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Home My WebLink About172680 05/26/2009 CITY OF CARMEL, INDIANA VENDOR: 362795 Page 'i 0 ONE CIVIC SQUARE A T T MOBILITY CHECK AMOUNT: $41.57 CARMEL, INDIANA 46032 PO BOX 6463 CAROL STREAM IL 60197 -6463 CHECK NUMBER: 172680 CHECK DATE: 5126/2009 DEPARTMENT AC PO NUM INVO NUMBE AMOUNT DES CRIPTIO N 1115 4344100 874486198X05 41.57 874486198 i G aW Page: l of 18 Billing Cycle Date: 04104/09 05/03/09 Account Number: 874486198 Y�Ci Foundation Account Number 02581749 Invoice Number: 874486198X05112009 How To Contact Us: Previous Balance 285.79 1 -800- 331 -0500 or 611 from your cell phone Payments Posted 222.34 For Deaf/Hard of Hearing Customers (TTY /T])1)) 1- 866 -241 -6567 Payable immed Monthly Service Charges 104.97 Usage Charges 12.22 Wireless Number(s) Credits /Adjustments /Other Charges -13.51 317- 379 -2609 Government Fees Taxes 8.72 317 -379 -5654 TRRENT CH ARG} S 11240 OTAL CU 317- 379 -5842 Aue May 26, 2(10 Fate lees assessed afterJun 03 317- 565 -9636 In 317 379 0029 <q `InOtlll U :IiKje fl In accordance with your contract or appropriate government regulations your billing accountwas changed from bill in advance to bill in arrears. *This Bill Includes A Past Due Balance If payment has already been made, thank you, please disregard. If not, payment must be made immediately. Please send your payment, including current charges, in the enclosed envelope. You may also pay 24 hours a day, by ma or credit card or electronic check at 1- 800 -331 -0500, or att.cofn/MyWireless. If your service is suspended, a reconnection fee will apply. If you have questions regarding your account, contact us at 1 -800- 947 -5096. Return the portion below with payment only to AT &T Mobility. at &t Page: 2 of 18 r v Billing Cycle Date: 04 /04/09 05/03/09 C Account dumber: 874486198 Foundation Account Number 02581749 General Information Late fee: Accounts with former AT &T Wireless plans are charged 1.5% or less of the balance unpaid as of the next bill period. Accounts with Cingular /new AT &T plans are charged $5 in CT, DC, DL, IL, KS, MA, MD, ME, MI, MO, NH, NJ ,NY,PA,OK,0I 1,RI,VA,VT,WI,WV; or 1.5% of the balance unpaid as of the next bill period in all other states. Accounts with former AT &T Wireless and Cingular /new AT &T plans incur the lesser of these charges. Notations made on checks or accompanying materials are not effective. Do not send notes/letters with payment. We cannot guarantee receipt. Send notes /letters to AT &T, PO Box 1180, Greeley, CO 80652 -1098 Calls to Customer Service may be monitored to ensure high quality service. Questions on accessibility by persons with disabilities: 1- 866 241 -6568 AT &T Mobility Tax ID 84- 1659970 AT &T surcharges include regulatory programs /cost recovery, universal service, gross receipts, and other fees to defray the costs of complying with government regulations. They are not taxes and are subject to change. Electronic Check Conversion When you pay your bill by check, you authorize us to either use the information from your check to make a one -time electronic funds transfer from your account or to process the payment as a check transaction. When we use information from your check to make an electronic fund transfer, funds may be withdrawn from your account as soon as the same day we receive your payment, and you will not receive your check back from the bank. You agree to pay a fee of up to $30 if your. check is returned unpaid. Returned checks may be represented electronically. Single Payment Agreement (for kiosk payment) I authorize AT &T to pay my bill by debiting my bank account. if my bank rejects a payment, I may be charged a return fee up to $30. at&t Page: 3 of 18 Billing Cycle Date: 04/04/09 05/03/09 Account Number: 874486198 Foundation Account Number: 02581749 Prior Activity 874486198 Previous Balance 285.79 Detail of Payments Posted Payment by Visa posted on Apr 16, 2009 -199.00 Payment by Check posted on May 01, 2009 -23.34 :A m,.-;- I _N_V- Wireless Detail 874486 Credits, Government Non-Comm Wireless Minutes Msg/KB/ Monthly Usage Adj Other Fees Related Number Used MB Used Service Charges Charges Taxes Charges go 317-379-0029 ..11 18,711 42.00 10.80 3.20 0 _(4 48..90 IPHONE LINE (See Page 5 for a list of individual charges.) 317-379-2609 0 0 12.99 0.00 -0.99 1.33 0.00 13.33 COMMUNICATIONS LINE (See Page 7 for a list of individual charges.) 317-379-5654 3 5 12.99 0.35 -0.98 1.35 0.00 13.71 COMMUNICATIONS LINE (See Page 9 for a list of individual charges.) 317-379-5942 26 2 12.99 1.07 -0.94 1.41 0.00 14.53 COMMUNICATIONS LINE (See Page 13 for a list of individual charges.) 317-565-9636 0 142,953 24.00 0.00 -3.50 1.43 0100 21.93 GO BOOK MR I (See Page 17 for a list of individual charges.) _40 �5 16 -97. -1222.. 3. __T ___71 674 __104. I 1r= Group Details Note: The following information summarizes only the shared plan services for your account. For additional information and details relating to all other services for a subscriber, please refer to the subscriber's individual pages. FT9NTN550RUM2MUNW Shared Minutes Used Wireless Period Monthiv Rollover Other Shared Billed Billed Number Service Minutes Minutes Minutes Charges 317-379-2609 04/04-05/03 0.00 0 0 0 0.00 317-379-5654 04/04-05/03 0.00 0 0 0 0.00 317-379-5842 04/04-05/03 0.00 0 0 0 0.00 Total S aW Page: 4 of 18 �!FY Billing Cycle Date: 04/04/09 05/03/09 Account Number: 874486198 Foundation Account Number 02581749 a I &t Page: 50118 Billing Cycle Date: 04104/09 05103/09 Account Number: 874486198 Foundation Account Number 02581749 Wireless Line Summary For: 317- 379 -0029 User Name: ]PRONE LINE Prorated Monthly Total Monthly Service Charges Period Charge Charge Charge Rate Plan Previous Rate Plan(s): NTN900RUMMUNW 04104 -04 /15 24 24.00 Other Services AT &T Direct Bill 04/04 -04/15 0 -00 0.00 AT &T Domestic LD 04104 -04/15 0.00 0.00 Includes: Toll Domestic Toll International AT &T Roam LD 04/04 -04/15 0.00 0.00 Includes: Toll Domestic Toll International BMG VISUAL VM POSTPD 04/04 -04/15 0.00 0.00 GSM Coverage Area 04/04 -04/15 0.00 0.00 Off Network Roam 04104 -04/15 0.00 0.00 Unlimited Expd M2M 04/04 -04/15 0.00 0.00 Unlimited NSW 04/04 -04/15 0.00 0 -00 iPhone Customer 04/04- 0411.5 0.00 0.00 Wireless Data BMGMEDIAN4AaUNLMNET 04104 -04/15 0.00 0.00 ENT DATA PLAN IPHONE 04/04 -04115 18.00 1800 Text Msg Pay Per Use 04/04 -04 /15 0.00 0.00 Includes: Int'l Text Messaging -Text Messagin g TOTAU MONTHLY SERVICE CHARGFb Usage Charges (See UsaV Charge Details T,0T. LTSAGF CHARGES $i'0 80 Credits, Adjustments Other Charges Federal Universal Service Charge 0.60 Indiana Universal Service 0.07 State Gross Receipts Surcharge 0.63 National Account Discount -8 -40 TOTAti`CRED.LT�,. ADJUST.EIri'1'S �c flTHFR CHARG.1+ S x$710 Government Fees Taxes IN State Sales Tax 3.20 TOTAL] GUERNMFNT FEES Tz31 ES $3 2Q at&t Page: 6 Of 18 3 Billing Cycle Date: 04104/09 05/03/09 Account Number: 874486198 Foundation Account Number 02581749 Usage Charge Details 317 -379 -0029 User Name: PHONE LINE Minutes Summary o Included Minutes Billed Billed Total Usage Charges In Plan Used Minutes Rate Charge NTN900RUMMUNW 900 Rollover Mins 900 2 0.00 Unlimited Expd M2M 5 0.00 Unlimited N &W 4 0.00 111TfUtal -xg`` i x.45?' d... w.� `4e,c.`$ �'S� r Msg/Min/ KB/MB Msg/Min/ Msg/Min/ Summary of Included KB/MB KB/MB Billed Total Wireless Data In Plan Used Billed Rate Charge Text Msg Pay Per Use Text Messaging Incoming 4 4 $0.20 /Msg 0.80 Text Messaging Out 50 50 $0.20/Msg 10.00 BMGMEDIAMAXUNLMNET DATA ACCESS 18,657 18,657 $0.00 /KB 0.00 SabtalFa� $1.0 SQ TOTAL USAI�E CHARGES G aW Page: 7 of 18 14 �Wk Billing Cycle Date: 04 /04/09 05/03/09 Account Number: 874486198 Foundation Account Number 02581749 Wireless Line Summary For: 317 379 -2609 User Name: COMMUNICATIONS LINE Monthly Total Monthly Service Charges Period Charge Charge Rate Plan OBFRNTNUMfN W 04/04 -05/03 12.99 12.99 Includes: Basic Voice Mail Call Forward Conditional Call Forward Immediate Call Hold Call Waiting Caller ID Detailed Billing Direct Bill Detail -Message Waiting Ind Nation GSM Three Way Calling UNL Nght Wknd Min Unlimited MUM Expnd Other Services AT &T Direct Bill 04/04 -05/03 0.00 0.00 AT &7' Domestic LD 04/04 -05/03 0.00 0.00 Includes: Toll Domestic Toll International AT &T Roam LD 04/04 -05/03 0.00 0.00 Includes: Toll Domestic -Toll International GSM Coverage Are 04/04 -05/03 0.00 0.00 Off Network Roam 04/04 -05/03 0.00 0.00 Unlimited Expd MUM 04/04 -05/03 0.00 0.00 Unlimited N &W 04/04 -05/03 0.00 0.00 Wireless Data DATA PAY PER USE 04/04 -05/03 0.00 0.00 Includes: DATA ACCESS Multimedia- PayPerMsg 04/04 -05/03 0.00 0.00 Text Msg Pay Per Use 04/04 -05/03 0.00 0.00 Includes: Intl Text Messaging Text Messaging TUTIIL.MONITI SERVICE CI[ARGFS ;$12.99 Credits, Adjustments Other Charges Regulatory Cost Recovery Charge 1.02 Telecom Relay Service Fund 0.03 Federal Universal Service Charge 0.36 Indiana Universal Service 0.04 State Gross Receipts Surcharge 0.16 I GaW Page: 8 of 18 EV Billing Cycle Date: 04 /04/09 05/03/09 Account Number: 874486198 Foundation Account Number 02581749 Wireless Line Summary For: (Continued) 317- 379 -2609 User Name: COMMUNICATIONS LINE Credits, Adjustments Other Charges National Account Discount -2.60 10'1'AL CKE1)ITS,- AllTUSTMEN7.'S O1`HHER $0.99 Government Fees Taxes 9 -1 -1 Service Fee 0.50 IN State Sales Tax 0.83 -OIAL (,OVERNM N I FEES 1AXES $1 33 o 'GGI omg m '7 0 ,3, GaW Page: 9 of 18 Billing Cycle Date: 04 /04/09 05/03/09 Account Number: 874486198 W N Foundation Account Number 02581749 Wireless Line Summary For: 317 379 -5654 User Name: COMMUNICATIONS LINE !Monthly 'Total Monthly Service Charges Period Charge Charge Rate Plan OBFRNTNUM/NW 04/04 -05/03 12.99 12.99 Includes: Basic Voice Mail Call Forward Conditional Call Forward Immediate Call Hold Call Waiting Caller ID Detailed Billing Direct Bill Detail Message' Waiting Ind' Nation GSM Three Way Calling UNL Nght Wknd Min Unlimited M2M Expnd Other Services AT &T Direct Bill 04/04 -05/03 0.00 0.00 AT &T Domestic LD 04/04 -05/03 0.00 0.00 Includes: Toll Domestic Toll International AT &T Roam LD 04/04 -05/03 0.00 0.00 Includes: Toll Domestic Toll International GSM Coverage Area 04/04 -05/03 0.00 0.00 Off Network Roam 04/04-05/03 0.00 0.00 Unlimited Expd M2M 04/04 -05/03 0.00 0.00 Unlimited N &W 04/04 -05/03 0.00 0.00 Wireless Data DATA PAY PER USE 04/04 -05/03 0.00 0.00 Includes: DATA ACCESS Multi media PayPerMsg 04/04 -05/03 0.00 0.00 Text Msg Pay Per Use 04/04-05/03 0.00 0.00 Includes: Int'1 Text Messaging Text Messaging TOTAti MONTHLY SFRVICE CHIRGES $12.99 Usage Charges See Usage Charge Details Credits, Adjustments Other Charges Regulatory Cost Recovery Charge 1.02 Telecom Relay Service Fund 0.03 Federal Universal Service Charge 0.37 -Y- at &t Page: 10 of 18 Billing Cycle Date: 04/04/09 05/03/09 Account Number: 874486198 Foundation Account Number: 02581749 Wireless Line Summary For: (Continued) 317 379 -5654 User Name: COMMUNICATIONS LINE Credits, Adjustments Other Charges Indiana Universal Service 0.04 State Gross Receipts Surcharge 0.16 National Account Discount -2.60 TOTAi ;'CREDITS, AWSTMI� NTS: .nTAFiLCNARGES 0 98 Government Fees Taxes 9 -1 -1 Service Fee 0.50 IN State Sales Tax 0.85 TOTAL;_GOVMNMENT EFS &TAXES Usage Charge Details 317- 379 -5654 User Name: COMMUNICATIONS LINE Minutes Summary of Included Minutes Billed Billed Total Usage Charges In Plan Used Minutes Rate Charge OBFRNTNUM/NW Unlimited N &W 1 0.00 Daytime 2 2 0.15 0.30 Subtotal� Msg/Min/ KB/MB Msg/Min/ Msg/tMln/ Summary of Included KBMB KB/MB Billed Total Wireless Data In Plan Used Billed --Rate Charge DATA PAY PER USE DATA ACCESS 5 5 $0.01 /KB 0.05 Subtotal .$0 05 T OTAY. USAGE CHARGES Call Detail 3t7- 379 -5654 User Name: COMMUNICATIONS LINE Rate Code: ODNB= OBFRNTNUM/NW, UNW9= Unlimited N &W Rate Period (PD): DT= Daytime, NW =Nwknd Number Rate Rate Fea- Airtime LD /Add'I Total Item Day Date Time Called Call To Min Code Pd titre Charge Charge Charge 1 00641W 4.43P tNCOMICL 1..ODNB DT 0:1;5 2 04123 4:44PM`- 317 -Si'8 5015 INGOMI'CL 1 =ODNB DT 0 il5 0.15: 3 SAT OS /D2'! 10:52AM :800- 465 7962 INCOMI::CL 1 .':UNW9 :NW 0.00: Subtotal Minutes 3 0.30 0.30 Totals 0:30 0 3 at&t Page: 11 of 18 Billing Cycle Date: 04/04/09 05/03/09 Account Number: 874486198 Foundation Account Number: 02581749 Data Detail 317-379-5654 User Name: COMMUNICATIONS LINE Rate Gode: WXP1 =DATA PAY PER USE Rate Period (PD): AT=Anytime Feature: GPRR=GPRS not roaming $0.01 rate for APNO02 PPU Rate Rate Fea- In/ Total Item Day Date Time To/From Type MsWKB/Min Code I'd lure Out Charge V68 04WT THW----- Subtotal of KB's 5 KB 0.05 .0 €0 5: a &t Page: 12 of 18 Billing Cycle Date: 04/04/09 05/03/09 Account Number: 874486198 Foundation Account Number 02581749 Page: 13 of 18 Billing Cycle Date: 04/04/09 05/03/09 Account Number: 874486198 Foundation Account Number: 02581749 Wireless Line Summary For: 317- 379 -5842 User Name: COMMUNICATIONS LINE Monthl 'Total Monthly Service Charges Period Charge Charge Rate Plan OBFRNTNUM/NW 04/04 -05/03 12.99 12.99 Includes: Basic Voice Mail Call Forward Conditional Call Forward Immediate Call Hold Call Waiting Caller ID Detailed Billing Direct Bill Detail Message Waiting Ind Nation GSM Three Way Calling UNL Nght Wknd Min Unlimited M2M Expnd Other Services AT &T Direct Bill 04/04 -05/03 0.00 0.00 AT &T Domestic LD 04/04 -05/03 0.00 0.00 Includes: Toll Domestic Toll International AT &T Roam LD 04/04 -05/03 0.00 0.00 Includes: Toll Domestic Toll International GSM Coverage Area 04/04 -05/03 0.00 0.00 Off Network Roam 04/04 -05/03 0.00 0.00 Unlimited Expd M2M 04/04 -05/03 0.00 0.00 Unlimited N &W 04/04 -05/03 0.00 0.00 Wireless Data DATA PAY PER USE 04/04 -05/03 0.00 0.00 Includes: DATA ACCESS Multi medi a-PayPerMsg 04/04 -05/03 0.00 0.00 Text Msg Pay Per Use 04/04 -05/03 0.00 0.00 Includes: Intl Text Messaging Text Messaging TOTAIMONIH7 Y SFRVIC.E CIIA:RGES $12 99 Usage Charges See Usage Charge Details TOTAIUbAG>, CAARGES 07 Credits, Adjustments Other Charges Regulatory Cost Recovery Charge 1.02 Telecom Relay Service Fund 0.03 Federal Universal Service Charge 0.39 at &t Page: 14 of 18 Billing Cycle Date: 04 /04/09 05/03/09 Account Number: 874486198 Foundation Account Number: 02581749 Wireless Line Summary For: (Continued) 317 379 -5842 User Name: COMMUNICATIONS LINE Credits, Adjustments Other Charges Indiana Universal Service 0.04 State Gross Receipts Surcharge 0.18 National Account Discount -2.60 TOTAL: CREDIT 3, ADJUSTM>a NTb_8c .OTHER CI{ARGE'� 94. Government Fees Taxes 9 -1 -1 Service Fee 0 .50 IN State Sales'1'ax 0.91 TOTAL:.GOVERNMENT FEES &.TAXES $'4•S'. Usage Charge Details 31.7- 379 -5842 User Name: COMMUNICATIONS LINE Minutes Summary of Included Minutes Billed Billed Total Usage Charges In Plan Used Minutes Rate Charge OBFRNTN UMIN W Unlimited N &W 19 0.00 D aytime ime 0 1.05 0 5 €_ubtotat F S u tMsg/Min/ KB/MB Msg/Min/ Msg/Min/ Summary of Included KBMB KB /MB Billed Total Wireless Data Plan -Used- Billed Rate Charge DATA PAY PER USE DATA ACCESS 2 2 $0.01 /M3 0.02 Subtotal $0 02 T ®TAY. IJSGE CI�ARGES 1 07; Call Detail 317 -379 -5842 User Name: COMMUNICATIONS LINE Rate Code: UNW9= Unlimited N &W, ODNB= OBFRNTNUM/NW Rate Period (PD): NW= Nwknd, DT= Daytime Number Rate Rate Fea- Airtime LD /Add'i Total Item Day Date Time Called Call To Min Code Pd ture Charge Charge Charge 1 SAT.:_ 04/04 1 20PM S03 21f4 3656 "tNCOMI 1 UNW9 NW 0.00:' 2 -MON 04/06 4.02PM 973 804 -0195 INCOMI'Gl 1 .QDNB 'DT 0.1:5 c3 04/06 6.50M 773-321 2945 INCOMI >GL .1. -ODNB :DT :0.1'5 4 TUE` D41D7 -11 35AM 978;SZ0 2245 =1NCOM1:'CL 1 ODN$' .'DT A:1i5 0.15 5 04/07 7 33PM_. 954 =69:1 9353 tNCOM1�CL .1 _QDNB DT O;i:S 0 15 6 THU 04/09 1:32PM 800- 733 -5641 INCOMI CL 1 ODNB DT 0.15 0.15 7 FRI 04/17 3:07PM 978 570 -2381 INCOMI CL 1 QDNB DT 0.15 0.15 8 THU 04/30 10:10AM 904 863 -0205 INCOMI CL 1 ODNB DT 0.15 0.15 &t Page: 15 of 18 Billing Cycle Date: 04/04/09 05/03/09 LK Account Number: 874486198 Foundation Account Number: 02581749 .Call Detail (Continued) 317- 379 -5842 User Name: COMMUNICATIONS LINE Rate Code: UNW9= Unlimited N &W, ODNB= OBFRNTNUMMW Rate Period (PD): NW= Nwknd, DT= Daytime Number Rate Rate Fea- Airtime [,D /Add'I Total Item Day Date Time Called Call To Min Code Pd ture Charge Charge Charge 9 SAT 05/02 11:49PM 317- 331 -0821 INDIAN IN 1 UNW9 NW 0.00 10 05/02 11:52PM 317 331 -0821 INDIAN IN 1 UNW9 NW 0.00 11. =SUN 05t03'.=i2.24AM= .917 3310821 _INGOMI'CL... i .16 :_liNW9 _;NW 0:00:; Subtotal Minutes 26 1.05 1.05 Totals 26 1U5 1 05; Data Detail 317 379 -5842 User Name: COMMUNICATIONS LINE Rate Code: WXPI =DATA PAY PER USE Rate Period (PD)_ Anytime Feature: GPRR =GPRS not roaming $0.01 rate for APNO02 Rate Rate Fea- In/ Total Item Day Date Time 7b /From Type Msg/KB/Min Code Pd ture Out Charge i MON .;0 U06. 4 04PM _;Data Transfer ::Data. 2K6 WXP1 ..Ai GPRR_ =.Out ..0 02s Subtotal of KB's 2 KB 0.02 Totals 0 02- at Page: 16 of 18 r Billing Cycle Dale: 04 /04/09 05/03/09 Account Number: 874486198 Foundation Account Number 02581749 at &t Page: 17 of 18 Billing Cycle Date: 04 /04/09 05/03/09 Account Number: 874486198 Foundation Account Number: 02581749 Wireless Line Summary For: 317 -565 -9636 User Name: GO BOOK MR l Prorated Monthly Total Monthly Service Charges Period Charge Charge Charge Rate Plan DATACNCFWIFI_NV5GB 04/22 -05/03 24.00 24.00 Includes: Direct Bill Detail Data Services DataConnect_5GB 04/22 -05/03 0.00 0.00 Includes: DATA ACCESS isp.cingular Multimedia- PayPerMsg 04/22 -05/03 0.00 0.00 Other Services S.69 Roam Rate 04/22 -05/03 0.00 0.00 AT &T DirectBill 04/22 -05/03 0.00 0.00 AT &T Home "roll 04/22 -05/03 0.00 0.00 AT &T Roarn Toll 04122 -05/03 0.00 0.00 GSM Coverage Area 04/22 -05/03 0.00 0.00 Voice Restricted 04/22 -05/03 0.00 0.00 Includes: No Incoming Calls No Outgoing Calls t Q f V NIONTFCLY= SERVICI� CTIt1I2GES $24 00 Usage Charges See Usage Charge Details TOTA_t USAGE.GHARGES 0... 00. Credits, Adjustments- Other Charges Activation Fee Credit -36.00 Activation Fee 36.00 Regulatory Cost Recovery Charge 1.02 Federal Universal Service Charge 0.00 Indiana Universal Service 0 State Gross Receipts Surcharge 0.28 National Account Discount -4.80 Government Fees Taxes IN State Sales Tax 1.43 TOTAL GOVFIRNMENT.FFFS &:TAXES 0 t M a Page: t8 of 18 Billing Cycle Date: 04/04/09 05/03/09 Account Number: 874486198 Foundation Account Number 02581749 Usage Charge Details 317-565-9636 User Name: GO BOOK MR I Msg/Min/ KB/iMB MSg/Ml1t/ Msg(Min/ Summary of Included KB11MB KBPMB Billed Total Wireless Data In Plan Used Billed Rate Charge DaIaConnect 5GB isp.cingular 2,097,152 142,953 0.00 .TOTAL (USAGE CHARGES 00 NOTICE OF REVISED ARBITRATION CLAUSE IN CONTRACT We wish to infonn you that, effective immediately, AT&T has revised the arbitration clause in your Wireless Service Agreement. For more inforniation, please visit http://www.att.com/disputeresolution 1 2 6 n VOUCHER NO. WARRANT NO. ALLOWED 20 AT&T Mobility IN SUM OF P.O. Box 6463 Carol Stream, IL 60197 $41.57 ON ACCOUNT OF APPROPRIATION FOR Carmel Clay Communications PO# 1 Dept. INVOICE NO. ACCT #!TITLE AMOUNT Board Members 1115 874486198X051 43- 441.00 $41.57 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, May 18, 2009 Director Title Cost distribution ledger classification if claim paid motor vehicle highway fund 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)) 05/03/09 I874486198XO511 I $41.57 onno I 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