219716 05/07/2013 CITY OF CARMEL, INDIANA VENDOR: 093000 Page 1 of 1
0 ` ONE CIVIC SQUARE FEDEX-SHIPPING CHARGES CHECK AMOUNT: $1,894.85
CARMEL, INDIANA 46032 PO BOX 94515
PALATINE IL 60094-4515 CHECK NUMBER: 219716
CHECK DATE: 5/7/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1203 4359300 2-243-53533 1, 894 . 85 ECONOMIC DEVELOPMENT
Invoice Number Invoice Date Account Number Page
2-243-53533 Apr 17 2013
Billing Address: Shipping_Address:
CITY OF CARMEUMAYOR'S OFC CITY OF CARMEL
SHARON KIBBE 1 CIVIC SG
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 17,2013 Internet: www.fedex.com
FedEx Express Services
Transportation Charges 1,672.65
Special Handling Charges 222.20
Total Charges USD $1,894.85
TOTAL THIS INVOICE USD $1,894.85
Other discounts may apply.
Detailed descriptions of surcharges can be located atfedex.com
Invoice Number Invoice Date
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.
n 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 I Date W/ W / W
U
a Phone 1 1 1 1 I I I I I I I I I Fax# Wu WWW ( I I I I
c
t E-mail Address 0 Yes,I wantto update account contact with the above information.
R Tracking Number Bill to Account $Amount
bLlllllllllllllll IIIIIIIIII LIIIII • III
LIIIIIIIIIIIIIII IIIlffllll IIIIII • W
iIIIIIIIIIIIIIIII IIIIIIIIII llllll • W
tIIIIIIIIIIIIIIII IIIIIIIIII IIIIII • W
SIIIIIIIIIIIII111 Illlllilll IIIIII • W
AD -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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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 • I I I LWW WWI x WI X1 I I
l 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 II I I Ix 1 I I I x l I I I
t ! I f 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 IW1W WWI X1 I I x I I I I
5 1 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 LWJW LWWI X I X W1WW
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 WWW WLWJ X I X WWW
Invoice Number Invoice Date Account Number Page
2-243-53533 A r17 2013 3of4
FedEx Express Shipment Summary By Reference
FedEx Express Multiweight Shipments(Original)
Rated Special
Weight Transportation .handling Ret ChgtTax
Reference Packages lbs Charges Charges Credits/Other Discounts Total Charges
NO REFERENCE INFORMATION 1 315.0 1,672.65 222.20 1,894.85
Total FedEx Express 1 315.0 $1,672:65 $22220 51899,85
Total This Invoice USD $1,894.85
1106-01-00-0032069-0001-0077036
Invoice Number Invoice Date Account number Page
2-243-53533 Apr 17, 2013 4ot4
FedEx Express Multiweight- Shipper Detail (Original)
Picked up:Apr 12,2013 Service Type:FedEX Priority Overnight Svc Area Al
Payor.Shipper Rate Method:Hundredwt Rated Wgt:315.0 lbs,142,9 kgs
Bundle ID-NIA Zone:07 #Packages:6
Package Type:Customer Packaging Automation:USAS
Sender
MAYOR JI BRAINARD
CITY OF CARMEL
1 CIVIC SO
CARMEL IN 46032-2584 US
Rated Weight/Actual Weight Declared Value FedEx Use Cust.RefJRef.#2/Ref.#3/RMA# Amount
315.0lbs,142.9 kgs USD 2,000.00 010246881/0001595/_ NO REFERENCE INFORMATION 1894.85
M.MAKK
• Fuel Surcharge-FedEx has applied a fuel surcharge of 12.00%to this shipment.
• Distance Based Pricing,Zone 7
Transportation Charge 1672.65
Declared Value Charge 17.00
Fuel Surcharge 201.20
Courier Pickup Charge 4.00
Direct Signature 0.00
Total Charge USD $1,894.85
Multiweight- Shipper Subtotal USD $1,894.85
Total FedEx Express USD $1,894.85
i
I
I
I
1106-01-00-0032069-0001-0077036
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))
04/17/13 2-243-53533 $1,894.85
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
120
Clerk-Treasurer
VOUCHER NO. WARRANT NO.
ALLOWED 20
FedEx IN SUM OF $
PO Box 94515
Palatine, IL 60094-4515
$1,894.85
ON ACCOUNT OF APPROPRIATION FOR
Community Relations
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1203 I 2-243-53533 I 43-593.00 I $1,894.85 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
Sunday, May 05, 2013
Director, Co munity Relations/Economic Development
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund