215348 12/11/2012 CITY OF CARMEL, INDIANA VENDOR: 366667 Page 1 of 1
ONE CIVIC SQUARE JEFBAR SOFTWARE SERVICES
CARMEL, INDIANA 46032 80 BLUE RAVINE ROAD,STE,230 CHECK AMOUNT: $11,000.00
FOLSOM CA 95630
CHECK NUMBER: 215348
CHECK DATE: 12/11/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
102 4463202 24397 49972 11, 000 . 00 BILLING SOFTWARE
JefBar Software Services Invoice
81 Blue Ravine Rd#230
Folsom, CA 95630 Date Invoice#
11/9/2012 49972
Bill To
City of Carmel IN
APPRO 102-632.02 PO 24397
Michelle Harrington
One Civic Square
Carmel,IN 46032
OA Number(Estimate) Terms
PO 24397 Due on receipt
Quantity Description Rate Amount
1 Billing Software License-Per Contract with 11,000.00 11.000.00
City of Carmel IN
Appropriation Number 102-632.02 PO#
24397
Project Name-JefBar Software Services-
EMS Billing software
Total $11,000.00
Phone# Fax# E-mail Web Site
800-495-2772 916-669-0853 sales @jefbar.com www.jefbar.com
VOUCHER NO. WARRANT NO.
ALLOWED 20
Jefbar Software Services
IN SUM OF $
81 Blue Ravine Road, Suite 230
Folsom, CA 95630
$11,000.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
�s
PO#/Dept. INVOICE NO. ACCT#/TITLE I AMOUNT Board Members
24397 y 49972 1 102-632.02 I $11,000.00 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
DEC 1. 0 2
Fire Chief
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
Nhom, 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))
49972 $11,000.00
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