213542 10/09/2012 CITY OF CARMEL, INDIANA VENDOR: 358122 Page 1 of 1
ONE CIVIC SQUARE L-COM CONNECTIVITY PRODUCTS CHECK AMOUNT: $319.67
y` CARMEL, INDIANA 46032 PO BOX 55758
>a� BOSTON MA 02205-5758 CHECK NUMBER: 213542
CHECK DATE: 1019/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1115 4350900 2047845 319 . 67 OTHER CONT SERVICES
INV®ICE
LM Global Please Remit to: Bank Transfers To:
C&11-
Connectivity P.0 Box 55758 Citibank,Miami,FL
Boston,MA 02205-5758 Branch#61-Boca Raton,FL.
ABA 9 266-086-554
978-682-6936 978-689-9484 Account 9119834971
Swift Code:CITIUS33
Account Name L-coin,Inc.
Invoice # 2047845 Invoice Date 18-Sep-12 Page # 1 US funds only
Sold CARMEL,CITY OF COMMUNICATIONS DEPT
To: 31 FIRST AVE NW Ship CARMEL, CITY OF COMMUNICATIONS DEPT
CARMEL, IN 46032 To: Attn: VERBAL TODD
31 FIRST AVE NW
CARMEL, IN 46032
Ship'via Ship Date Due Date Purchase Order# Our Order# Order Date
FX GD 18-Sep-12 18-Oct-12 VERBAL TODD 3642259 18-Sep-12
Shipment# Terms Buyer Account# Salespeople
1849864 NET 30 TODD LUCKOSKI 171655 70 616
P ORD QTY/ UNIT
LIN/rrEbI#/DESCRIPTION •CUSTOMER ITEM# U/AI BALANCE SHIPPED.„ PRICE : AA40U VT
Thank you for your order,we appreciate your business.
I CA-AM_NMCN 19 EA 1 1 14.99000 . 14.99
CA,CA100 ALPROX/NM'19 IN� 0
2 CA-AMNMCN19 EA 2 2 14.99000 29.98
CA,CA 100 ALPROX/NM 19 IN 0
3 HGV-4907U EA 2
2 99.99000 199.98
ANT,Omni 4.9GHz 7dBi 0
4 CA-NMNMH005 EA 3 3 22.25000 66.75
CA,NM/NM 5FT CA-40OUF 0
ALL CLAIMS MUST BE MADE SEVEN(7)DAYS AFTER RECEIPT.
CERTIFICATE OF COMPLIANCE:This is to certify that the product shipped against your purchase order Subtotal (USD) 311.70
conforms to the requirements of your purchase order.
CERTIFICATE OF ORIGIN:This Certifies the items listed above originated in the country indicated on the -
individual packaging label.Thomas Barczak,Corporate Quality Manager
Freight(USD) 7.97
Total(USD) 319.67
SHIPPING TRACKING# 045946870617296
Created On: 09/18/12 5:32:58 PM Printed On: 09/19/12 7:36:00 AM
VOUCHER NO. WARRANT NO.
ALLOWED 20
L - Corn Global Connectivity
IN SUM OF $
P.O. Box 55758
Boston, MA 02205-5758
$319.67
ON ACCOUNT OF APPROPRIATION FOR
Carmel Clay Communications
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1115 I 2047845 I 43-509.00 I $319.67 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
Director
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
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))
09/18/12 2047845 $319.67
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