219314 04/24/2013 +,F CITY OF CARMEL, INDIANA VENDOR: 093000 Page 1 of 1
` ONE CIVIC SQUARE FEDEX-SHIPPING CHARGES
eQ CARMEL, INDIANA 46032 PO BOX 94515 CHECK AMOUNT: $46.50
%« ? PALATINE IL 60094-4515 CHECK NUMBER: 219314
CHECK DATE: 4/24/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1160 4342100 2-235-84302 46 . 50 POSTAGE
Invoice Number Invoice ae D t Account Number Page
2-235-84302 Apr 10 2013 1of4
FedEx Tax ID: 71-0427007
Billing Address: Shipping Address:
CITY OF CARMEUMAYOR'S OFC CITY OF CARMEL
SHARON KIBBE 1 CIVIC SO.
1 CIVIC SO. CARMEL IN 46032-2584 Invoice Questions?
Contact FedEx Revenue Services
CARMEL IN 46032-2584 Phone: (800)622-1147 M-Sa 7-6(CST)
Fax: (800)548-3020
Invoice Summary Apr 10, 2013 Internet: www.fedex.com
FedEx Ground Services
Transportation Charges 33.76
Other Handling Charges 12.74
Total Charges USD $46.50
TOTAL THIS INVOICE USD $46.50
Other discounts may apply.
Detailed descriptions of surcharges can be located atfedex.com
- -r
Invoice Number Invoice Date Account Number Page
2-235-84302 Apr 10 2013 11 2of4
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.
Re uestor Namel 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
n q
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a Phone WWW I I I I I I I I I Fax#
c I I I I WWW I I I I I
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t E-mail Address ❑Yes,I want to update account contact with the above information.
R 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
oDVC- Declared Value INS- Incorrect Service RSU- Residential Delivery surcharges please use our web
e IAN- Invalid Acct# OCF- Gird 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)
C Tracking Number Code $Amount LBS L W H
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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 I WI I WW X1 I I I X1 I I I
Fed1- % Invoice Number Invoice Date Account Number Page
2-235-84302 Apr 10, 2013 3of4
FedEx Ground Shipment Summary By Reference
FedEx Ground Shipments(Original)
Rated .....
Weight :Transportation; Other Handling Ret Ch* ax
Reference Shipments Ibs Charges: Charges Credits/Other Total Charges
NO REFERENCE INFORMATION 2 70 33.76 12.74 46.50
Total .......FedEx Ground 2 70 $33:76.: . _ __._._ 12.74 _._._:.. $46:50;
Total This Invoice USD $46.50
1099-01-00-0003862-0001-0009698
Invoice Number Invoice Date ) F—Account Number--"*) Page
2-235-84302 Apr 10, 2013 11 4 of 4
FedEx Ground Shipment Detail By Reference (Original)
Ic upp;ke
Or.0 1,'
013 Gust
Ref.: 0 RFERENffINFORMATION:i
ra: ir d P a rty. D
Tracking ID 468 645015275076 Sender Recipient Transportation Charge 16.88
Service Type Direct Signature Req KINKO'S/GD NONACCT BRCD/LOC CITY OF CARMEL Declared Value 5.10
Zone 04 4691 POPLAR AVE MAYORS OFFICE Fuel Surcharge 1.27
Packages I MEMPHIS TN 38117-4401 1 civic SO Total Charge USD 523.25
Actual Weight 34.5 lbs CARMEL IN 46032-258401
Rated Weight 35lbs
Declared Value USD 600.00
Delivered Apr 04,2013
Pickup bate:Apr 01;2013 Cust.R NO REFERENCEINFORMATION
ar
Payor:Third.P ty b e
Tracking 10 468 645015275083 Sender Recipient Transportation Charge 16.88
Service Type Direct Signature Req KINKO'S/GD NONACCT BRCD/LOC CITY OF CARMEL Fuel Surcharge 1.27
Zone 04 4691 POPLAR AVE MAYORS OFFICE Declared Value 5.10
Packages I MEMPHIS TN 38117-4401 1 civic SO Total Charge USD S23.25
Actual Weight 34.6 lbs CARMEL IN 46032-258401
Rated Weight 35lbs
Declared Value USD 600.00
Delivered Apr 03,2013
NO REFERENCE INFORMATION Reference Subtotal USD $46.50
Total FedEx Ground USD $46.50
1099-01-00-0003862-0001-0009698
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))
04/10/13 2-235-84302 $46.50
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 $
PO Box 94515
Palatine, IL 60094-4515
$46.50
ON ACCOUNT OF APPROPRIATION FOR
Mayor's Office
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1160 2-235-84302 43-421.00 $46.50 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
Friday, April 19, 2013
Mayor
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund