215694 12/18/2012 CITY OF CARMEL, INDIANA VENDOR: 357004 Page 1 of 1
ONE CIVIC SQUARE KONICA MINOLTA BUSINESS SOLUTIOSECK AMOUNT: $438.57
CARMEL, INDIANA 46032 DEPT CH 19188
oN.o PALATINE IL 60055-9188 CHECK NUMBER: 215694
CHECK DATE: 12/18/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1701 4353004 223085498 438 . 57 COPIER
Invoice Number: 223085498 Please Remit To: K09
KONICA MINOLTA BUSINESS SOLUTIONS
Invoice Date: 12/09/2012 ® USA INC
Page I of 2 DEPT. CH 19188
Subject to E.O.112478 and the regulations
KONICA MINOLTA PALATINE, IL 60055-9188
of the Secretary of Labor on Affirmative For Billing Inquiries Call: 317-870-7000
Action and Equal Opporturnity
CORPORATE DUNS No. 00-170-7322 INVOICE
FEDERAL DUNS No. 62-657-8041
Bill To: Ship To:
CITY OF CARMEL CLERK TREASURER CITY OF CARMEL CLERK TREASURER
1 CIVIC SQ TREASURER JEAN BELCHER
OFC 1 CIVIC SQ TREASURER
CARMEL IN 46032 CARMEL IN 46032
Purchase Order Nbr Delivery Nbr Sales Order Nbr Date Account Nbr
Diana Cordray 42411997 / 08/17/2010 263622 / 261654
Cartons I Tot Weight Carrier Shipping Point Terms of Payment Comments
NET 30 DAYS
Quantity Quantity Quantity
Ordered BackOrdered Material Nbr Description Shipped Unit Net Price Amount
7670882802 Per Copy Charge -Color 157.61
Copies Overage Charge
C451
AOOKO 1 0008945
11/30/2012 40,591
05/30/2012 39,314
Usage 1,277
Tot Usage 1,277
Allowance 0
Overage 1,277 @
0.12342
7670772802 Per Copy Charge-B&W 280.96
Copies Base Charge
. .. ........ ..... ..... .. .. .. ...... ....... .
DETACH HERE AND RETURN WITH REMITTANCE
CUST. NO. INVOICE NO. AMOUNT
CITY OF CARMEL CLERK TREASURER 263622 / 261654 223085498 438.57
1 CIVIC SQ TREASURER DATE ORDER REF. PAYMENT TERMS
OFC
CARMEL IN 46032 12/09/2012 42411997 NET 30 DAYS
SEND YOUR PAYMENT TO:
You may also pay on line at www.MyKMBS.com KONICA MINOLTA BUSINESS SOLUTIONS
using your Payer ID # 263622 USA INC
DEPT. CH 19188
PALATINE, IL 60055-9188
AMERICAN
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Invoice Number: 223085498 Please Remit To: K09
KONICA MINOLTA BUSINESS SOLUTIONS
Invoice Date: 12/09/2012 ® USA INC
Page 2 of 2 DEPT. CH 19188
Subject to E.O.112478 and the regulations
KONICA MINOLTA PALATINE, IL 60055-9188
of the Secretary of Labor on Affirmative For Billing Inquiries Call: 317-870-7000
Action and Equal Opporturnity
CORPORATE DUNS No. 00-170-7322 INVOICE
FEDERAL DUNS No. 62-657-8041
Bill To: Ship To:
CITY OF CARMEL CLERK TREASURER CITY OF CARMEL CLERK TREASURER
1 CIVIC SQ TREASURER JEAN BELCHER
OFC 1 CIVIC SQ TREASURER
CARMEL IN 46032 CARMEL IN 46032
Purchase Order Nbr Delivery Nbr Sales Order Nbr Date Account Nbr
Diana Cordray 42411997 / 08/17/2010 263622 / 261654
Cartons I Tot Wei ht Carrier Shi in PFkff Terms of Payment Comments
NET 30 DAYS
Quantity Quantity Quantity
Ordered BackOrdered Material Nbr Description Shipped Unit Net Price Amount
C451
AOOKOI0008945
11/30/2012 174,575
05/30/2012 171,668
Usage 2,907
Tot Usage 2,907
Allowance 18,000
Overage 0 @
0.01573
TOTAL NBFI OF UNi T S - — -
TOTAL AMT 438.57
Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No.201(Rev.1995)
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.
Paynee,�
I'W V Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s or bill(s))
Total
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.
20
Clerk-Treasurer
VOUCHER NO. WARRANT NO.
ALLOWED 20
IN SUM OF $
ON ACCOUNT OF APPROPRIATION FOR
-� L t �JC U
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
r
Signature
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund