217232 02/13/2013 CITY OF CARMEL, INDIANA VENDOR: 358122 Page 1 of 1
ONE CIVIC SQUARE L-COM CONNECTIVITY PRODUCTS
CHECK AMOUNT: $356.66
CARMEL, INDIANA 46032 Po Box 55758
BOSTON MA 02205-5758 CHECK NUMBER: 217232
CHECK DATE: 2/13/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1115 4238900 2107473 356 . 66 OTHER MAINT SUPPLIES
m` Global INV®ICE
® C sf,� i Please Remit to: Bank Transfers To:
Connectivity P.O.Box 55758 Citibank,Miami,FL
L Boston,MA 02205-5758 Branch#61-Boca Raton,FL.
ABA#266-086-554
978-682-6936 978-689-9484 Account4 9119834971
Swift Code:CITIUS33
Account Name:L-corn,Inc.
Invoice # 2107473 Invoice Date 04-Feb-13 Page # 1 US funds only
Sold CARMEL, CITY OF COMMUNICATIONS DEPT
To: 31 FIRST AVE NW Ship CARMEL, CITY OF COMMUNICATIONS DEPT
CARMEL, IN 46032 To: Attn: TODD LUCKOSKI
31 FIRST AVE NW
CARMEL, IN 46032
Ship Via- Ship Date Due Date Purchase Order# Our Order# Order-Date
FX GD 04-Feb-13 06-Mar-13 01312013 TODD 3704734 31-Jan-13
Shipment# Terms Buyer Account# Salespeople
1953799 NET 30 "TODD LUCKOSKI 171655 70 616
ORD QTl/�.: '•�; .UNI I'-
LIN/("1'GNl#%llESC1211'1'ION `CUSTOpIER ITEIII# U/M BALANCE-,z, SI IIPftD PRICts: AAIOUN f
Thank you for your order, we appreciate your business.
I CA-AMNMCIM5 EA 2 2 12.99000 25.98
CA,CAI00,ALPROX/NM 1.5M 0
2 CA-AMNMC2M5 EA 4 4 24.95000 99.80
CA,CA 100 ALPROX/N-MALE 2.5m 0
3 HGV-4907U EA 2 2 99.99000 199.98
ANT,Omni 4.9GHz 7dBi 0
4 AXA-NMSM EA 5 5 3.99000 19.95
ADP,N-Male to SMA Male 0
ALL CLAIMS MUST BE JNIADE SEVEN(7)DAYS AFTER RECEIP•I'.
CERTIFICATE OF COMPLIANCE:This is to certify that the product shipped against your purchase order Subtotal (USD) 345.71
F
conforms to the requirements of your purchase order.
CERTIFICATE O ORIGIN:This Certifies the items listed above originated in the country indicated on the
individual packaging label.Thomas Barczak,Corporate Quality Manager
Freight(USD) 10.95
Total(USD) 356.66
SHIPPING"TRACKING# 045946870676590 X
Created On: 02/04/13 10:42:02 AM Printed On: 02/04/13 11.23:43 AM
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))
02/04/13 2107473 $356.66
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.
L - Corn Global Connectivity ALLOWED 20
IN SUM OF $
P.O. Box 55758
Boston, MA 02205-5758
$356.66
ON ACCOUNT OF APPROPRIATION FOR
Carmel Clay Communications
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT
Board Members
1115 I 2107473 I 42-389.00 I $356.66 ( 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
c.i
Director
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund