211837 08/14/2012 CITY OF CARMEL, INDIANA VENDOR: 366094 Page 1 of 1
ONE CIVIC SQUARE KONICA MINOLTA BUSINESS SOLUTIO_CHECK AMOUNT: $582.00
CARMEL, INDIANA 46032 PO BOX 642333
«o� PITTSBURGH PA 15264-2333 CHECK NUMBER: 211837
CHECK DATE: 8/14/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1125 4353004 57529172 291 . 00 COPIER
1091 4353004 57535184 291 . 00 COPIER
Please remember to reference Account Schedule#(s)pertaining to your request(s).
Phone#: 8004-52-1623
Fax: 319-841-6324
Correspondence Only:PO BOX 3083
CEDAR RAPIDS IA 52406-3083
KONICA MINOLTA BUSINESS SOLUTI
P.O.BOX 642333 Billing ID Number 90136136234
PITTSBURGH PA 15264-2333
VisitMyAccountsAt:WWW.CONNECTTOMYACCOUNTS.COM Invoice Number 57529172
18519 1 MB 0.404 Invoice Date 07/29/2012
18519
80 09/09/2012
#BWNHXFZ Due Date:
#0901 3613 6234 8# 291.00
CARMEL CLAY PARKS&RECREATION Current Items Date:
1411 E 116TH ST
CARMEL IN 46032-3455 Total Amount Due: 291.00
I�II�I'11'IIIII�IIIII"IIII"'IIII�IIIII'I'IIII'IIII'I'III'llllll KMPSCH
No
Our Federal Tax Id# 941686094
INVOICE FOR CURRENT ITEMS DUE
Account Schedule Due Date Purchase Order Number Line Item Acct/Sched
Number Equipment Description Amount Total
7725582-001
- - - 0001 KONICA MINOLTA COPIER _
— -} —�-- - SERIAL NUMBER AOP1011009876 --- - —'
09/09/2012 PAYMENT/INSTALUIENT DUE 291.00
ACCOUNT SCHEDULE 7725582-001 TOTAL 291.00
Purchase COPIER- LE49L eEP'f2- LAUG 2 2012 Description A0
P.O.# PorF
G.L.# 112�j-►-02-113�j3p
Buclget
Line Descr— �R
Purchaser Date_
Approval Date
Please include your Billing ID number on all correspondence.
All correspondence should be sent to the correspondence only address,which is indicated on the front of this invoice.
Payments: Please detach the remit to portion of this invoice and mail your payment(s) to our payment processing center using the
return envelope provided. Please send only the remit to portion with your payment - retain the top portion of the invoice for your
records.
Sales, Use, Rental Tax (Tax): The sales, use, or rental tax rate is determined by the location of the leased equipment, when
applicable. Equipment location changes are subject to approval. Prior to the equipment being moved, the lessor is to be notified. Call
the Customer Service number on the front of this invoice for instructions for reporting an equipment location change. If you are sales
tax exempt, fax a completed,signed exemption certificate, including your account schedule number,to the fax number on the front of
the invoice or mail a copy to the correspondence only address on the front of the invoice,Attention: Sales Tax Exemption.
Personal Property Taxes: Personal Property Tax is assessed on leased equipment as required by the local taxing jurisdiction. If
the lessor is required to report and pay the tax bill, the lessee will be billed for reimbursement as agreed to in the lease agreement.
This may be invoiced separately and/or included in this invoice. If the Lessee paid property taxes directly to the taxing jurisdiction in
error,please contact the jurisdiction for instructions to file for a refund and pay the amount on your invoice from the lessor.
Taxes are determined by the location of the leased equipment, when applicable. Equipment location changes are subject to approval.
Prior to the equipment being moved, the lessor is to be notified. Call the Customer Service number on the front of this invoice for
instructions for reporting an equipment location change.
Purchase Order Number(s): For your convenience we can display your purchase order number on your invoice. However, the
contract terms and conditions are not modified in any way by your purchase order. If you need your purchase order number to appear
on the invoice or if you need to update your purchase order information, fax a copy of the purchase order including your account
schedule number(s),the purchase order effective and expiration dates to the fax number on the front of the invoice or mail a copy to
the correspondence only address referenced on the front of this invoice.
Late Charges: To avoid late charges, all payments must be received by the due date. Late charges will be added to your invoice
consistent with the terms and conditions of your contract.
Insurance: Your contract requires you to provide and maintain insurance coverage against all risks of loss for your equipment, and
provide proof of coverage information. Please be sure we are named as LOSS PAYEE and Additional Insured and your account
schedule number appears on the certificate and fax a copy to the fax number on the front of the invoice or mail a copy to the
correspondence only address.
Name Changes: Fax a copy of the amendment that was filed with the secretary of state, including your account schedule number,to
the fax number on the front of the invoice or mail a copy to the correspondence only address. Changes are subject to fees.
Acceptable Forms of Payment: We will accept payments in the form of company checks, (or personal checks in the case of sole
proprietorships), direct debit, or wires only. Cash and cash equivalents are not acceptable forms of payment and such forms of
payment may delay processing or be returned. Furthermore, only you or your authorized agent as approved may remit payments on
these accounts.
Disputed Payments: Without prejudice to any of our rights and remedies under your contract, all written communication
concerning disputed amounts, including any check or other payment instrument that (a) indicates that the written payment constitutes
"payment in full" or is tendered as full satisfaction of a disputed amount or (b) is tendered with other conditions or limitation must be
mailed or delivered to us at the correspondence only address and not to the payment address.
Please remember to reference Account Schedule#(s)pertaining to pour request(s).
Phone#: 800-452-1623
Fax: 319-841-6324
Correspondence Only:PO BOX 3083
CEDAR RAPIDS IA 52406-3083
KONICA MINOLTA BUSINESS SOLUTI
P.O.BOX 642333 Billing ID Number 90136136232
PITTSBURGH PA 15264-2333
Visit MyAccounts At.,WWW.CONNECTTOMYACCOUNTS.COM Invoice Number 5753184
18520 1 MB 0.404 Invoice Date 07/29/2012
18520
#BWNHXFZ
80 Dare Date: 09/09/2012
#0901 3613 6232 0# Current Items Due: 291.00
CARMEL CLAY PARKS&RECREATION
1411 E 116TH ST
CARMEL IN 46032-3455 Total Amount Due: 291.00
KMPBCH
Our Federal Tax Id# 941686094
INVOICE FOR CURRENT ITEMS D UE
Account Schedule Due Date Purchase Order Number Line Item AcctlSched
Number Equipment Description Amount Total
7725582-002
0001 KONICA MINOLTA COPIER
_ - — - SERIAL NUMBER AOP1011009747`
09/09/2012 PAYMENT/INSTALLMENT DUE 2 91.00
ACCOUNT SCHEDULE 7725582-002 TOTAL 291.00
Purchase (!WIER LEA 5EP't 2
Description MC'C E-PI�
P.O.# P or F
G.L.# . I- `?) C)(QL-V RE c F E N7
Budget
Linebescr � v A u G g ,� 2012
Purchaser Date_
Approval Date r A =--- —---
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice of 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.
366094 Konica Minolta Business Solutions Terms
P.O. Box 642333 Date Due
Pittsburgh, PA 15264-2333
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO# Amount
7/29/12 57529172 Copier lease Sep'12 AO $ 291.00
7/29/12 57535184 Copier lease Sep'12 MCC East $ 291.00
Total $ 582.00
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
120
Clerk-Treasurer
i
Voucher No. Warrant No.
366094 Konica Minolta Business Solutions Allowed 20
P.O. Box 642333
Pittsburgh, PA 15264-2333
In Sum of$
$ 582.00
ON ACCOUNT OF APPROPRIATION FOR
101 -General Fund 1 109 - Monon Center
PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members
Dept#
1125 57529172 4353004 $ 291.00 1 hereby certify that the attached invoice(s), or
1091 57535184 4353004 $ 291.00 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
9-Aug 2012
Signature
$ 582.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund
1