216693 01/29/2013 f CITY OF CARMEL, INDIANA VENDOR: 093000 Page 1 of 1
ONE CIVIC SQUARE FEDEX-SHIPPING CHARGES CHECK AMOUNT: $11.88
CARMEL, INDIANA 46032 Po Box 94515
PALATINE IL 60094x515 CHECK NUMBER: 216693
CHECK DATE: 1/29/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1115 4342100 2-145-75186 11 . 88 POSTAGE
Invoice Number Invoice Date Account Number Page
2-145-75186 Jan 16, 2013 1 of
FedEx Tax ID: 71-0427007
Billing Address: Shipping Address:
CARMEL COMMUNICATIONS CARMEL COMMUNICATIONS
31 1ST AVE NW 31 1ST AVE NW
CARMEL IN 46032-1715 CARMEL IN 46032-1715 Invoice Questions?
Contact FedEx Revenue Services
Phone: (800)622-1147 M-Sa 7-6(CST)
Fax: (800)548-3020
Invoice Summary Jan 16,2013 Internet: www.fedex.com
FedEx Ground Services
Transportation Charges 8.10
Other Handling Charges 3.78
Total Charges USD $11.88
TOTAL THIS INVOICE USD $11.88
Other discounts may apply.
Detailed descriptions of surcharoes can be located atfedex.rom
Invoice Number I Invoice Date Account Number Page
2-145-75186 Jan 16 2013 11 2 of 4
Adjustment Request
Fax t0 (800) 5483020
Use this form to fax requests for adjustments due to the reasons indicated below. Requests for adjustments
due to other reasons, including service failures, should be submitted by going to www.fedex.com or calling
800.622.1147. Please use multiple forms for additional requests.
C Please complete all fields in black ink.
Requestor Name I I I I I I I I I I I I I I I I I I I I I I I I I I I I Date W/ W/ W
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a Phone WWW WWW ( I I I I Fax# WWW WWW V I I I
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R Tracking Number Bill to Account $Amount
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AD -Address Correction INW-Incorrect Weight OVS- Oversize Surcharge For all Service failures or other
o DVC- Declared Value INS- Incorrect Service RSU- Residential Delivery surcharges please use our web
e IAN- Invalid Acct# OCF- Grd Pick-up Fee PND - Pwrshp Not Delivered site www.fedex.com or call
OCS-Exp Pick-up Fee SDR- Saturday Delivery (800)622-1147
Rerate information only (round to nearest inch)
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Invoice Number Invoice Date Account Number Page
2-145-75186 Jan 16 2013 3 of 4
FedEx Ground Shipment Summary By Payor Type
FedEx Ground Shipments(Original)
::Rated
Weight :Transportation Other Hantllmg Ret`Chg/Tax
Date; Shipments Ibs Charges Charges Credits/Other Total Charges
Ground-Prepaid
01/09 1 4 8.10 3.78 11.88
Ground-Prepaid Subtotal $11.88
Total FedEx Grguntl 1 4 $8.10 $3.78 $11.88
Total This Invoice USD $11.88
1015-01-00-0041068-0001-0097501
Invoice Number Invoice Date Account Number Page
2-145-75186 Jan 16 2013 4 of 4
FedEx Ground Prepaid Detail (Original)
Plcktp Date J'an 09 2013 Cust Ref CPDRIMAGE P 0#
Payor Shipper Dept#
Tracking ID 321003815000289 Sender Recipient Transportation Charge 8.10
Service Type Ppd,Domestic Greg Bedell CASSIE GERRES RE:30038518 NDOC P/U-Auto Comin 3.00
Zone 04 Carmel Clay Communications Cen RIMAGE Fuel Surcharge 0.78
Packages 1 31 1st Ave.N.W. 7725 WASHINGTON AVE S Total Charge USD 511.88
Actual Weight 3.8lbs Carmel IN 46032 EDINA MN 55439-242225
Rated Weight 4 Ibs
Delivered Jan 11,2013
Prepaid Subtotal USD $11.88
Total FedEx Ground USD $11.88
1015-01-00-0041069-0001-0097501
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))
01/16/13 2-145-75186 $11.88
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
VOUCHER NO. WARRANT NO.
ALLOWED 20
FedEx
IN SUM OF $
P.O. Box 94515 —
Palatine, IL 60094-4515
$11.88
ON ACCOUNT OF APPROPRIATION FOR –
Carmel Clay Communications
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
r —
1115_ l 2-145-75186 I 43-421.00 I $11.88 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
Tuesday, Janua ,22, 2013
Director
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund