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Home My WebLink About216319 01/15/2013 CITY OF CARMEL, INDIANA VENDOR: 353561 Page 1 of 1 ONE CIVIC SQUARE BRIGHT HOUSE NETWORK CHECK AMOUNT: $7,112.25 o CARMEL, INDIANA 46032 Po Box 30262 TAMPA FL 33630-3262 CHECK NUMBER: 216319 CHECK DATE: 1/15/2013 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1110 4355400 64 . 95 403944601 1120 4344000 1, 009 . 80 400159201 1120 4344000 1, 009 . 80 402836002 1120 4344000 1, 009 . 80 403312201 1120 4344000 1, 009 . 80 403917601 1202 4353099 409 . 80 400159201 1202 4353099 409 . 80 402836002 1202 4353099 409 . 80 40312201 1202 4353099 409 . 80 403917601 601 5023990 1, 368 . 90 401398901 lil! -- bright house Account # Billing Period Due Date Amount Due NETWORKS 403944601 01/13-02/12 01/24/13 $64.95 "l Service Address: Customer Code: 6104 Apt PI Hse This statement reflects payments received through January 3, 2013. 1411E 116th St Carmel IN 46032 ® Previous Activity Previous Balance ....................................... $64.95 Payments Received .........:................................................ $64.95 CR EASYPay Previous Remaining Balance $0.00 .. ............................................. Go paperless! Sign up for EASYPay ® and enjoy the convenience of automatic recurring online bill Current Charges payments. EASYPay lets you review High Speed Internet services ............................................ $64.95 your monthly statements online and --m ¢-- -- Total-.Balance-Due_............................................................$64.95_.. even select your method of payent. ® Get started today at brighthouse.com/myservices or call Thank you for your business. You are a valued Bright House Networks customer. We 1-855-222-1012. are committed to bringing you the best in home entertainment and information. In order to avoid a minimum late fee of$4.50',your Total Balance Due must be received in our office no later than 01/24/13. Thank You Important Information: Customer Code (Located below Your Account Number) Your customer code is,a unique identifier that we use to ensure the protection of your personal information. You may be asked to identify your customer code when _ ..-_. registering for online access to your account and billing information. You will have to EASYpay: Sign-up todayl enter your Customer Code during the Home Phone registration process. If this process Never miss a payment again. Pay is not completed you will not be able to view your Bright House Networks call details your bill automatically each month online. with a credit card, debit card, checking or savings account. You For immediate closed captioning complaints, please call 1-800-753-2253. Written can sign-up by filling out the complaints may be mailed to D. Kramer, Closed Captioning Coordinator, at Bright EASYpay enrollment form included House Networks, 3030 Roosevelt Ave, Indianapolis, IN 46218 or by on the back of this statement or fax(317)713-0043 or email to ClosedCaptionini�IND @mvbrij�hthouse.com i. enroll online at brighthouse.com E - i I� a ' bgt�� i� Customer Account 403944601 Detail 1111 ®use Monthly Charges for 01/13-02/12 NETWORKS T� Payment History Fauthorize nvenience, if you 12/31 Payment-Thank you! ............................................... $64.95 CR ck as payment, you High Speed Internet services ght House Networks ormat ion from your 01/13-02/12 10Mbps X 1Mbpsps ................................................. $64.95 check to make a one-time electronic fund transfer from your Monthly Charges ................................................................................. $64.95 account. If you have any Previous Remaining Balance $0.00 ................................................................. questions, please call our Customer Care number. To assist Total Balance Due ......••••°••°........................••°°......•••••°..................• $64.95 you in future payments, your bank or credit card information may be electronically stored in our system in a_secure encrypted manner. Sales &Service Center 352(Gradle Drive Carmel, IN 46032 Mon-Fri 8:00am to 6:00pm Saturday 9:00am to 1:00pm If you have any questions or for customer support, please call Business Solutions at 1(866) 713-3278 or visit our website at htt r)://business.briohthouse.com . Fiber Customers, please call 1(866) 246-3423. LPIeasemail all questions and concerns to: customersupport.indiana @mybrighthouse.com Your franchising authority is the Indiana Utility Regulatory Commission,101 W.Washington St.,Suite 1500 E., Indianapolis,IN 46204,(317)232-2712 or toll free 1-800-851-4268.Your FCC Community Unit ID number is IN0087. VOUCHER NO. WARRANT NO. ALLOWED 20 Bright House IN SUM OF $ P.O. Box 30262 Tampa, FL 33630-3262 $64.95 ON ACCOUNT OF APPROPRIATION FOR Carmel Police Department PO#/Dept. INVOICE NO. I ACCT#/TITLE AMOUNT Board Members 1110 I 43-554.00 $64.95 I hereby certify that the attached invoice(s), or I I 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 Thursday, January 10, 2013 Chief of Police 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)) 01/13/13 monthly payment $64.95 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 bright house Account # Billing Perlod Due Date Amount Due NETWORKS 403917601 01/13-02/12 01/24/13 $1,419.60 Service Address: Customer Code: 1772 5032E 131st St This statement reflects payments received through January 3, 2013. Carmel IN 46033 �. Previous Activity Previous Balance ........................................................ $1,419.60 - - - - Payments Received ...................... $1,419.60 CR EASYPay Previous Remaining Balance ............... $0.00 Go paperless! Sign up for EASYPay """""" "' ' "' "' ® and enjoy the convenience of automatic recurring online bill Current Charges payments. EASYPay lets you review High Speed Internet services .......................................$1,400.00 your monthly statements online and Taxes-and-Fees_.................., ..... _ $19.60_ even select your method of payment: "' """ — -- - ® Get started today at Total Balance Due ..................... $1,419.60 brighthouse.com/myservices or call 1-855-222-1012. Thank you for your business. You are a valued Bright House Networks customer. We are committed to bringing you the best in home entertainment and information. In order to avoid a minimum late fee of$4.50,your Total Balance Due must be received in our office no later than 01/24/13. Thank You Important Information: Customer Code (Located below your Account Number) - = Your customer code is a unique identifier that we use to ensure the protection of your personal information. You may be asked to identify your customer code when EASYpay: Sign-up todayl registering for.online access to your account and billing information. You will have to Never miss a payment again. Pay enter your Customer Code during the Home Phone registration process. If this process your bill automatically each month is not completed you will not be able to view your Bright House Networks call details with a credit card, debit card, online. checking or savings account. You can sign-up by filling out the For immediate closed captioning complaints, please call 1-800-753-2253. Written EASYpay enrollment form included complaints may be mailed to D. Kramer, Closed!Captioning Coordinator, at Bright i' on the back of this statement or House Networks, 3030 Roosevelt Ave, Indianapolis, IN 46218 or by enroll online at brighthouse.com fax(317)713-0043 or email to ClosedCaationinglND Qmybrighthouse.com bright house *;;N c FMonthmly Account 403917601 Detail � arges for 01/13-02/12 NETWORKS TY Payment History Futhorize venience, if you 12/31 Payment-Thank you! .......................................... $1,419.60 CR as payment, you High Speed Internet services t House Networks mation from your 01/13-02/12 Point to Poin t Connectivity .................................. $1,400.00 check to make a one-time Taxes and Fees electronic fund transfer from your account. If you have any Indiana Utility Receipts Tax ....................................... $19.60 questions, please call our Customer Care number. To assist Monthly Charges ........................................................................... $1,419.60 you in future payments, your bank Previous Remaining Balance $0.00 .............................................................. . or credit card information may be D l l Balance aance ue electronically stored in our system To ............................................................••••.......•• $1,419.60 in a secure encrypted manner. Sales &Service Center 352 Gradle Drive Carmel, IN 46032 Mon -Fri 8:00am to 6:00pm Saturday 9:00am to 1:00pm If you have any questions or for customer support, please call Business Solutions at 1(866) 713-3278 or visit our website at http://business.brij?hthouse.com . Fiber Customers, please call 1(866)246-3423. Please email all questions and concerns to: customersupport.indiana @mybrighthouse.com Your franchising authority is the Indiana Utility Regulatory Commission,101 W.Washington St.,Suite 1500 E., Indianapolis,IN 46204,(317)232-2712 or toll free 1-800-851-4268.Your FCC Community Unit ID number is IN0087. li® bright house Account # Billing Period Due Date Amount Due NETWORKS � �'� 402836002 01/15-02/14 01/24/13 $1,419.60 Service Address: Customer Code: 4983 540 W 136th St This statement reflects payments received through January 3, 2013. Carmel IN 46032 ® Previous Activity Previous Balance $1,419.60 Payments Received ...........................................:......... $1,419.60 CR EASYPay Previous Remaining Balance $0.00 Go paperless! Sign up for EASYPay . ............................................. ® and enjoy the convenience of es automatic recurring online bill Current Charges payments. EASYPay lets you review High Speed Internet services ..................... $1,400.00 your monthly statements online and Taxes_and_Fees_.......... x$19.60 even select your method of`payrrent—` f - - — -- - —F Total Balance Due $1,419.60 ® ' Get started today at ..................................................... , I: ' brighthouse.com/myservices or call 1-855-222-1012. Thank you for your business. You are a valued Bright House Networks customer. We i• are committed to bringing you the best in home entertainment and information. In order to avoid a minimum late fee of$4.50,your Total Balance Due must be received in our office no later than 01/24/13. Thank You Important Information: Customer Code (Located below your Account Number) Your customer code is a unique identifier that we use to ensure the protection of your EASYpay: Sign-up today! personal information. You may be asked to identify your customer code when registering for online access to your account and billing information. You will have to Never miss a payment again. Pay enter your Customer Code during the Home Phone registration process. If this process your bill automatically each month is not completed you will not be able to view your Bright House Networks call details with a credit card, debit card, online. checking or savings account. You can sign-up by filling out the For immediate closed captioning complaints, please call 1-800-753-2253. Written EASYpay enrollment form included complaints may be mailed to D. Kramer, Closed Captioning Coordinator, at Bright on the back of this statement or House Networks, 3030 Roosevelt Ave, Indianapolis, IN 46218 or by enroll online at brighthouse.com fax(317)713-0043 or email to CloseclCaptioninglND @mybrighthouse.com right � Customer Account 402836002 Detail use W Monthly Charges for 01/15-02/14 NETWORKS TM Payment History For your convenience, if you 12/31 Payment-Thank you! .......................................... $1,419.60 CR Cauthorize rovide a check as payment, you High Speed Internet services Bright House Networks o use the information from your 01/15-02/14 Point to Point Connectivity .................................. $1,400.00 check to make a one-time Taxes and Fees electronic fund transfer from your account. If you have any Indiana Utility Receipts Tax ....................................... $19.60 questions, please call our Customer Care number. To assist Monthly Charges ........................................................................... $1,419.60 you in future payments, your bank Previous Remaining Balance ................................................................. $0.00 or credit card information may be electronically stored in our system Total Balance Due ......................................................................... $1,419.60 in a secure encrypted manner. Sales &Service Center 352 Gradle Drive Carmel, IN 46032 Mon -Fri 8:00am to 6:00pm Saturday 9:00am to 1:00pm If you have any questions or for customer support, please call Business Solutions at 1(866)713-3278 or visit our website at http:(/business.brighthouse.com . Fiber Customers, please call 1(866)246-3423. Please email all questions and concerns to: customersupport.indiana @mybrighthouse.com Your franchising authority is the Indiana Utility Regulatory Commission,101 W.Washington St.,Suite 1500 E., Indianapolis,IN 46204,(317)232-2712 or toll free 1-800-851-4268.Your FCC Community Unit ID number is IN0087. bright houseAccount # Billing Period Due Date Amount Due NETWORKS �•� 403312201 01/15-02/14 01/24/13 $1,419.60 Service Address: Customer Code: 8449 3610 W 106th St This statement reflects payments received through January 3, 2013. Carmel IN 46032 Previous Activity Previous Balance $1,419.60 Payments Received ......:....... EASYPay ...................................................... $1,419.60 CR Go paperless! Sign up for EASYPay Previous Remaining Balance. .:........................................... $0.00 and enjoy the convenience of ® is automatic recurring online bill Current Charges payments. EASYPay lets you review High S eed Internet services .......................$1,400.00 your monthly statements online and - -- ---- — �—Taxes-and_Fees.. _ $19.600 even select your method of payment: Total Balance Due ........ $1419.60 ® � Get started today at + brighthouse.com/myservices or call !`. 1-855-222-1012. Thank you for your business. You are a valued Bright House Networks customer. We are committed to bringing you the best in home entertainment and information. In order to avoid a minimum late fee of$4.50;your Total Balance Due must be received in our office no later than 01/24/13. Thank You Important Information: Customer Code (Located below your Account Number) Your customer code is a unique identifier that we use to ensure the protection of your EASYpay: Sign-up today! personal information. You may be asked to identify your customer code when registering for online access to your account and billing information. You will have to Never miss a payment again. Pay enter your Customer Code during the Home Phone registration process. If this process your bill automatically each month is not completed you will not be able to view your Bright House Networks call details with a credit card, debit card, online. I; checking or savings account. You f i can sign-up by filling out the ` For immediate closed captioning complaints, please call 1-800-753-2253. Written EASYpay enrollment form included complaints may be mailed to D. Kramer, Closed Captioning Coordinator, at Bright i; on the back of this statement or House Networks, 3030 Roosevelt Ave, Indianapolis, IN 46218 or by enroll online at brighthouse.com fax(317)713-0043 or email to ClosedCaptioningIND @mvbrighthouse.com 777,777, 77-1 i -- - i g ht FMonthmlyeCharges Account 403312201 Detail house for 01/15-02/14 NETWORKS n Payment History For your convenience, if you 12/31 Payment-Thank you! .......................................... $1,419.60 CR provide a check as payment, you High Speed Internet services authorize Bright House Networks to use the information from your 01/15-02/14 Point to Point Connectivity .................................. $1,400.00 check to make a one-time Taxes and Fees electronic fund transfer from your account. If you have any Indiana Utility Receipts Tax ....................................... $19.60 questions, please call our Customer Care number. To assist Monthly Charges ........................................................................... $1,419.60 you in future payments, your bank Previous Remaining Balance ....... $0.00 .......................................................... or credit card information may be electronically stored in our system Total Balance Due ......................................................................... $1,419.60 in a secure encrypted manner. Sales &Service Center 352 Gradle Drive Carmel, IN 46032 Mon- Fri 8:OOam to 6:OOpm Saturday 9:OOam to 1:OOpm If you have any questions or for customer support, please call Business Solutions at 1(866) 713-3278 or visit our website at http://business.brighthouse.com . Fiber Customers, please call 1(866)246-3423. Please email all questions and concerns to: customersupport.indiana @mybrighthouse.com brightr' house Account # Billing Period Due Date Amount Due NETWORKS �'^^ 400159201 01/15-02/14 01/24/13 $1,419.60 Service Address: Customer Code: 9490 3242E 106th St This statement reflects payments received through January 3, 2013: Carmel IN 46033 r... Previous Activity Previous Balance $1419.60 - Payments Received ....................................... $1,419.60 CR EASYPay Previous Remaining Balance $0.00 l` Go paperless! Sign up for EASYPay g """"""""""""""""""""""' ® and enjoy the convenience of automatic recurring online bill Current Charges payments. EASYPay lets you review High Speed Internet services $1,400.00 your monthly statements online and - 7- —Taxes:and_Fees....:........................................... ... $_19.60_. method of payment. even select your - - """ - ® Total Balance Due I' Get started today at ..................................................... $1,419.60 is brighthouse.com/myservices or call 1-855-222-1012. Thank you for your business. You are a valued Bright House Networks customer. We ii are committed to bringing you the best in home entertainment and information. In order to avoid a minimum late fee of$4.50',your Total Balance Due must be received in our office no later than 01/24/13. Thank You Important Information: Customer Code (Located below your Account Number) Your customer code is a unique identifier that we use to ensure the protection of your EASY pay: personal information. You may be asked to identify your customer code when p y: Sign-up today! registering for online access to your account and billing information. You will have to ' Never miss a payment again. Pay enter your Customer Code during the Home Phone registration process. If this process your bill automatically each month is not completed you will not be able to view your Bright House Networks call details I. with a credit card, debit card, online. j! checking or savings account. You ii can sign-up by filling out the For immediate closed captioning complaints, please call 1-800-753-2253. Written I EASYpay enrollment form included complaints may be mailed to D. Kramer, Closed Captioning Coordinator, at Bright !4 on the back of this statement or House Networks, 3030 Roosevelt Ave, Indianapolis, IN 46218 or by enroll online at brighthouse.com fax(317)713-0043 or email to ClosedCaptioninaIND @mvbriahthouse.com f; I r ' h Customer Account 400159201 Detail house Monthly Charges for 01/15-02/14 NETWORKS ^' Payment History Futhorize nvenience, if you 12/31 Payment-Thank you! .......................................... $1,419.60 CR ck as payment, you High Speed Internet services ght House Networks ormation from your 01/15-02/14 Point to Point Connectivity .................................. $1,400.00 check to make a one-time Taxes and Fees electronic fund transfer from your account. If you have any Indiana Utility Receipts Tax ....................................... $19.60 questions, please call our Customer Care number. To assist Monthly Charges ........................................................................... $1,419.60 you in future payments, your bank Previous Remaining Balance $0.00 .............................................................. . or credit card information may be Total Balance Due $1,419.60 electronically stored in our system ° ° °°° °° in a secure encrypted manner. _j Sales &Service Center 352 Gradle Drive Carmel, IN 46032 Mon- Fri 8:00am to 6:00pm Saturday 9:00am to 1:00pm If you have any questions or for customer support, please call Business Solutions at 1(866)713-3278 or visit our website at httr)://business.brij�hthouse.com . Fiber Customers, please call 1(866)246-3423. Please email all questions and concerns to: customersupport.indiana @mybrighthouse.com Your franchising authority is the Indiana Utility Regulatory Commission,101 W.Washington St.,Suite 1500 E., Indianapolis,IN 46204,(317)232-2712 or toll free 1-800-851-4268.Your FCC Community Unit ID number is IN0087. VOUCHER NO. WARRANT NO. ALLOWED 20 Brighthouse IN SUM OF $ P.O. Box 30262 Tampa, FL 33630-3262 $5,678.40 ON ACCOUNT OF APPROPRIATION FOR Carmel Fire Department PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members 1120 403917601 1202-530.99 $409.80 1 hereby certify that the attached invoice(s), or 1120 400159201 1202-530.99 $409.80 bill(s) is (are) true and correct and that the 1120 403312201 1202-530.99 $409.80 materials or services itemized thereon for 1120 402836002 1202-530.99 $409.80 which charge is made were ordered and 1120 403917601 43-440.00 $1,009.80 received except 1120 403312201 43-440.00 $1,009.80 JAN 1 4 2013 1120 400159201 43-440.00 $1,009.80 1120 402836002 43-440.00 $1,009.80 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)) 403917601 IT Portion-44 $409.80 400159201 IT Portion-43 $409.80 403312201 IT Portion-42 $409.80 402836002 IT Portion-46 $409.80 403917601 44- Fiber $1,009.80 403312201 42- Fiber $1,009.80 402836002 46- Fiber $1,009.80 400159201 43- Fiber $1,009.80 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 bright house Account # Billing Period Due Date Amount Due NETWORKS 401398901 01/19-02/18 01/27/13 $1,368.90 Service Address: Customer Code: 3711 3450 W 131st St This statement reflects payments received through January 7, 2013. ' Carmel IN 46074 Previous Activity Previous Balance $1,368.90 -_ Payments Received ..................................................... $1,368.90 CR EASYPay Previous Remaining Balance ... $0.00 Go paperless' Sign up for EASYPay ® ! and enjoy the convenience of automatic recurring online bill Current Charges payments. EASYPay lets you review High Speed Internet services ....................................... $1,350.00 your monthly statements online and — _______ Taxes-and-Fees,_:..............:.................................................. even-se ect your method of payment. Total Balance Due .......... Get started today at ..................•••••........•••.......•• $1,368.90 brighthouse.com/myservices or call �i 1-855-222-1012. Thank you for your business. You are a valued Bright House Networks customer. We are committed to bringing you the best in home entertainment and information. I In order to avoid a minimum late fee of$4.50,your Total Balance Due must be I received in our office no later than 01/27/13. Thank You �i Important Information: Customer Code (Located below Your Account Number) Your customer code is a unique identifier that we use to ensure the protection of your EASYpay: Sign-up today! personal information. You may be asked to identify your customer code when registering for online access to your account and billing information. You will have to Never miss a payment again. Pay enter your Customer Code during the Home Phone registration process. If this process your bill automatically each month is not completed you will not be able to view your Bright House Networks call details j with a credit card, debit card, 'l checking or savings account. You online. {` can sign-up by filling out the For immediate closed captioning complaints, please call 1-800-753-2253. Written �I EASYpay enrollment form included complaints may be mailed to D. Kramer, Closed Captioning Coordinator, at Bright p on the back of this statement House Networks, 3030 Roosevelt Ave, Indianapolis, IN 46218 or.by enroll online at brighthouse.com fax(317)713-0043 or email to ClosedCaptioning lND @mybrighthouse.com rI / bright house Customer Account 401398901 Detail NETWORKS Monthly Charges for 01/19-02/18 TM Payment History For your convenience, if you 12/31 Payment-Thank you! .......................................... $1,368.90 CR raut hori ze vide a check as payment, you High Speed Internet services Bright House Networks use the information from your 01/19-02/18 Point to Point Connectivity .................................. $1,350.00 check to make a one-time Taxes and Fees electronic fund transfer from your account. If you have any Indiana Utility Receipts Tax ....................................... $18.90 questions, please call our Customer Care number. To assist Monthly Charges ........................................................................... $1,368.90 you in future payments, your bank Previous Remaining Balance ................................................................. $0.00 or credit card information may be electronically stored in our system Total Balance Due ......................................................................... $1,368.90 in a secure encrypted manner. F�Sales Service Center Gradle Drive el, IN 46032 Mon-Fri 8:00am to 6:00pm Saturday 9:00am to 1:00pm If you have any questions or for customer support, please call Business Solutions at 1(866)713-3278 or visit our website at http://business.brig_hthouse.com . Fiber Customers, please call 1(866)246-3423. LPleasequestions and concerns to: customersupport.indiana @mybrighthouse.com Your franchising authority is the Indiana Utility Regulatory Commission,101 W.Washington St.,Suite 1500 E., Indianapolis,IN 46204,(317)232-2712 or toll free 1-800-851-4268.Your FCC Community Unit ID number is IN0087. VOUCHER# 123275 WARRANT # ALLOWED 353561 IN SUM OF $ BRIGHT HOUSE NETWORK PO BOX 30262 TAMPA, FL 33630-3262 Carmel Water Utility ON ACCOUNT OF APPROPRIATION FOR k Board members PO # INV# ACCT# AMOUNT Audit Trail Code i 401398901 01-6360-06 $1,368.90 'i- i Voucher Total $1,368.90 Cost distribution ledger classification if claim paid under 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 of service rendered, by whom, rates per day, number of units, price per unit, etc. Payee 353561 BRIGHT HOUSE NETWORK Purchase Order No. PO BOX 30262 Terms TAMPA, FL 33630-3262 Due Date 1/10/2013 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) Amount 1/10/2013 401398901 $1,368.90 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 Date Officer