215794 12/18/2012 d`=c•F CITY OF CARMEL, INDIANA VENDOR: 366767 Page 1 of 1
` ONE CIVIC SQUARE VAN AUSDALL&FARRAR
CARMEL, INDIANA 46032 PO BOX 713683 CHECK AMOUNT: $445.70
'. d CINCINNATI OH 45271-3683 CHECK NUMBER: 215794
CHECK DATE: 12/18/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1701 4353004 CNIN246630 445 . 70 COPIER
Van Ausdall Lafayette, 45271 Muncie, 45271 South Bend, 45271 INVOICE
& Farrar P.O.Box 713683 P.O.Box 713683 P.O.Box 713683 Page I of 2
(800)467-7474 (800)467-7474 (800)467-7474 MAIL REMITTANCE TO:
® VAN AUSDALL AND FARRAR,INC.
OFFICE TECHNOLOGY o Evansville, 47710 Columbus, 45271 Fort Wayne, 46802 PO BOX 713683,Cincinnati,OH 45271-3683
SOLUTIONS o 1810 First Ave. P.O.Box 713683 3234 Illinois Rd.
SINCE 1914 Phone(317)634-2913 Fax(317)638-1843
Q (812)424-5736 (800)467-7474 (260)432-1547
p Email invoice questions to:
billinq@vanausdall.com
Pay from this invoice.
1 1/2% Monthly- 18% Per Annum - Finance Charge after 30 days. INVOICE NO. TERMS
This is to certify that the merchandise and or services listed on this invoice was manufactured CNIN246630 Net 10
or produced in accordance with the fair labor standards act of 1938 as amended,including
section 12A.
SHIP,VIA': --UPs�
SOLD TO: 103781 SHIP TO: 103781 --'+ � •'
CITY OF CARMEL CITY OF CARMEL DEC
1 CIVIC SQ 1 CIVIC SQ 2 2
DOCS _:.
DOCS
CARMEL IN 46032 ; 4 `
CARMEL, IN 46032 = r
TERMS:NET 10 DAYS. MAKE ALL REMITTANCES TO CINCINNATI. -
ORDER NO. SALES ORDER NO. CUSTOMER P.O.OR REF# SALES REP INVOICE DATE DUE DATE
492327 Mundt,Tom 12/11/2012 12/21/2012
ORD SHIP B.O. U/M DESCRIPTION ITEM NUMBER UNIT PRICE AMOUNT
* Maintenance Contract No. 16089
1 1 0 ea RICOH AFICIO MPC5502A 416077 0.000 0.00
Serial: W542L500535
Machine id:70454
**** CITY OF CARMEL
**** 1 CIVIC SQ
****DOCS
**** CARMEL_IN 46032
CLICKS Used from 6/1,2012 through 11/30/2012
**Black and White
20457 Current Meter Reading
22 Prior Meter Reading
20435 Total CLICKS
20435 Net Billable CLICKS
1 1 0 20435 CLICKS @ 0.004800 Black and White 98.090 98.09
CLICKS Used from 6/1/2012 through 11/30/2012
** Color
8186 Current Meter Reading
7 Prior Meter Reading
SUBTOTAL 98.09
--- --- -
.......... ---- ---------------....- - -
DETACH HERE AND RETURN WITH PAYMENT
Van Ausdall
& Farrar
OFFICE TECHNOLOGY o
SOLUTIONS o
SINCE 1914 � CONTINUED
p
Thank You For Your Business
Van Ausdall Lafayette, 45271 Muncie, 45271 South Bend, 45271 INVOICE
OICE
P.O.Box 713683 RO.Box 713683 P.O.Box 713683 Page 2 of 2
& Farrar (800)467-7474 (800)467-7474 (800)467-7474 MAIL REMITTANCE TO:
VAN AUSDALL AND FARRAR,INC.
,OFFICE TECHNOLOGY`—°O�— Evansville, 47710 Columbus, 45271 Fort Wayne, 46802 PO BOX 713683,Cincinnati,OH 45271-3683
SOLUTIONS 1810 First Ave. P.O.Box 713683 3234 Illinois Rd.
SINCE 1914 Phone(317)634-2913 Fax(317)638-1843
(812)424-5736 (800)467-7474 (260)432-1547 Email invoice questions to:
billinq@vanausdall.com
Pay from this invoice.
1 1/2% Monthly- 18% Per Annum- Finance Charge after 30 days. INVOICE NO. TERMS
This is to certify that the merchandise and or services listed on this invoice was manufactured CNIN246630 Net 10
_ or produced in accordance with the fair labor standards act of 1938 as amended,including
section 12A.
SHIP VIA: UPS
SOLD TO: 103781 SHIP TO: 103781
CITY OF CARMEL CITY OF CARMEL
1 CIVIC SQ
DOCS 1 CIVIC SQ
CARMEL IN 46032 DOCS
CARMEL, IN 46032
TERMS:_NET 10-DAYS..._, MAKE ALL REMITTANCES TO CINCINNATI.
ORDER NO. SALES ORDER NO. CUSTOMER P.O.OR REF# SALES REP INVOICE DATE DUE DATE
492327 Mundt,Tom 12/11/2012 12/21/2012
ORD SHIP B.O. U/M DESCRIPTION ITEM NUMBER UNIT PRICE AMOUNT
8179 Total CLICKS
8179 Net Billable CLICKS
1 1 0 8179 CLICKS @ 0.042500 Color 347.610 347.61
SUBTOTAL 445.70
FREIGHT 0.00
SALES TAX 0.00
nT VAQC n1V TII10 AX41"II T%TT A——
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.
Payee V �/�` k�da 4 Famy-- 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
N SUM OF $
ON ACCOUNT OF APPROPRIATION FOR
Board Members
PO#or INVOICE NO. ACCT#/TITLE AMOUNT
DEPT.# I hereby certify that the attached invoice(s), or
CK(f Jjq 0,O) 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
20
Signature
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund