223175 08/13/2013 CITY OF CARMEL, INDIANA VENDOR: 359284 Page 1 of 1
ONE CIVIC SQUARE RICOH AMERICAS CORPORATION
o CARMEL, INDIANA 46032 21146 NETWORK PLACE CHECK AMOUNT: $174.13
' + CHICAGO IL 60673-1211
CHECK NUMBER: 223175
CHECK DATE: 8/13/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1301 R4353004 26683 23696933 174 . 13 036-0026232-000
RICOH USA, INC. PAGE 1 of 1
ATTN: CUSTOMER SERVICE
P.O. BOX 550599 INVOICE NO. 23696933
JACKSONVILLE, FL 32255-0599
INVOICE DATE 07/29/2013
View your account online at CONTRACT NO. 036-0026232-000
` DUE DATE 08/18/2013
www.QDSontheweb.com
Contract Number Description of charge(s) f Amount Due Sales Tax Total Due
Asset Description v
036-0026232-000 PREVIOUSLY BILLED It-W 0 03543 4 SI —1.7 .13 0.00
S/N S7514900096 PAYMENT DUE 08/18/13 174.13 0.00
RICOH COPIER 348.26
CARMEL/IN
Model#MPC400SR
RICOH
INVOICE TOTAL 348.26 0.00 348.26
INQUIRIES "
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IMPORTANT INFORMATION
Your account is delinquent more than 1 days. If you have not already done so,please remit your payment online using www.qdsontheweb.com. A late fee penalty may be assessed on your account. ..
Keep upper portion for your records
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.
Payee
�Icoff U 54 , _�G
Purchase Order No.
c� L4 b Nl=TLA/UK2 < / LAG1— Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
-7 3 a3O qO3 (2()1016k LSE' 17q, t 3
Total 3
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
IN SUM OF $
ON ACCOUNT OF APPROPRIATION FOR
00 )- —612 Board Members
PO#or INVOICE NO. ACCT#/TITLE AMOUNT
DEPT.# I hereby certify that the attached invoice(s), or
oltoG8 S P 2 3G �G93 3 s3D.o 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
20
Signat e
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund