215719 12/18/2012 CITY OF CARMEL, INDIANA VENDOR: 353739 Page 1 of 1
0 t ONE CIVIC SQUARE NATIONAL LICENSE CHECK AMOUNT: $250.00
�a CARMEL, INDIANA 46032 12591 BROMPTON ROAD
CARMEL IN 46033 CHECK NUMBER: 215719
CHECK DATE: 12118/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1115 4350900 17725 250 . 00 OTHER CONT SERVICES
National License LLC Invoice
voice
12591 Brompton Road
Date Invoice#
Carmel IN 46033
Ph: 317-564-8018 1012212111 17725
Bill To
CARMEL,CITY OF-INDIANA
CARMEL CLAY COMMUNICATIONS CENTER
2 CARMEL CIVIC SQUARE
CARMEL,IN 46032
P.O. No. Terms Project
Due on receipt
Quantity Description Rate Amount
2 FCC Radio License Application Preparation 125.00 250.00
and Filing
KSZ831
KB63238
2 MODIFICATIONS TO CHANGE TO NARROWBAND
I FCC Radio License Ten Year Renewal Fee 0.00 0.00
WPNI579
RENEWED AT NO CHARGE
TODD LUCKOSKI
Thank you for your business.
Total $250.00
VOUCHER NO. WARRANT NO.
ALLOWED 20
National License
IN SUM OF $
998 3Fd-AvaPuo-N-VV—.
Carmel, IN 2- L16033
$250.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel Clay Communications
PO#/Dept. INVOICE N0. I ACCT#/TITLE AMOUNT Board Members
1115 17725 43-509.00 $250.00 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
a
Monday, December , 2012
Director
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))
10/22/12 17725 $250.00
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