219800 05/07/2013 i
CITY OF CARMEL, INDIANA VENDOR: 358122 Page 1 of 1
ONE CIVIC SQUARE L-COM CONNECTIVITY PRODUCTS
CARMEL, INDIANA 46032 PO BOX 55758 CHECK AMOUNT: $210.95
BOSTON MA 02205-5758 CHECK NUMBER: 219800
CHECK DATE: 5/7/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1115 4350000 2142169 210 . 95 EQUIPMENT REPAIRS & M
® Global INVOICE
Low co'111- Please Remit to: Bank Transfers To:
Connectivity P.O.Boa 55758 Citibank,Miami,
Boston,MA 02205-5758 Branch N 61-Boca a
Raton,FL
ABA#266-086-554
978-682-6936 978-689-9484 Account 9119834971
Swift Code CITIUS33
Account Name L-com,Inc.
US fiords only
Invoice # 2142169 Invoice Date 18-Apr-13 Page # 1
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 18-Apr-13 I 18-May-13 TODD 3724364 1 I-Mar-13
Shipment# Terms Buyer Account Salespeople
2012536 NET 30 TODD LUCKOSKI 171655 70 616
` , ice.• .:`.,z OKU'Q I1'/ UNIT' `�:' r',}?
LtN"/ITEM`#/dDESCRIPTION '= "'-. CUSTOMER ITEM# U/NI 13ALANGE., SHIPPED- ERICC A1110UNf
Thank you for your order, Nve appreciate your business.
1 HG4958-17DP-090 EA 2 2 100.00000 200.00
ANT,PANEL 4.9-5.8GHz 17dBi 0
ALL CLAINIS MUST BE MADE SEVEN(7)DAPS AFTER RECEIPT.
CERTIFICATE OF CONIP.LIANCE:This is to certify(hat the product shipped against your purchase order Subtotal (USD) 200.00
conforms to the requirements of your purchase order.
CERTIFICATE OF 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) 210.95
x
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))
04/18/13 2142169 $210.95
I
I 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
$210.95
ON ACCOUNT OF APPROPRIATION FOR
Carmel Clay Communications
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1115 I 2142169 I 43-500.00 I $210.95 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
Tuesday, April 30, 2013
Director
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
I