222529 07/30/2013 CITY OF CARMEL, INDIANA VENDOR: 367042 Page 1 of 1
0 of ONE CIVIC SQUARE PAPERLESS BUSINESS SYSTEMS CHECK AMOUNT: $784.94
CARMEL, INDIANA 46032 1417 FOURTH AVE,4TH FLOOR
til soh�o. SEATTLE WA 98101 CHECK NUMBER: 222529
CHECK DATE: 7/30/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4355200 PF604681 392 .47 SUBSCRIPTIONS
1091 4355200 PF604681 392 . 47 SUBSCRIPTIONS
Invoice
paperless t r °
business systems
1417 Fourth Ave,4th Floori Invoice Number PF6-04681
Seattle,WA 98101 1 JUL 1 7 2013 Invoice Date 7/16/2013
p 206.256.0771
f 206.282.3312 Purchase Order 29557
Customer Number CACL001
SOLD TO: SHIP TO
Carmel Clay Parks& Recreation Carmel Clay Parks&Recreation
Attention: Accounts Payable Attention: Accounts Payable
1411 E 116th Street 1411 E 116th Street
Carmel, IN 46032 Carmel, IN 46032
TERMS PBS CONTACT
Net 30 Accounts Receivable
Description Amount
eRequester Hosted Subscription (SAAS)
Hosting Period: month 6 of 12, 8/28/13-9/27/13
eRequester Hosting for 50 Named Users 713.55
Hosted Receiving Module 164.65
Monthly Discount for 1 st Year -93.26
Ract azLnc - 6 712
o9551 P
43552D r ?92,g7
10.9/ - Z43552,00 = 39-2 ,q-1
`1gq .9q
Invoice is due within thirty(30)days of receipt.
A 11/2%monthly charge is payable on all overdue balances.
The grant of any license or right is conditioned on receipt of full payment.
All payments and dollar amounts are in U.S.Dollars.
Remit to: Paperless Business Systems, Inc.
1417 Fourth Ave, 4th Floor, Seattle, WA 98101
p 206.256.0769 f 206.282.3312 www.paperlessbusiness.com info @paperlessbusiness.com TOTAL AMOUNT USD $784.94
Wire Information: Swift#BOFAUS3N Bank of America,WA3-177-01-01
Bank Name:Bank of America Routing#:125000024 408 Pike St.Seattle,WA 98101
ABA#026009593 Account#: 138019775709(savings)
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.
367042 Paperless Business Systems Terms
1417 Fourth Avenue, 4th Floor
Seattle, WA 98101
Invoice Invoice Description
Date Number (or note attached invoice(s)or bill(s)) PO# Amount
7/16/13 PF604681 Purchasing software license 8/28 - 9/27/13 29557 $ 392.47
7/16/13 PF604681 Purchasing software license 8/28 - 9/27/13 29557 $ 392.47
Total $ 784.94
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.
367042 Paperless Business Systems Allowed 20
1417 Fourth Avenue, 4th Floor
Seattle, WA 98101
In Sum of$
$ 784.94
ON ACCOUNT OF APPROPRIATION FOR
108 -ESE/ 109 MCC
PO#or Board Members
INVOICE NO. ACCT WTITLE AMOUNT
Dept#
1081-99 PF604681 4355200 $ 392.47 1 hereby certify that the attached invoice(s), or
1091 PF604681 4355200 $ 392.47 bill(s) is(are)true and correct and that the
mater1als �r ceniirec itP nl7ed thereon for
which charge is made were ordered and
received except
25-Jul 2013
a"z�j Nrn M
Signature
$ 784.94 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund