209621 06/05/2012 CITY OF CARMEL, INDIANA VENDOR: 353739 Page 1 of 1
ONE CIVIC SQUARE NATIONAL LICENSE
CARMEL, INDIANA 46032 12591 BROMPTON ROAD CHECK AMOUNT: $250.00
CARMEL IN 46033
CHECK NUMBER: 209621
CHECK DATE: 6/5/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1115 4350900 16916 250.00 OTHER CONT SERVICES
National License LLC I voice
12591 Brompton Road Date Invoice
Carmel IN 46033
Ph: 317 -564 -8018 3/2/2012 16916
Bill To
CARMEL, CITY OF INDIANA
CARMEL CLAY COMMUNICATIONS CENTER
2 CARMEL CIVIC SQUARE
CARMEL, IN 46032
P.O. No. Terms Project
Due on receipt
Quantity Description Rate Amount
1 FCC Radio License Application Preparation 250.00 250.00
and Filing
KA73415
KSK266
2 MODIFICATIONS TO CHANGE TO NARROWBAND EMISSION
DESIGNATORS: 1 I K2F3E
TODD LUCKOSKI
DISCOUNTED PRICE
Thank you for your business.
Total $250.00
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))
03/02/12 16916 $250.00
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
1 20
Clerk- Treasurer
VOUCHER NO. WARRANT NO.
ALLOWED 20
National License
IN SUM OF
Carmel, IN 4603 t fbo3 �j
$250.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel Clay Communications
PO# Dept. INVOICE NO. I ACCT #/TITLE AMOUNT Board Members
1115 I 16916 I 43- 509.00 I $250.00 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
Wednesday, May 30, 2012
Director
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund