208248 04/15/2012 a CITY OF CARMEN, INDIANA VENDOR: 366184 Page 1 of 1
ONE CIVIC SQUARE COMMUNICATIONS SPECIALTIES INC
CARMEL, INDIANA 46032 55 CABOT COURT CHECK AMOUNT: $640.00
HAUPPAUGE NY 11788
CHECK NUMBER: 208248
CHECK DATE: 4/25/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1115 4350900 52710 640.00 OTHER CONT SERVICES
MGM
Comm o°r as i c n U mra
INVOICE
Specialties. Inc. invoice #'r Invoice Dale Page
55 Cabot Court, Hauppauge, NY 11788 Phone: (631) 273 -0404 Fax: (631) 273 -1638 00052710 4/4/2012 1
Bill To: Ship To:
CARMEL COMMUNICATION CENTER CARMEL COMMUNICATION CENTER
31 1STAVE NW 31 1STAVE NW
CARMEL, IN 46032 317 571 -2586
USA CARMEL, IN 46032
USA
n' CUSTOMER TERMS
PO NUMBER a
r, SHIP VIA F.O.B. POINT
PO #27697/RMA #11277 NET 30 UPS GROUND ORIGIN
ORDERED BY SALESREPRESENTATIVE ORDER' DATE `.'OUR ORDER# I.,CUSTOMERID.'
GREG BEDELL PAUL SEIDEN 3/22/2012 20050679 15983
fr,
I, QUANTITY x DESCRIPTION
r
r r. .illl
l DL ORDERED SHIPPED "PART IDENTIFIER COMMENTS UNIT UNIT PRICE i r E' XTENDED PRICE
01 01 2.00 2.00 RP9115 REPAIR OF 2240 EA 300.0000 600.00
DEUCE SDQ
1z1561270362354539
QCA20050902
REPALCED 5V POWER SUPPLI
QCA20050905
REPLACED PWB.
WGT: 0.00 EXT WGT: 0.00 Oz
,LINE ITEM TOTALS'" .DISCOUNT SUB TOTAL ,FREIGHT I TAXABLE AMOUNT a TAX' MISC 'INVOICE TOTAL
600.00 0.00 600.00 40.00 0.00 0.00 0.00 640.00
*Note: No discounts may be taken on credit card payments
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))
04/04/12 52710 $640.00
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
Communications Specialties, Inc.
IN SUM OF
55 Cabot Court
Hauppauge, NY 11788
$640.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel Clay Communications
PO# Dept. INVOICE NO. ACCT #!TITLE AMOUNT Board Members
1115 52710 43- 509.00 I $640.00
hereby certify that the attached invoice(s), or
I I
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
Wednesday, April 18, 2012
Director
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund