210835 07/17/2012 CITY OF CARMEL, INDIANA VENDOR: 093000 Page 1 of 1
ONE CIVIC SQUARE FEDEX-SHIPPING CHARGES
CHECK AMOUNT: $10.51
�s,?o CARMEL, INDIANA 46032 PO BOX 94515
PALATINE IL 60094-4515 CHECK NUMBER: 210835
CHECK DATE: 7/17/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1115 4350900 793416046 10 . 51 OTHER CONT SERVICES
Invoke Number Invoice Date Account Number Page
7-934-16046 Jun 27, 2012 11 3134-0235-5 1 of
FedEx Tax ID: 71-0427007
Billing Address: Shipping Address:
CARMEL COMMUNICATIONS CARMEL COMMUNICATIONS
31 1 STAVE NW 31 1 STAVE NW Invoice Questions?
CARMEL IN 46032-1715 CARMEL IN 46032-1715 Contact FedEx Revenue Services
Phone: (800)622-1147 M-Sa 7-6(CST)
Fax: (800)548-3020
Invoice Summary Jun 27,2012 Internet: www.fedex.com
FedEx Ground Services
Transportation Charges 6.68
Other Handling Charges 3.83
Total Charges USD $10.51
TOTAL THIS INVOICE USD $10.51
Other discounts may apply.
Detailed descriptions of surcharges can be located atfedex.com
Invoice Number Invoice Date Account Number Page
7-934-16046 Jun 27, 2012 11 3134-0235-5 2of4
Adjustment Request
Fax to (800) 548-3020
Use this form to fax requests for adjustments due to the reasons indicated below. Requests for adjustments
due to other reasons, including service failures, should be submitted by going to www.fedex.com or calling
800.622.1147. Please use multiple forms for additional requests.
C Please complete all fields in black ink.
n Requestor Name I I I I I I I I I I I I I I I I I I I I I I I I I I I I Date l I I/ W! W
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a Phone I I I I I I I I I I I I I Fax# WWW WU I I I I I
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t' E-mail Address ❑Yes,I wantto update account contact with the above information.
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R Tracking Number Bill to Account $Amount
e'1111111111111111 IIIIIIIIII IIIIII• W
billllllllllllllll IIIIIIIIII IIIIII• W
j!IIIIIIIIIIIIIIII llllllllll IIIIII• W
I'IIIIIIIIIIIIIIII IIIIIIIIII 111111• W
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ADR-Address Correction INW-Incorrect Weight OVS- Oversize Surcharge For all Service failures or other
o DVC- Declared Value INS- Incorrect Service RSU- Residential Delivery surcharges please use our web
d e IAN- Invalid Acct# OCF- Gird Pick-up Fee PND- Pwrshp Not Delivered site www.tedex.com or call
OCS-Exp Pick-up Fee SDR- Saturday Delivery (800)622-1147
Rerate information only (round to nearest inch)
C Tracking Number Code $Amount LBS L W H
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tl I I I I I I I I I I I I I I I I I I I I I I I I I I• W l 1 1 ll 1 1 lx I I I I x I I I I
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Invoice Number Invoice Date F Account Number Page
7-934-16046 Jun 27 2012 3134-0235-5 3 of 4
FedEx Ground Shipment Summary By Payor Type
FedEx Ground Shipments(Original)
Rated ITT
Weight iiii
Transportat►on Other Handling Ret Chg/Tax
Qate Shipmerrts Ihs Charges; Charges Credits/Othe Total Charges;
Ground-Prepaid
06115 1 4 6.68 3.83 10.51
Ground-Prepaid Subtotal $10.51
Total FedEx Ground t 4 x.68 S;i 83 $1051:
Total This Invoice USD $10.51
SGZE6LO-L000-6ZL9Z00-00-LO-8(LL
Invoice Number Invoice Date Account Number Page
7-934-16046 Jun 27, 2012 3134-0235-5 4 of 4
FedEx Ground Prepaid Detail (Original)
Pickup D U:::z.15 2012 Cus 6A REFERENCE I NFORMATION P 0#
Payor: Shipper Dept#
Tracking ID 321 003815000067 Sender Recipient Transportation Charge 6.68
Service Type Ppd,Domestic Greg Bedell RA#20120613-2 NDOC P/U-Auto Comm 3.00
Zone 03 Carmel Clay Communications Cen Central Service Center Fuel Surcharge 0.83
Packages 1 31 1st Ave.N.W. 715 N BRIGHT ST Total Charge USD S10.51
Actual Weight 31 Ibs Carmel IN 46032 DECATUR IL 62522
Rated Weight 4 Ibs
Delivered Jun 18,2012
Prepaid Subtotal USD $10.51
Total FedEx Ground USD $10.51
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))
06/27/12 7-934-16046 $10.51
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
FedEx
IN SUM OF $
P.O. Box 94515
Palatine, IL 60094-4515
$10.51
ON ACCOUNT OF APPROPRIATION FOR
Carmel Clay Communications
PO#/Dept. INVOICE NO. I ACCT#/TITLE AMOUNT Board Members
1115 I 7-934-16046 I 43-509.00 I $10.51 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
Thursday, July 12, 2012
Director
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund