215180 12/04/2012 CITY OF CARMEL, INDIANA VENDOR: 358080 Page 1 of 1
ONE CIVIC SQUARE SOUTHEASTERN SECURITY CONSULT p��
CARMEL, INDIANA 46032 1853 PIEDMONT ROAD �HCK AMOUNT: $296.00
c.s� SUITE 100 CHECK NUMBER: 215180
MARIETTA GA 30066
CHECK DATE: 12/4/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4341990 60782 166 . 50 CRIMIINAL BACKGROUND
1091 4341990 60782 129 . 50 CRIMIINAL BACKGROUND
Southeastern Security Consultants, Inc. Invoice
SSCJ 1853 Piedmont Road
1853 Piedmont Road DATE INVOICE#
Suite 100 9/25/2012 60782
Marietta, GA 30066
BILL TO SHIP TO
Carmel Clay Parks Carmel Clay Parks
Lynn Russell Lynn Russell
1411 E. 1 16th Street 1411 E. 116th Street
Carmel, IN 46032 Carmel, IN 46032
CUST# TERMS DUE DATE REP TAX ID#
3799 Net 15 10/10/2012 CMG 58-2558254
QTY ITEM DESCRIPTION PRICE AMOUNT
16 S.S.Trace Social Security Trace Report 0.00 0.00
16 AIM Address Information Management Report 0.00 0.00
16 Crim Check Smart Check Criminal History Search 18.50 296.00
16 US Crim US Crim (50 State search for criminal 0.00 0.00
convictions)
16 Sex 011ender Sex Offender Registry Search(50 State search 0.00 0.00
plus the District of Columbia).
09/06/12= 2 forms received
Purchase 10 09/10/12= I form received
Description �Q 9/12/12= 2 forms received
P.O.# 9/18/12= 4 forms received
PorF /19/12= 2 forms received
09/20/12= 2 forms received
rL�iuneg'De7scjr 09/24/12= l form received
09/25/12= 2 forms received
Date ?�(�1(Z
Approval Date
�0 9s�
�f 9 9 - 'f3 6 kS-D
Thank you for your business, prompt payment is appreciated! Late fees(LS%,)may apply
after due dale Total
$296.00
Phone# Fax# E-mail Web Site
866-996-7412 866-996-1292 cbreeden a ssci2000.com w\y\v.ssci2000.com
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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.
358080 Southeastern Security Consultants, Inc. Terms
1853 Piedmont Road, Suite 100 Date Due
Marietta, GA 30066
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO# Amount
9%25/12 60782 Criminal background checks 129.50
9/25/12 60782 Criminal background checks 166.50
Total $296.00
I hereby certify that the attached invoice(s), or bill(s)is(are)true and correct and I have audited same in accordance
with IC 5-11-10-1.6
120
Clerk-Treasurer
Voucher No. Warrant No.
358080 Southeastern Security Consultants, Inc. Allowed 20
1853 Piedmont Road, Suite 100
Marietta, GA 30066
In Sum of$
$ 296.00
ON ACCOUNT OF APPROPRIATION FOR
108 ESE/ 109 Monon Center
PO#or Board Members
INVOICE NO. ACCT#/TITLE AMOUNT
Dept#
1091 60782 4341990 $ 129.50 1 hereby certify that the attached invoice(s), or
1081-99 60782 4341990 $ 166.50 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
29-Nov 2012
�!•,d
Signature
$ 296.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund