214351 11/07/2012 „*f CITY OF CARMEL, INDIANA VENDOR: 358122 Page 1 of 1
ONE CIVIC SQUARE L-COM CONNECTIVITY PRODUCTS CHECK AMOUNT $13.45
CARMEL, INDIANA 46032 PO Box 55758
BOSTON MA 02205-5758 CHECK NUMBER. 214351
CHECK DATE. 1117/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1115 4350900 2064642 13 45 OTHER CONT SERVICES
® INVOICE
Global
CS LM '70W 0 0, Please Remit to: Bank Transfers To
Connectivity PO Box 55758 Citibank, B
Boston,MA 02205-5758 Branch#61 1 Boca
Raton,FL
ABA#266-086-554
978-682-6936 978-689-9484 Account 9119834971
Swift Code CI"rlUS33
Account Name.L-corn,Inc.
Invoice# 2064642 Invoice Date 23-®ct-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 EDue Date Purchase Order# Our Order# Order Date
FX GD 23-Oct-12 I 22-Nov-12 VERBAL TODD 3642259 18-Sep-12
Shipment# Terms Buyer Account# Salespeople
1883170 NET 30 TODD LUCKOSKI 171655 70 616
ORO)TYi' UNIT
l IN/'ITEM#/,D ESCRIPTION ~CUSTOMER ITEM# BALANCE SKIPPED PRICE AMOUNT
"Thank you for your order, we appreciate vour business.
5 AXA-NFNFB2 EA 3 3 3 49000 1047
ADP,N-Female to N-Female 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) 1047
conforms to the requirements of your purchase order
CER'T'IFICATE 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) 2.98
Total (USD) 13 45
SHIPPING TRACKING# 045946870633517
Created On 10/23/12 3 41.25 PM Printed On 10/24/)2 7 48 49 AM
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))
10/23/12 2064642 $1345
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
L - Com Global Connectivity IN SUM OF $
P O Box 55758
Boston, MA 02205-5758
$1345
ON ACCOUNT OF APPROPRIATION FOR
Carmel Clay Communications
PO#/Dept. INVOICE NO ACCT#/TITLE AMOUNT Board Members
1115 I 2064642 I 43-509 00 I $1345 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
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund