutions Invoice
1011 Pawtucket Boulevard
Lowe# MA 01853 REPEAT PRINTOUT
Bdtrn Address Account Ref :I 26051. Irtforrrmfiivn
9
Carmel, City of Invoice Number 90954702
l Carmel Clay Communications Center Invoice Date 01/16/2009
31 1st Avenue N.W. Purchase Order No. 18419
Carmel IN 46032 Purchase Order Date 01/16/2009
Sales Order Number 309642
Shlpprng A ddress Accc�urRt Ref 26061 Incoterms EXW Shippers Plant
Carmel, City of Payment Terms Net 30 Days
Carmel Clay Communications Center
31 1st Avenue N.W.
Carmel IN 46032
P�ye3 Address Account Ref 26t�61
1 of 1
Carmel, City of For all Invoice Issues please contact
Carmel Clay Communications Center Jeff Aultice
31 1st Avenue N.W.
:e. ep. one 434 455-923 2
Carmel IN 46032 IFAX ;800 &3..7592
For;all atler xssces core #act your customer; ssrusce
representative
Invoice Details
�Ilrrercy USb
Item Material Quantity Unit Price Amount
Description
0010 SSSV1 C 1 EA 20,000.00 20,000.00
SERVICE,SW,ANNUAL,LVL 2 SGL SITE W /DISP per 1 EA
Subtotal 20,000.00
Tax Amount 0.00
Total Amount 20,000.00
The items above are sold for use in the U.S. only. Any export may require prior authorizatiot by the U.S.
Gover ment. The purchaser solely is responsible for complyi g with all U.S. export licensing equirements.
Contact: Janet Arnone
h: 317 -571 -2586
Billing Period: 01/01/09 12/31/09
nnual renewal of Software FX agreement per Amendm nt dated 01/07/C9 and Purchas Order
1 18419 dated 01/07/09
00146
00213
9
INDIANA RETAIL TAX EXEMPT PAGE
City Carmel CERTIFICATE NO. 003120155 002 0 o 11 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 13419
35- 60000972
ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES, A/P
CARMEL, INDIANA 46032 -2584 VOUCHER DELIVERY MEMO, PACKING SLIPS,
SHIPPING LABELS AND ANY CORRESPONDENCE.
FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL 1997
PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION
1I?I2009
MIA -Com Carmel Clay Communications
,VENDOR SHIP 31 First Avenue NW
TO
221 Jefferson Ridge Parkway Carmel, IN 46032
Lynchburg, VA 24501 (317) 571 -25 ®6
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY I UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Account 43- 515.02
1 Each EDACS FX Agreement $20,000.00 $20,000.00
Sub Total: $20,000.00
r'
Send Invoice To:
Carmel Clay Communications
31 First Avenue NW
Carmel, IN 46032-
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
Communications PAYMENT $20,000.00
A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O.
NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND
VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED.
SHIPPING INSTRUCTIONS I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN F 9
THIS APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER.
SHIP REPAID.
C.O.D. SHIPMENTS CANNOT BE ACCEPTED. 1w
ORDERED BY ,.4ar e ,,ss• -G--�] P
PURCHASE ORDER NUMBER MUST APPEAR ON ALL
SHIPPING LABELS.
THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945 TITLE �"�✓G 1� r /`7��`°^�
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
j a A l CLERK- TREASURER
DOCUMENT CONTROL NO A COPY SIGN AND RETURN TO CLERK'S OFFICE
VOUCHER NO, WARRANT NO.__
ALLOWED 20
IN THE SUM OF
ON ACCOUNT OF APPROPRIATION FOR
Board Members
PO# or INVOICE NO. ACCT /TITLE* AMOUNT
DEPT I 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
i
20
Signature
Title
I
i
Cost distribution ledger classification if
claim paid motor vehicle highway fund
i
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))
01/16/09 I 90954702 I I $20,000.00
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
VOUCHER NO. WARRANT NO.
ALLOWED 20
M/A -Corn
IN SUM OF
221 Jefferson Ridge Parkway
Lynchburg, VA 24501
$20,000.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel Clay Communications
PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members
18419 90954702 43- 515.02 $20,000.00 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
Tuesday, January 27, 2009
Director
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund