218821 04/09/2013 CITY OF CARMEL, INDIANA VENDOR: 365814 Page 1 of 1
�. ONE CIVIC SQUARE DIVERSIFIED BUSINESS SYSTEMS,INC
CARMEL, INDIANA 46032 8200 HAVERSTICK ROAD,SUITE 260 CHECK AMOUNT: $211.89
INDIANAPOLIS IN 46240 CHECK NUMBER: 218821
CHECK DATE: 4/9/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1091 4345000 34490 211 . 89 PRINTING (NOT OFFICE
8200 Haverstick Road, Suite 260— Indianapolis, Indiana 46240
Phone: (317)254-8668 Fax: (317)254-0801
OGJb0t1C� ° ' •
� ccE'IV 3/28/2013 ;j 34490
MAR 29 2013
BILL TO { SHIP TO
BY;
Carmel Clay Parks & Recreation Carmel Clay Parks & Recreation
Administrative Offices 1235 Ce°rival Park=D'ive"'E'a`st=sS SPECIFIED
1411 E. 116th.Street Carmel, IN 46032
Carmel, IN 46032 Attn: Brooke Taflinger
Attn: Paula Schlemmer
MC0 13931 Net 20. JC 3/26/2013 UPS Ground 033113
QUANTITY ITEWCODE o • li0• • ,.AMOUNT
1 09 Adaptive Private Lessons Punch Cards 205.10 Lot 205.10
(quantity: 500
1 99 Freight 6.79 Lot 6.79
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Purchase
De.-c'iption
G.L.#
Sudret
Li"Mescr
Purchaser Date
Approval DF to
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Thank you for your business $211.89
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice of 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.
365814 Diversified Business Systems, Inc. Terms
8200 Haverstick Road, Ste 260
Indianapolis, IN 46240
Invoice Invoice Description
Date Number (or note attached invoice(s)or bill(s)) PO# Amount
3/28/13 34490 Adaptive punch cards $ 211.89
Total $ 211.89
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.
365814 Diversified Business Systems, Inc. Allowed 20
8200 Haverstick Road, Ste 260
Indianapolis, IN 46240
In Sum of$
$ 211.89
ON ACCOUNT OF APPROPRIATION FOR
109 Monon Center
PO#or Board Members
Dept#
INVOICE NO. ACCT#/TITL AMOUNT
1091 34490 4345000 $ 211.89 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
4-Apr 2013
10,E & 1._...j-n.rrw,�
Signature
$ 211.89 _ Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund