213514 10/09/2012 CITY OF CARMEL, INDIANA VENDOR: 162800 Page 1 of 1
ONE CIVIC SQUARE INFORMATION SERVICES AGEN.
CARMEL, INDIANA 46032 200 E WASHINGTON CHECK AMOUNT: $175.00
?• SUITE 1942
CHECK NUMBER: 213514
INDIANAPOLIS IN 46204-3327
CHECK DATE: 10/9/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1115 4350900 175 . 00 OTHER CONT SERVICES
INFORMATION SERVICES AGENCY
OF INDIANAPOLIS AND MARION COUNTY
.�. 200 East Washington Street
Suite 1942
Indianapolis,Indiana 46204-3327
Chargeback Account Invoice/Statement
Statement Date: 8131112
Bill To Pay To
Account X800830
Carmel Clay Communication Ctr Information Services Agency
31 First Avenue Northwest 200 E.Washington
Suite 1960
Carmel, IN 46032 Indianapolis, IN 46204
ATTN:Janet Arnone
Rate Description Units Amount YTD Units YTD Amount
Base Billing Information
Base Rate 0.00 $150.00 0.00 $1,200.00
Monthly Access Fee 0.00 $25.00 0.00 $200.00
SubTotal:Base Billing Information 0.00 $175.00 0.00 $1,400.00
Total For: Current Month 0.00 $175.00 0.00 $1,400.00
Total For: Carmel Clay Communication Ct $175.00
VOUCHER NO. WARRANT NO.
ALLOWED 20
Information Services Agency
IN SUM OF $
200 E. Washington Street, Ste.1942
Indianapolis, IN 46204
$175.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel Clay Communications
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1115 I I 43-509.00 I $175.00 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
Tuesday, October 02, 2012
21 Dire for
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
i
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))
08/31/12 $175.00
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