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222583 07/30/2013 CITY OF CARMEL, INDIANA VENDOR: 361528 Page 1 of 1 t ONE CIVIC SQUARE STAPLES BUSINESS ADVANTAGE CHECK AMOUNT: $1,123.71 CARMEL, INDIANA 46032 DEPT DET a� PO BOX 83689 CHECK NUMBER: 222583 CHICAGO IL 60696-3689 CHECK DATE: 7/30/2013 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1093 4238000 3202781691 139 . 00 SMALL TOOLS & MINOR E 1081 4230200 3203242683 105 . 30 OFFICE SUPPLIES 1082 4239039 3203242684 10 . 75 GENERAL PROGRAM SUPPL 1091 4230200 3203242685 3 . 53 OFFICE SUPPLIES 1125 4230200 3203242686 47 . 53 OFFICE SUPPLIES 911 4239099 3204535504 74 . 67 OTHER MISCELLANOUS 1205 4230200 3204535505 173 . 97 OFFICE SUPPLIES 1205 4230200 3204535506 71 . 99 OFFICE SUPPLIES 1301 4230200 3204535507 60 . 62 OFFICE SUPPLIES 1301 4230200 3204535508 397 . 35 'OFFICE SUPPLIES 1701 4230200 3204975013 39 . 00 OFFICE SUPPLIES INVOICE:>DATE';': :::>'C1J ST0f 4IER<;:;:; ::> i;:'::: SUMMAR.Y.INVOICE 7/13/13 DET 1061088 8026268786 ° U : 8/12/13 Net 30 Days 778.60 AW01 10% UE DETAIL Staples Advantage Federal ID #:04-3390816 CITY OF CARMEL-NJPA CITY OF CARMEL JIM SPELBRING ATTN: BONNIE LEWIS 1 CIVIC SQUARE 1 CIVIC SQUARE CARMEL, IN 46032 DELIVER BY 4PM CARMEL, IN 46032 Bill to Account: 1030382 Ship to Account: 1 CIVIC SQUARE Budget Ctr: 130 - CITY COURT Invoice Number: 3204535507 P 0 Number: Release: Order: 7102586363-000-001 Ordered by: BONNIE LEWIS Job: Order Date: 7/09/13 Order Order Unit Ship Unit ERTEFOETI Line Item Number Description Oty Oty Meas Oty Price Price 1 503707 HP 02613A BLACK TONER 1 EA 1 60.62 60.62 Freight: ax - o a Total: 60.62 Customer Service inquiries # 877-826-7755 Invoice Payment Inquiries 888-753-4104 Page: 1 Make checks payable to Staples Advantage, Dept DET PO Box 83689, Chicago IL 60696-3689 0015930-0053827-0000006 'INVOICE:::DATE:::::: CUSTOMER:::: :::>`':<: SUMMARY`. :INVOICE: 7/13/13 DET 1061088 8026268786 8/12/13 Net 30 Days 778.60 INVOICE DETAIL Staples Advantage Federal ID #:04-3390816 CITY OF CARMEL-NJPA CITY OF CARMEL JIM SPELBRING ATTN: BONNIE LEWIS 1 CIVIC SQUARE 1 CIVIC SQUARE CARMEL, IN 46032 DELIVER BY 4PM CARMEL, IN 46032 Bill to Account: 1030382 Ship to Account: 1 CIVIC SQUARE Budget Ctr: 130 - CITY COURT Invoice Number: 3204535508 P 0 Number: Release: Order: 7102628389-000-001 Ordered by: BONNIE LEWIS Job: Order Date: 7/09/13 F7Fc9r Urder B/O Unit Ship Unit -- ERYe-r--'Ua� Line Item Number Description Qty Qty Meas Oty Price Price 1 804574 HP CE255A BLACK TONER 3 EA 3 132.45 397.35 Freight: ax:( -0000 -00 Sub-Total: Total- 397.35 I Customer Service inquiries # 877-826-7755 Invoice Payment Inquiries 888-753-4104 Page: 1 Make checks payable to Staples Advantage, Dept DIET PO Box 83689, Chicago IL 60696-3689 0015931-0053827-0000007 Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No.201 (Rev 1995) 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. Pa ee bIAN"7rAre—_�_ Purchase Order No. l T P d )!5() )( 0 3(0 Terms 01,'OCA-Go �Q / Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) 7��3 aatS�SSa � �� Toni E� 67 a-- -"O Af Total , 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. ALLOWED 20 —� IN SUM OF $ Ck(c +-Go $ 01-7 ON ACCOUNT OF APPROPRIATION FOR Board Members PO#or INVOICE NO. ACCT#/TITLE AMOUNT DEPT.# I hereby certify that the attached invoice(s), or 3 QM-3S5b V6R 3©a0 , 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 2k ignature Cost distribution ledger classification if Title claim paid motor vehicle highway fund INVOICE w.::DATE.... CUSTOMER':...;. ..... :—:SUMMARY:INVOICE 6/22/13 DET 1061088 8026043220 • .-- 7/22/13 Net 30 Days 515.04 wo INVOICE DETAIL Staples Advantage Federal ID #:04-3390816 PAUL'ALSCHLEMMERKS AND RECREATI ` P T ', ATTN:OJEANINELPOTTRIDGE 1411 E 116TH ST 2 7 2013 1235 DR E CARMEL, IN 46032 CARMEL, IN 46032 Bill to Account: 1030597 Ship to Account: 1235 CNTRL PK E I Budget Ctr: 1091-4230200 MCC ADMINISTRATION Invoice Number: 3202781691 P 0 Number: #004280 Release: Order: 7101800213-000-001 Ordered by: JEANINE POTTRIDGE Job: Order Date: 6/19/13 r r Order ni ipt., Unit— x Line Item Number Description Qty Ot -Meas Qt _ Price :, Price : 1 AVAM09003SST 0.9 CF MICROWAVE OV-STAINSTEEL 1 EA 1 139.00 139.00 red ax- _ - o a Total: 139.00 o.�oo WAVt ovLf J ooTag(D �9 0 n U--Y-) 7-I&--13 Customer Service inquiries # 877-826-7755 Invoice Payment Inquiries 888-753-4104 Page: 1 Make checks payable to Staples Advantage, Dept DIET PO Box 83689, Chicago IL 60696-3689 0016350-0052505-0000006 >INVOICE'>DATE::< CUSTOMER SUMMARY INVOICE 6/29/13 DET 1061088 1 8026115464 PMASE::;IPAY AMOUNT 50V77 7/29/13 Net-TOT'Days 167.11 INVOICE DETAIL Staples Advantage Federal ID #:04-3390816 CARMEL CLAY PARKS AND RECREATION CITY OF CARMEL PAULA SCHLEMMER ATTN: JENNIFER BROWN 1411 E 116TH ST 1235 BEFORE CENTRAL PARK DR E CARMEL, IN 46032 5 DLV 4PM B LY _ ?013 CARMEL, IN 46032 Bill to Account: 1030597 Ship to Account: 1235 CNTRL PK E Budget Ctr: 1081-99-4230200 ESE ADMINISTRATION Invoice Number: 3203242683 P 0 Number: E0003505 Release: Order: 7101479026-000-001 Ordered by: DAWN KOEPPER Job: Order Date: 6/12/13 F-OFae-r Order B/U Unit Ship UnMiT Extencle-cl Line Item Number Description Qty Qty Meas Qty Price Price 1 556359 CLIST SELF INK STAMP3/4X1-7181N 5 EA 5 21 .06 105.30 ?3221432? Freight: .00 Tax:( .0000 %) .00 Sub-Total: Total: 105-30 Backorder of 7101479026 DILCI &_O�Plo POO Customer Service inquiries # 877-826-7755 Invoice Payment Inquiries 888-753-4104 Page: Make checks payable to Staples Advantage, Dept DIET PO Box 83689, Chicago IL 60696-3689 L 0003957-0048457-0000003 .�_. < INVOICE DATE CUSTOMER SUMMARY INVOICE 6/29/13 DET 1061088 8026115464 PLEASE PAY TERMS AMOUNT DUE- up JUL .v 2013 7/29/13 Net 30 Days 167. 11 LBY: 4 hwOICE DETAIL Staples Advantage Federal ID #:04-3390816 . CARMEL CLAY PARKS AND RECREATION CITY OF CARMEL PAULA SCHLEMMER ATTN: JAMES DOWELL 1411 E 116TH ST 1235 CENTRAL PARK DR E CARMEL, IN 46032 DLV BEFORE 4PM CARMEL, IN 46032 Bill to Account: 1030597 Ship to Account: 1235 CNTRL PK E Budget Ctr: 1081-99-4230200 ESE ADMINISTRATION Invoice Number: 3203242684 P 0 Number: E0003546 Release: Order: 7101929283-000-001 Ordered by: DAWN KOEPPER Job: Order Date: 6/21/13 r Urder Unit Ship Unit ERT&06T] Line Item Number Description Qty Qty Meas Qty Price Price 1 146308 PUNCH ONE HOLE PAPER 146308 25 EA 25 .43 10.75 2 685255 DUAL ACTION CARPET SWEEPER 1 1 EA 59. 18 .00 Freight: ax:( .0000 %) .00 Sub-Tota Total: 10.75 Balance to follow Backorder of 7101929283 E 000540 /age-13_ 2 ��U39 i Customer Service inquiries # 877-826-7755 Invoice Payment Inquiries 888-753-4104 Page: 1 Make checks payable to Staples Advantage, Dept DET PO Box 83689, Chicago IL 60696-3689 V 0003958-0048457-0000004 1NVOICE:DATE CUSTOMER» SUMMARY YZECEIVED JUL _ 2013 <'INVOICE 6/29/13 DET 1061088 8026115464 7/29/13 Net 30 Days 167. 11 I1V VOI CE DETAIL Staples Advantage Federal ID #:04-3390816 CARMEL CLAY PARKS AND RECREATION CITY OF CARMEL PAULA SCHLEMMER ATTN: JEANINE POTTRIDGE 1411 E 116TH ST 1235 CENTRAL PARK DR E CARMEL, IN 46032 DLV BEFORE 4PM CARMEL, IN 46032 Bill to Account: 1030597 Ship to Account: 1235 CNTRL PK E Budget Ctr: 1091-4230200 MCC ADMINISTRATION Invoice Number: 3203242685 P 0 Number: MC004232 Release: Order: 7101196127-000-002 Ordered by: JEANINE POTTRIDGE Job: Order Date: 6/07/13 r Order Unit Ship Unit ER15FR16irl Line Item Number Description Oty Oty Meas Qty Price Price 4 806950 STAPLES ROTARY DESK ORGANIZER 1 EA 1 3.53 3.53 Freight: ax -Total: Total: 3.53 Backorder of 7101196127 Item 785429 has been discontinued by the manufacturer A possible sub is 861615 SPLS 8GB RELAY FLASH - SLED Please contact your customer service team for further assistance WROIC 1 D g ) Customer Service inquiries # 877-826-7755 Invoice Payment Inquiries 888-753-4104 Page: 1 Make checks payable to Staples Advantage, Dept DET PO Box 83689, Chicago IL 60696-3689 0003959-0048457-0000005 INVOICE DATE:>> CUS..TOMER: SUMMARY::::INVOICE JUL - 5 2013 6/29/13 DET 1061088 8026115464 B 7/29/13 Net 30 Days 167.11 INVOICE DETAIL Staples Advantage Federal ID #:04-3390816 CARMEL CLAY PARKS AND RECREATION CITY OF CARMEL PAULA SCHLEMMER ATTN: DAWN KOEPPER 1411 E 116TH ST 1411 E 116TH ST CARMEL, IN 46032 CARMEL, IN 46032 Bill to Account: 1030597 Ship to Account: 1411 E 116TH ST Budget Ctr: 1125-100-010-4230200 ADMINISTRATION Invoice Number: 3203242686 P 0 Number: A0000264 Release: Order: 7102190945-000-001 Ordered by: DAWN KOEPPER Job: Order Date: 6/27/13 r Order Unit Ship Unit F-TfEF06T] Line Item Number Description Oty Qty Meas Qty Price Price 1 551911 CURRENCY BAND $500 RD 1 PK 1 3.57 3.57 2 551879 CURRENCY BAND $100 BLE 1 PK 1 3.57 3.57 3 551861 CURRENCY BAND $50 ORANGE 1 PK 1 3.57 3. 57 4 135848 SPLS 8.5X11 COPY CS 1 CT 1 36.82 36.82 Freight: -00 Tax:( - o a Total: 47.53 �uffzj OrY2 Ilz 62 - q12-�X) Customer Service inquiries # 877-826-7755 Invoice Payment Inquiries 888-753-4104 Page: 1 Make checks payable to Staples Advantage, Dept DET PO Box 83689, Chicago IL 60696-3689 0003960-0048457-0000006 ACCOUNTS PAYABLE VOUCHER CITY OF CARM EL 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. Terms 361528 Staples Business Advantage Dept DET 2368 P.O. Box 83689 Chicago, IL 60696-3689 Invoice Invoice Description PO#;T:AMOUnt Date Number (or note attached invoice(s) or bill(s)) 139.00 6/22/13 3202781691 Microwave oven 105.30 6/29/13 3203242683 Check stamps $ 10.75 6/29/13 323242684 Supplies $ 3.53 6/29/13 3203242685 Office supplies MCC $ 47.53 6/29/13 3203242686 Office supplies I hereby certify that the attached invoice(s),or bill(s)is(are)true and correct and I have audited same in accordance $ 306.11 with IC 5-11-10-1.6 20_ Clerk-Treasurer — J Voucher No. Warrant No. 361528 Staples Business Advantage Allowed 20 Dept DET 2368 P.O. Box 83689 Chicago, IL 60696-3689 In Sum of$ $ 306.11 Total ON ACCOUNT OF APPROPRIATION FOR 101 General / 108 ESE/ 109 MCC PO#or Board Members Dept# INVOICE NO ACCT#/TITLE AMOUNT 1093 3202781691 4238000 $ 139.00 1 hereby certify that the attached invoice(s), or 1081-99 3203242683 4230200 $ 105.30 bill(s) is (are)true and correct and that the 1082-13 323242684 4239039 $ 10.75 materials or services itemized thereon for 1091 3203242685 4230200 $ 3.53 which charge is made were ordered and 1125 3203242686 4230200 $ 47.53 received except 25-Jul 2013 $ 306.11 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund INVOICE DATE: 'CUSTOMER. SUMMARY INVOICE as 7/13/13 DET 1061088 8026268786 8/12/13 Net 30 Days 778.60 I1V VOI CE DETAIL Staples Advantage Federal ID #:04-3390816 CITY OF CARMEL-NJPA CITY OF CARMEL JIM SPELBRING ATTN: JEFF BARNES 1 CIVIC SQUARE 1 CIVIC SQUARE CARMEL, IN 46032 DELIVER BY 4PM CARMEL, IN 46032 Bill to Account: 1030382 Ship to Account: 1 CIVIC SQUARE Budget Ctr: 1205-DOA Invoice Number: 3204535505 P 0 Number: JEFF BARNES Release: Order: 7102724239-000-001 Ordered by: JEFF BARNES Job: Order Date: 7/11/13 FTFr-cFer Order Unit Ship Unit Extencle-cl Line Item Number Description Qty Qty Meas Qty Price Price 1 943815 SAMSUNG CLT-Y406S YELLOW TONER 1 EA 1 57.99 57.99 2 943813 SAMSUNG CLT-M406S MAGENTA TONR 1 EA 1 57.99 57.99 3 943816 SAMSUNG CLT-C406S CYAN TONER 1 EA 1 57.99 57.99 4 943814 SAMSUNG CLT-K406S BLACK TONER 1 1 EA 71.99 .00 Freight: ax:( .0000 .00 Sub-Total. Total: 173.97 Balance to follow D � � JUL 2 9 2013 By Customer Service inquiries # 877-826-7755 Invoice Payment Inquiries 888-753-4104 Page: 1 Make checks payable to Staples Advantage, Dept DET PO Box 83689, Chicago IL 60696-3689 0015928-0053827-0000004 INVOICE DATE CUSTOMER SUMMARY INVOICE. 7/13/13 DET 1061088 8026268786 PLEASE PAY BY. TERMS AMOUNT DUE 8/12/13 Net 30 Days 778.60 INVOICE DETAIL Staples Advantage Federal ID #:04-3390816 CITY OF CARMEL-NJPA CITY OF CARMEL JIM SPELBRING ATTN: JEFF BARNES 1 CIVIC SQUARE 1 CIVIC SQUARE CARMEL, IN 46032 DELIVER BY 4PM CARMEL, IN 46032 Bill to Account: 1030382 Ship to Account: 1 CIVIC SQUARE Budget Ctr: 1205-DOA Invoice Number: 3204535506 P 0 Number: JEFF BARNES Release: Order: 7102724239-000-002 Ordered by: JEFF BARNES Job: Order Date: 7/11/13 Fur r Order Unit Ship m x e Line Item Number Description Oty Qty Meas Qty Price. Price 4 943814 SAMSUNG CLT-K406S BLACK TONER 1 EA 1 71 .99 71 .99 reig . ax:( .0000 .00 Sub-Total: Total: 71.99 I JUL 2 9 2013 By Customer Service inquiries # 877-826-7755 Invoice Payment Inquiries 888-753-4104 Page: 1 Make checks payable to Staples Advantage, Dept DET PO Box 83689, Chicago IL 60696-3689 0015929-0053827-0000005 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)) 07/13/13 3204535505 $173.97 07/13/13 3204535506 $71.99 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. ALLOWED 20 Staples Advantage IN SUM OF $ Dept DET PO Box 83689 Chicago, IL 60696-3689 $245.96 ON ACCOUNT OF APPROPRIATION FOR Administration Department PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members 1205 3204535505 42-302.00 $173.97 I hereby certify that the attached invoice(s), or bill(s) is (are)true and correct and that the 1205 3204535506 42-302.00 $71.99 materials or services itemized thereon for which charge is made were ordered and received except Monday, July 29, 2013 Director, Administra on Title Cost distribution ledger classification if claim paid motor vehicle highway fund INVOICE DATE CUSTOMER SUMMARY INVOICE 7/13/13 DET 1061088 8026268786 PL�AS5 PAY BYJ TERMS AMOUNT DUE 8/12/13 Net 30 Days 778.60 11V 01 CE DETAIL Staples Advantage Federal ID #:04-3390816 CITY OF CARMEL-NJPA CITY OF CARMEL JIM SPELBRING ATTN: MARIE DOAN 1 CIVIC SQUARE 3 CIVIC SQUARE CARMEL, IN 46032 DELIVER BY 4PM CARMEL, IN 46032 Bill to Account: 1030382 Ship to Account: 3 CIVIC SQUARE Budget Ctr: 110 - POLICE DEPARTMENT Invoice Number: 3204535504 P 0 Number: Release: Order: 7102555420-000-001 Ordered by: MARIE DOAN Job: Order Date: 7/08/13 r r Order Unit Ship m x e Line Item Number Descri tion Qt Qt Meas Qt Price Price 1 684613 24 COMPARTMENT SORTER LTR SIZE 1 EA 1 74.67 74.67 Freight: ax:( .0000 -00 Sub-Total: _ Total: . 74.67• Customer Service inquiries # 877-826-7755 Invoice Payment Inquiries 888-753-4104 Page: 1 Make checks payable to Staples Advantage, Dept DET PO Box 83689, Chicago IL 60696-3689 0015927-0053827-0000003 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)) 07/13/13 3204535504 $74.67 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 Staples Advantage Dept. DET IN SUM OF $ P.O. Box 83689 Chicago, IL 60696-3689 $74.67 ON ACCOUNT OF APPROPRIATION FOR Project 2013-911 Task 2013-2 PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members 911 I 3204535504 I 42-390.99 I $74.67 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 Thursday, July 25, 2013 ac",,,,.. Major Title Cost distribution ledger classification if claim paid motor vehicle highway fund INVOICE DATE CUSTOMER: :. SUMMARY INVOICE 7/20/13 DET 1061088 8026341736 TMSE 07W BY TERMS :: AMOUNT DUE 8/19/13 Net 30 Days 39.00 1 ®10E DETAIL Staples Advantage Federal ID #:04-3390816 CITY OF CARMEL-NJPA CITY OF CARMEL JIM SPELBRING ATTN: ANN DAVIS 1 CIVIC SQUARE 1 CIVIC SQUARE CARMEL, IN 46032 DELIVER BY 4PM CARMEL, IN 46032 Bill to Account: iO3O382 Ship to Account: 1 CIVIC SQUARE Budget Ctr: 140 - COMMON COUNCIL Invoice Number: 3204975013 P 0 Number: Release: Order: 7102941032-000-001 Ordered by: ANN DAVIS Job: Order Date: 7/16/13 r r Order B/O Unit Ship UHIT Extended Line Item Number Description Qty Qty Meas Qty Price Price 1 792801 SCISSOR STRAIGHT BCA 8 1 EA 1 9. 49 9.49 2 379168 LABEL FILE FOLD RMV 213X3-7/16 1 PK 1 17. 75 17.75 3 379383 POST- IT SIGN HERE ARROW FLAGS 3 PK 3 3.92 11 .76 Freight: ax Sub-Total: Total: =39.00 Customer Service inquiries # 877-826-7755 Invoice Payment Inquiries 888-753-4104 Page: 1 Make checks payable to Staples Advantage, Dept DIET PO Box 83689, Chicago IL 60696-3689 0013455-0014528-0000003 Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No.201(Rev.1995) 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. 9' a Payee Q Purchase Order No. Terms Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) i � Total 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 G � IN SUM OF $ FO 1 m 1 � '2 j • $ ON ACCOUNT OF APPROPRIATION FOR (�—'T �{ Board Members Po#or INVOICE NO. ACCT#/TITLE AMOUNT DEPT.# 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 _ d 20 Signature Title Cost distribution ledger classification if claim paid motor vehicle highway fund