214242 11/07/2012 �,\*f CITY OF CARMEL, INDIANA VENDOR: 00350381 Page 1 of 1
0 ONE CIVIC SQUARE BENTLEY SYSTEMS,INC CHECK AMOUNT: $15,000.00
CARMEL, INDIANA 46032 PO BOX 828836
PHILADELPHIA PA 19182-8836 CHECK NUMBER: 214242
CHECK DATE: 11/7/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1202 4351502 27710 47475161 15, 000 . 00 SELECT SUBSCRIPTIONS
mnBenttey'` Invoice
1 Sustaining Infrastructure Page 1 of
Bill to party Summary
Invoice Number 47475161
City of Carmel Invoice Date 08/23/2012
Terry Crockett PO Number
One Civic Square Customer Number 4010851
CARMEL IN 46032-2584, USA Currency USD
Remittance Information SELECT Billing Period 09/21/2012-09/20/2013
Payment Terms: Net 30 Days
RemifPaymer t To: Bentley Systems, Inc. Please reference your customer and invoice number with your
PO Box 828836, Philadelphia, PA 19182-8836 payment.
SWIFT/BIC: PNCCUS33
Account No.: 8013590333
TRANS#031207607
ELECTRONIC DELIVERY
Federal Tax Id.
95-3936623
Item Description Qty Total
10 MicroStation SELECT Subscription 7 5,740.00
30 Bentley WasteWater SELECT Subscription 1 750.00
40 Bentley Water SELECT Subscription 2 1,500.00
80 Bentley Map SELECT Subscription 7 3,430.00
90 Bentley Map PowerView SELECT Sub 12 3,240.00
110 Bentley PowerMap SELECT Subscription 1 340.00
Total Amount 15,000.00
Tax Amount 0.00
Total Invoice Amount 15,000.00
6e�ti\ey Systems,Incorporated 685 Stockton Drive,Exton,PA 19341
Phone: 1 800 513 5103 Fax:+1 (610)458 2779
Website:www,bentley.com E-mail:bac @bentley.com
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Details
Sustaining Infrastructure Page 2 of 2
Invoice Number 47475161
Ship to:
City of Carmel
Terry Crockett
One Civic Square
CARMEL IN 46032-2584, USA
Description Qty Unit Price Gross Price Discount/Surcharge Total
MicroStation SELECT Subscription
09/21/2012-09/20/2013 7 820.00 5,740.00 0.00 5,740.00
Bentley WasteWater SELECT Subscription
09/21/2012-09/20/2013 1 750.00 750.00 0.00 750.00
Bentley Water SELECT Subscription
09/21/2012-09120/2013 2 750.00 1,500.00 0.00 1,500.00
Bentley Map SELECT Subscription
09/21/2012-09/20/2013 7 490.00 3,430.00 0.00 3,430.00
Bentley Map PowerView SELECT Sub
09/21/2012-09/20/2013 12 270.00 3,240.00 0.00 3,240.00
Bentley PowerMap SELECT Subscription
09/21/2012-09/20/2013 1 340.00 340.00 0.00 340.00
Site Subtotal 15,000.00
Tax 0.00 % 0.00
Site Total 15,000.00
Bentley Systems, Incorporated 685 Stockton Drive, Exton, PA 19341
Phone: 1 800 513 5103 Fax: +1 (610)458 2779
Website:www.bentley.com E-mail:bac @bentley.COM
3:
INDIANA RETAIL TAX EXEMPT PAGE
Cit y ®f Carmel CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT
35-60000972 ')
ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES,A/P
CARMEL, INDIANA 46032-2584 VOUCHER, DELIVERY MEMO, PACKING SLIPS,
SHIPPING LABELS AND ANY CORRESPONDENCE.
FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL- 1997
'URCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION
912712012 Bentley Support
Bentley Systems Inc City of Carmel
VENDOR PO O Z-�- O -3)- SHIP Terry Crockett �
nee To 3 Civic Square O A
,zxtorr,:PA—�- 1 Carmel, IN 46032 �_ '�
(31 7)5711-2567
CONFIRMATION BLANKET rO:F�M=EASURE PAYMENTTERMS FREIGHT
QUANTITY UNIT DESCRIPTION UNIT PRICE EXTENSION
Account 43-595.02
1 Each Bentley PowerMap SELECT Subscription 110 $340.00 $340.00
12 Each Bentley Map PowerView SELECT sub 90 $270.00 $3,240.00
7 Each Bentley Map SELECT Subscription 807 $490.00 $3,430.00
2 Each Bentley Water SELECT Subscri pn 40 $750.00 $1,500.00
1 Each Bentley Wastewater SELEC �> ( X30• a $750.00 $750.00
Subscription r awl • <>
7 Each MicroStation SELECT SU n p\on, • 10 •• $820.00 $5,740.00
Sub Total: $15,000.00
Ike
a�
7
Send Invoice To:
City of Carmel
Terry Crockett
3 Civic Square
Carmel, IN 46032- PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
Carmel IS Dept. PAYMENT $15,000.90
• A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O.
NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND
VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED.
SHIPPING INSTRUCTIONS I HEREBY CERJTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN
SHIP REPAID.
THIS APPRO.RIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER.
• ,.�.�
•C.O.D.SHIPMENTS CANNOT BE ACCEPTED.
•PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY
SHIPPING LABELS. L
•THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE Director
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
CLERK-TREASURER
DOCUMENT CONTROL NO. 2 U l 9 1® A.P.V. COPY-SIGN AND RETURN TO CLERK'S OFFICE
VOUCHER NO._ -WARRANT NO. —
ALLOWED 20
IN THE SUM OF$
'I
ON ACCOUNT OF APPROPRIATION FOR
Board Members
PO#or INVOICE NO. ACCT#/TITLE AMOUNT
DEPT.# I 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
20
-..._.....- - -....- - — ------- ---- - ...- ---- ------------------ -
Signature —
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))
08/23/12 47475161 $15,000.00
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
VOUCHER NO. WARRANT NO.
ALLOWED 20
Bentley Systems Inc
IN SUM OF $
685 Stockton Drive
Exton, PA 19341
$15,000.00
ON ACCOUNT OF APPROPRIATION FOR
IS Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT_ Board Members
27710 I 47475161 I 43-515.02 I $15,000.00_ 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
Thursday, November 01,_2012
Director , IS
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund