217129 02/13/2013 CITY OF CARMEL, INDIANA VENDOR: 093000 Page 1 of 1
ONE CIVIC SQUARE FEDEX-SHIPPING CHARGES CHECK AMOUNT: $11.72
CARMEL, INDIANA 46032 PO BOX 94515
PALATINE IL 60094-4515 CHECK NUMBER: 217129
CHECK DATE: 2/13/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1115 4342100 216772365 11 . 72 POSTAGE
Fedlz I Invoice Number Invoice Date Account Number Page
2-167-72365 Feb 06, 2013 1 of 4
FedEx TaxlD: 71-0427007
Billing Address: Shipping Address:
CARMEL COMMUNICATIONS CARMEL COMMUNICATIONS
31 1 STAVE NW 31 1 STAVE NW Invoice Questions?
CARMEL IN 46032-1715 CARMEL IN 46032-1715 Contact FedEx Revenue Services
Phone: (800)622-1147 M-Sa 7-6(CST)
Fax: (800)548-3020
Invoice Summary Feb 06,2013 Internet: www.fedex.com
FedEx Ground Services
Transportation Charges 7.95
Other Handling Charges 3.77
Total Charges USD $11.72
TOTAL THIS INVOICE USD $11.72
Other discounts may apply.
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Invoice Number Invoice Date Account Number Page
2-167-72365 Feb 06, 2013 11 2 of 4
Adjustment Request
Fax to (800) 548-3020
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.
,o.,, 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 Date
a Phone WWW WWW I I I I I Fax# WWW I I I I I I I I I
t E-mail Address DYes,I want to update account contactwith the above information.
Tracking Number Bill to Account $Amount
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ADR-Address Correction INW-Incorrect Weight OVS- Oversize Surcharge For all Service failures or other
U 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)
Tracking Number Code $Amount LBS L W H
d'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• W I I I II I I IxI I I IxI I I I
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Fedizo I Invoice Number Invoice Date Account Number Page
2-167-72365 Feb 06 2013 11 3 of 4
FedEx Ground Shipment Summary By Payor Type
FedEx Ground Shipments(Original)
Rated
V4leight ;Transportation Other'Handling Ret Chg/Tax
Date Shipments Ibs Charges Charges Cretlits/Other Total Charges;
Ground-Prepaid
01/30 1 3 7.95 3.77 11.72
Ground-Prepaid Subtotal $11.72
Total FedEx Ground 1 3 a $7.95 $3.77 $11.72
Total This Invoice USD $11.72
1036-01-00-0039151-0001-0094850
Invoice Number Invoice Date Account Number Page
2-167-72365 Feb 06 2013 1 4of4
FedEx Ground Prepaid Detail (Original)
PicCUp Gate Jan 30,2013 Gust Ref 45213,4521 5 45283 45282 P.O.#:
Payor ShippeC Dept#
Tracking ID 321 003815000296 Sender Recipient Transportation Charge 7.95
Service Type Ppd,Domestic Carmel Clay Communications Con RA#'S 037080,037081,136586,136 NDOC P/U-Auto Comm 3.00
Zone 05 Carmel Clay Communications Con L-3 MOBILE-VISION INC. Fuel Surcharge 0.77
Packages 1 31 1st Ave.N.W. 90 FANNY RD Total Charge USD $11.72
Rated Weight 3lbs Carmel IN 46032 BOONTON NJ 07005-106599
Delivered Feb 01,2013
Prepaid Subtotal USD $11.72
Total FedEx Ground USD $11.72
1036-01-00-0039151-0001-0094850
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))
02/06/13 2-167-72365 $11.72
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 —
$11.72
ON ACCOUNT OF APPROPRIATION FOR
Carmel Clay Communications
PO#/Dept. INVOICE NO. I ACCT#/TITLE AMOUNT Board Members
1115 I 2-167-72365 I 43-421.00 I $11.72 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
Monday, February 11, 2013
Director
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund