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215376 12/11/2012 CITY OF CARMEL, INDIANA VENDOR: 362456 Page 1 of 1 ONE CIVIC SQUARE NEOGOV s 0 CHECK AMOUNT: $5,555.00 CARMEL, INDIANA 46032 222 N SEPULVEDA BLVD#2000 ED SEGUNDO CA 90254 CHECK NUMBER: 215376 CHECK DATE: 12/11/2012 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 102 4463202 07-8725 5, 555 . 00 SOFTWARE NEOGOV Invoice 222 North Sepulveda Blvd. Suite 2000 DATE INVOICE# El Segundo, CA 90245 12/5/2012 07-8725 BILL TO City of Carmel City of Carmel - Human Resources One Civic Square Carmel, IN 46032 Attn: Barbara Lamb TERMS Net 30 ITEM DESCRIPTION AMOUNT License-PE-Renewal Twelve (12) Month Performance Evaluation Module(From 1/1/2013 to 5,555.00 12/31/2013). Pay your bills online at: https://www.intuitbilipay.com/neogov Please make check(s) payable to GovernmentJobs.com, Inc. (EIN/Tax Payer ID: 33-0888748) Total Due: $5,555.00 For billing questions,or to pay with Visa/MasterCard, please call (310)426-6304 x134 or x110. Payments/Credits $0.00 Thank you for doing business with GovernmentJobs.com, Inc.! Balance Due $5.555.00 VOUCHER NO. WARRANT NO. ALLOWED 20 NeoGov IN SUM OF $ 222 N Sepulveda Blvd El Segundo, CA 90245 $5,555.00 ON ACCOUNT OF APPROPRIATION FOR Carmel Fire Department PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members �Q I 07-8725 1 102-632.02 I $5,555.00 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 d/ 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 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)) 07-8725 $5,555.00 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