HomeMy WebLinkAbout217183 02/13/2013 CITY OF CARMEL, INDIANA VENDOR: 355628 Page 1 of 1
ONE CIVIC SQUARE HOOSIER HERITAGE PORT AUTHORITY
_•
CARMEL, INDIANA 46032 33 N 9TH ST SUITE 215 CHECK AMOUNT: $20,850.00
NOBLESVILLE IN 46060 CHECK NUMBER: 217183
CHECK DATE: 2/1312013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1202 4351501 26647 177 20, 850 . 00 COUNTY FIBER RING SUP
1= HPA-Technology Oversight Board
33 North 9th Street DATE INVOICE#
Suite 215 1/17/2013 177
Noblesille,IN 46060
BILL TO SKIP TO
City Of Carmel
Attn: Terry Crockett
Three Civic Square
Carmel, IN 46032
DUE DATE P.O. NUMBED
2/16/2013
ITEM DESCRIPTION QTY [nJAMOUNT
2013 HHPA-TOB Annual Dues 20,850.00
Subtotal 20.850.00
Please remit to above address. 317-776-8268 0% Tax 0.00
Total 20,850.00
® /�° Carmel INDIANA RETAIL TAX EXEMPT City PAGE
,Jjr CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 2667
35-60000972
ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES,A/P
CARMEL, INDIANA 46032-2584 VOUCHER, DELIVERY MEMO, PACKING SLIPS,
SHIPPING LABELS AND ANY CORRESPONDENCE.
FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL- 1997
'URCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION
1/24/2013 County Fiber Ring support
HHPA-Technology Oversight Board Carmel Communications
SHIP Terry Crockett
VENDOR 33 North Sth Street,Suite 215 TO 3 Civic Square
Noblesville, IN 46060 , Carmel, IN 46032
(317)571-2567
CONFIRMATION BLANKET CONTRACT PAYMENTTERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Account,43-61 5.01
9 !Each Ann. Support for County Fiber Ring, Carmel $20,850.00 $20,850.00
Portion
Sub Total: $20,850.00
Ike °•
° a�
0
Pmrsuan Interiocal Agreement with o
Sena • t
invoice To: „
City of Carmel _.
Terry Crockett i
3 CIVIC Square
Carmel' IN 46032 PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT I PROJECT ACCOUNT AMOUNT
Carmel IS Dept. PAYMENT $20,850.00
• A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O.
NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND
VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED.
SHIPPING INSTRUCTIONS I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN
THIS APQROPRIATION SUFFICIENT TO PAY FOR E.BOVE-�ORDER.
•SHIP REPAID. /
•C.O.D.SHIPMENTS CANNOT BE ACCEPTED. ORDERED BY
•PURCHASE ORDER NUMBER MUST APPEAR ON ALL �.
SHIPPING LABELS. Director
•THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
CLERK-TREASURER
DOCUMENT CONTROL No- 26647 A.P.V. COPY-SIGN AND RETURN TO CLERK'S OFFICE
VOUCHER NO. WARRANT NO.
ALLOWED 20
IN THE SUM OF$
F >
ON ACCOUNT OF APPROPRIATION FOR
Board Members
PO#or INVOICE NO. ACCT#/TITLE AMOUNT
DEPT.# 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___-__,___
20
------------- Signature --------------- . —, � -
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))
01/17/13 177 $20,850.00
1 hereby certify that the attached invoice(s), or bill(s), is (are)true and correct and I have audited same in accordance
with 1C 5-11-10-1.6
20
Clerk-Treasurer
VOUCHER NO. WARRANT NO.
ALLOWED 20
HHPA -Technology Oversight Board
IN SUM OF $
33 North 9th Street, Suite 215
Noblesville, IN 46060
$20,850.00
ON ACCOUNT OF APPROPRIATION FOR
IS Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
26647 I I 43-515.01 I 1 hereby certify that the attached invoice(s), or
177 $20,850.00
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 04, 2013
i
Director , IS
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund