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HomeMy WebLinkAbout225516 10/23/2013 CITY OF CARMEL, INDIANA VENDOR: 244000 Page 1 of 1 ONE CIVIC SQUARE PITNEY BOWES INC. CARMEL, INDIANA 46032 PO BOX 371887 CHECK AMOUNT: $1,034.00 PITTSBURG PA 15250 CHECK NUMBER: 225516 CHECK DATE: 10/23/2013 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 601 5023990 1908435-OT13 240 . 00 OTHER EXPENSES 651 5023990 1908435-OT13 144 . 00 OTHER EXPENSES 1701 4353003 2018273-OT13 410 . 00 POSTAGE METER 1120 4353003 2278380-OT13 52 . 00 POSTAGE METER 1160 4353003 2637461-OT13 145 . 00 POSTAGE METER 1192 4353003 3968112-OT13 43 . 00 POSTAGE METER aILL Pitney Bowes Terra rental invoice# 2637461 -OT13 October 13,2013 Account name Invoice Summary - Schedule # 406 City Of Carmel Mayors Office Term rental charges $145.00 ....................................................................................................................................................... Sales tax $0.00 Acctnumber ....................................................................................................................................................... 2637461 Previous balance after payments $145.00 Total due November 6,2013 $290.00 Invoice number 2637461-OT13 Please see reverse side for invoice details. Payment Options Past due notice: Your account is now past due. Please mail your payment today to the return address. Online Account Management Register for MyAccount fa Your last payment of$145.00 was credited to your account on Sep 8, 2013. "-' www.pb.com/myaccount.Click Any payments received after Oct 6, 2013 may not be reflectea on this invoice. View and Pay Bills for online payments. Make check payable to Pitney Bowes. Pay by Phone Questions about your statement? Why not ask Sophie,our new On-Line Virtual 1-800-288-2357 Agent?You can visit Sophie 24 hours a day or choose to Chat with an agent from 8:00 AM -8:00 PM EST.GO TO:www.pb.com/support For Questions? Thank you for choosing Pitney Bowes. ask Sophie Pitney Bowes Virtual Agent 6, 'M Go to:www.pb.com/support or call: 1-800-288-2357 8 a.m to 6 p.m.EST Avoid late charges Malk your payment with the coupon below and allovt up tp:A da..ys for rnati and processing time. Page 1 of 2 TAX ID 06-0495050 4 Tearoff here 002623 wX JIL Term rental invoice � Pitney Bowes October 13,2013 Ir Pitney Bowes Acct number Invoice number 2637461 2637461-OT13 Details of term rental charges Charges for schedule 406 Equipment description: Charges for the period.Sep 30,2013 to Oct 30,2013 Mailing system Equipment location: 1 Civic Sq Floor,Carmel IN Model number: Serial number: Term rental charges _ $145.00 3C00 3158777 Previous balance after payments $145.00 0 Model number: Serial number: Total for schedule 406 $290.00 MP30 0178299 _° Meter model: Serial number: Total charges $290.00 -2 G900 3158777 0 0 0 r, N Additional equipment on file. N 0 Important information ° 0 To order supplies from Pitney Bowes,call:1-800-243-7824 This transaction is governed by the terms and conditions of the applicable Pitney Bowes Term Rental agreement,current as of the date of this invoice unless otherwise agreed to in writing by the parties. For questions,call: o Equipment purchase 1-800-322-8000 Rental 1-800-288-2357 This term rental invo:ca represents the amount ynu currently owe Pitney Bowes for the - Leasing 1-800-288-2357 Pitney Bowes equipment and services. Service 1-800-522-0020 Postage By Phone®account 1-800-243-7800 Overnight checks should be mailed to: Purchase Power®account 1-800-243-7800 Pitney Bowes Attn:Box 371887 Email:mybills.supportrdpb.com 500 Ross Street Suite 154-0470 or go to:www.pb.com/contact-us Pittsburgh,PA 15262-0001 Returns Check your agreement with us for our return policy on equipment,postage meters and software that you have purchased,licensed,leased or rented from Pitney Bowes. Page 2 of 2 VOUCHER NO. WARRANT NO. ALLOWED 20 Pitney Bowes, Inc. IN SUM OF $ P. O. Box 371887 Pittsburgh, PA 15250-7887 $145.00 ON ACCOUNT OF APPROPRIATION FOR Mayor's Office PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members 1160 2637461-OT13 43-530.03 $145.00 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 Sunday, October 20, 2013 v r Mayor Title Cost distribution ledger classification if claim paid motor vehicle highway fund 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)) 10/13113 2637461-OT13 $145.00 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 Pitney Bowes Term rental invoice 1 084,35-OT13 October 13, 2013 Account name Invoice Summary - Schedule ## 401 Carmel Utilities Term rental charges $384.00 ....................................................................................................................................................... Acct number Sales tax $0.00 1908435 ....................................................................................................................................................... Previous balance after payments $384.00 Invoice number Total due November 6,2013 $768.00 1908435-OT13 Please see reverse side for invoice details. Payment Options Past due notice: Your account is now past due. Please mail your payment today to Online Account Management the return address. Register for MyAccount Id ' www.pb.com/myaccount.Click Your last payment of$384.00 was credited to your account on Sep 8, 2013. View and Pay Bills for online Any payments received after Oct 6, 2013 may not be reflected on this invoice. payments. a Pay by Phone Make check payable to PitneyBowes. 1-800-288-2357 Questions about your statement? Why not ask Sophie,our new On-Line Virtual Agent?You can visit Sophie 24 hours a day or choose to Chat with an agent from For Questions? 8:00 AM -8:00 PM EST.GO T0:www.pb.com/support ask Thank you for choosing Pitney Bowes. Sophie Pitney Bowes Virtual Agent � . 6` Go to:www.pb.com/support or call: 1-800-288-2357 8 a.m to 6 p.m. EST Avoid late:charges Mail yvurpayment with the caupon below atd allow up to:>7 1d days for mall and pr©cessingitlme Page 1 of 2 TAX ID 06-0495050 4 Tearoffhere 001712 X PitneyBowes Term rental payment coupon Acct number:1908435 Amount you owe:$768.00 2225 American Drive Please make your check payable to Invoice number:1908435-OT13 Neenah,WI 54956-1005 Pitney Bowes Invoice date:Oct 13,2013 Clue date:Nov 6,2013 0131010017120000100110132013 C Amount paid $ 60 1908435 401 640 00076800 6 00000 1 0 PITNEY BOWES PO BOX 371887 CARMEL UTILITIES C 3RD STE 110 PITTSBURGH PA 15250-7887 AR ARMEL IN N 4 460033 2-7612 ❑ Change of contact information? Check here and fit[in the information on the back. VOUCHER # 136655 WARRANT # ALLOWED 244000 IN SUM OF $ PITNEY BOWES PO BOX 371887 PITTSBURGH, PA 15250 Carmel Wastewater Utility ON ACCOUNT OF APPROPRIATION FOR Board members PO# INV# ACCT# AMOUNT Audit Trail Code 19084350T13 01-7360-07 $144.00 I i i Voucher Total $144.00 Cost distribution ledger classification if claim paid under vehicle highway fund 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 of service rendered, by whom, rates per day, number of units, price per unit, etc. Payee 244000 PITNEY BOWES Purchase Order No. PO BOX 371887 Terms PITTSBURGH, PA 15250 Due Date 10117/2013 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) Amount 10/17/201: 19084350T1: $144.00 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 o LL t113 —C'- - 'P�'-- �- Date Officer OUILL Pitney Bowes Term rental invoice# 19084,35-OT13 October 13, 2013 Account name Invoice Summary - Schedule # 401 Carmel Utilities Term rental charges $384.00 ....................................................................................................................................................... Acct number Sales tax $0.00 1908435 ..................................................................................................................................I.................... Previous balance after payments $384.00 Invoice number Total due November 6, 2013 $768.00 1908435-OT13 Please see reverse side for invoice details. Payment Options Past due notice: Your account is now past due. Please mail your payment today to Online Account Management the return address. I_ .1 Register for Myaccount fd www.pb.com/myaccount.Click Your last payment of$384.00 was credited to your account on Sep 8, 2013. View and Pay Bills for online Any payments received after Oct 6, 2013 may not be reflected on this invoice. payments. Pay by Phone Make check payable to Pitney Bowes. 1-800-288-2357 Questions about your statement? Why not ask Sophie,our new On-Line Virtual Agent?You can visit Sophie 24 hours a day or choose to Chat with an agent from For Questions? 8:00 AM -8:00 PM EST.GO TO:www.pb.com/support ask Thank you for choosing Pitney Bowes. Sophie Pitney Bowes Virtual Agent Go to:www.pb.com/support or call: 1-800-288-2357 8 a.m to 6 p.m.EST Avoid,.ate charges»Mait your payment with the c.Ou..pon below and ailota up to.7 [0 days for matt and pracesstIft time. Page 1 of 2 TAX ID 06-0495050 4 Tear off here 001712 X Term rental invoice owe`+ October 13,2013 Pitney +'r J� v7 Acct number Invoice number V 1908435 1908435-OT13 / <✓� 11 t Details of term rental charges l Charges for schedule 401 Equipment description: Charges for the period:Sep 30,2013 to Oct 30,2013 Mailing system Equipment location. 760 3rd Ave SW,Carmel IN Model number: Term rental charges $384.00 AZBB Previous balance afterRayments $384.00 Model number: Total for schedule 401 $768.00 cli APSE ° Meter model: Serial number: Total charges $768.00 o WOO 1376944 0 N Important information To order supplies from Pitney Bowes,call:1-800-243-7824 ° pp Y This transaction is governed by the terms and conditions of the applicable Pitney Bowes Term Rental agreement,current ° For questions,call: as of the date of this invoice unless otherwise agreed to in writing by the parties. p Equipment purchase 1-800-322-8000 Rental 1-800-288-2357 This term rental invoice represents the amount you currently owe Pitney Bowes for the o Leasing 1-800-288-2357 Pitney Bowes equipment and services. V Service 1-BUO-522-OUZO Postage By Phone 0 account 1-800-243-7800 Overnight checks should be mailed to: Purchase Power®account 1-800-243-7800 Pitney Bowes Attn:Box 371887 Email:mybills.supportfapb.com 500 Ross Street Suite 154-0470 or go to:www.pb.com/contact-us Pittsburgh,PA 15262-0001 Returns Check your agreement with us for our return policy on equipment,postage meters and software that you have purchased,Licensed,leased or rented from Pitney Bowes. Page 2 of 2 VOUCHER # 133126 WARRANT # ALLOWED 244000 IN SUM OF $ PITNEY BOWES P.O. Box 856390 Louisville, KY 40285-6390 Carmel Water Utility ON ACCOUNT OF APPROPRIATION FOR Board members PO# INV# ACCT# AMOUNT Audit Trail Code 1908435071; 01-6360-07 $240.00 Voucher Total $240.00 Cost distribution ledger classification if claim paid under vehicle highway fund 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 of service rendered, by whom, rates per day, number of units, price per unit, etc. Payee 244000 PITNEY BOWES Purchase Order No. P.O. Box 856390 Terms Louisville, KY 40285-6390 Due Date 10/17/2013 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) Amount 10/17/201: 1908435OT1 $240.00 I hereby certify that the attached invoice(s), or bill(s) is (are) true and correct and I have audited same in accordance/w`with IC 5-11-10-1.6 Ulf Date Officer 14 Pitney Bowes Terra rental invoice# 3968112-OT13 October 13, 2013 Account name Invoice Summary - Schedule # 402 City Of Carmel Of Community Services Term rental charges $43.00 Sales tax $0.00 Acctnumber ....................................................................................................................................................... 3968112 Previous balance after payments $43.00 Total due November 6,2013 $86.00 Invoice number 3968112-OT13 Please see reverse side for invoice details. Payment Options Past due notice: Your account is now past due. Please mail your payment today to the return address. Online Account Management 1`0 Register for MyAccount fa Your last payment of$43.00 was credited to your account on Sep 8, 2013. °-' www.pb.com/myaccount.Click Any payments received after Oct 6, 2013 may not be reflected on this invoice. View and Pay Bias for online payments. Make check payable to Pitney Bowes. Pay by Phone Questions about your statement? Why not ask Sophie,our new On-Line Virtual 1-800-288-2357 Agent?You can visit Sophie 24 hours a day or choose to Chat with an agent from 8:00 AM-8:00 PM EST.GO TO:www.pb.com/support For Questions? Thank you for choosing Pitney Bowes. ask �...o Sophie �D r . s Pitney Bowes Virtual Agent Go to:www.pb.com/support or call: 1-800-288-2357 8 a.m to 6 p.m.EST . Avoid late xharges Mattyour payment...with th 0 1.1 coupon below:4 allow u6j.....6...:.1.....4. 10 da..ys for coati artd processing tlme. Page 1 of 2 TAX ID 06-0495050 4 Tear off here 003573 wX Term rental invoice Pitne /B®weS October 13,2013 �i�7 Acct number Invoice number 3968112 3968112-OT13 Details of term rental charges Charges for schedule 402 Equipment description: Charges for the period:Sep 30,2013 to Oct 30,2013 Mailing system Equipment location: One Civic Square,Carmel IN Model number: Serial number: Term rental charges $43.00 MP04 0503447 Previous balance after payments $43.00 Cq Cq Model number: Serial number: Total for schedule 402 $86.00 7POO 3976012 ° Meter model: Serial number: Total charges $86.00 0 P700 3976012 0 0 0 Additional equipment on file. M 0 Important information ° 70 order supplies from Pitney Bowes,call:1-800-243-7824 0 This transaction is governed by the terms and conditions of the applicable Pitney Bowes Term Rental agreement,current For questions,call: as of the date of this invoice unless otherwise agreed to in writing by the parties. 0 Equipment purchase 1-800-322-8000 Rental 1-COO-206-2357 This term ren.3t invoice renrefents the amount you currently owe Pitney Bowes for the - - Leasing 1-800-288-2357 Pitney Bowes equipment and services. Service 1-800-522-0020 Postage By Phone®account 1-800-243-7800 Overnight checks should be mailed to: Purchase Power®account 1-800-243-7800 Pitney Bowes Attn:Box 371887 Email:mybitls.supportfdpb.com 500 Ross Street Suite 154-0470 or go to:www.pb.com/contact-us Pittsburgh,PA 15262-0001 Returns Check your agreement with us for our return policy on equipment,postage meters and software that you have purchased,licensed,leased or rented from Pitney Bowes. Page 2 of 2 VOUCHER NO. WARRANT NO. ALLOWED 20 Pitney Bowes, Inc IN SUM OF $ P.O. Box 371887 Pittsburg, PA 15250-7896 $43.00 ON ACCOUNT OF APPROPRIATION FOR Carmel DOCS PO#/Dept. INVOICE NO. I ACCT#/TITLE AMOUNT Board Members 1192 I 3968112-OT13 I 43-530.03 I $43.00 I hereby certify that the attached invoice(s), or bill(s) is (are) true and correct and that the i materials or services itemized thereon for which charge is made were ordered and received except Monday, October 21, 2013 o ject TRIP Cost distribution ledger classification if claim paid motor vehicle highway fund 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)) 10/13/13 3968112-OT13 $43.00 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 i Clerk-Treasurer Pitney Bowes Term rental invoice# 2278380-OT13 October 13, 2013 Account name invoice Summary - Schedule # 404 City Of Carmel Fire Term rental charges $52.00 Department ....................................................................................................................................................... Sales tax . $0.00 Acctnumber ....................................................................................................................................................... 2278380 Previous balance after payments $52.00 Total due November 6, 2013 $104.00 Invoice number 2278380-OT13 Please see reverse side for invoice details. Payment Options Past due notice: Your account is now past due. Please mail your payment today to the return address. Online Account Management " Register for MyAccount fa Your last payment of$52.00 was credited to your account on Sep 8, 2013. °-' www.pb.com/myaccount.Click Any payments received after Oct 6, 2013 may not be reflected on this invoice. View and Pay Bills for online payments. Make check payable to Pitney Bowes. E Pay by Phone Questions about your statement? Why not ask Sophie,our new On-Line Virtual 1-800-288-2357 Agent?You can visit Sophie 24 hours a day or choose to Chat with an agent from 8:00 AM-8:00 PM EST.GO TO:www.pb.com/support For Questions? Thank you for choosing Pitney Bowes. ask Sophie ' Pitney Bowes Virtual Agent aaRI Go to:www.pb.com/support or call: 1-800-288-2357 8 a.m to 6 p.m.EST Avi Fd late..charges Flail your payment wnth,t..e eoupon belowt and allow up to 7 10 bays for matl and processing tlm @. Page 1 of 2 TAX ID 06-0495050 4 Tearoffhere 002248 WX Term rental invoice Pitney Bowes October 13,2013 ��IP�f Acct number Invoice number 2278380 2278380-OT13 Details of term rental charges Charges for schedule 404 Equipment description: Charges for the period:Sep 30,2013 to Oct 30,2013 Mailing system Equipment location: 2 Civic Square,Carmel IN Model number: Serial number: Term rental charges $52.00 MP04 1581630 Previous balance after payments $52.00 0 Model number: Serial number: Total for schedule 404 $104.00 M 7PO0 3885435 <° Meter model: Serial number: Total charges $104.00 0 P700 3885435 0 0 0 co v Additional equipment on file. N 0 Important information ° 0 To order supplies from Pitney Bowes,call:1-800-243-7824 This transaction is governed by the terms and conditions of the applicable Pitney Bowes Term Rental agreement,current For questions,call: as of the date of this invoice unless otherwise agreed to in writing by the parties. o Equipment purchase 1-800-322-8000 RentaL 1-800-288-2357 This term rental invoice represents the amount you cu FrentLy owe Pitney Bowes for the Leasing 1-800-288-2357 Pitney Bowes equipment and services. Service 1-800-522-0020 Postage By Phone®account 1-800-243-7800 Overnight checks should be mailed to: Purchase Power®account 1-800-243-7800 Pitney Bowes Attn:Box 371887 Email:mybills.supportrdpb.com 500 Ross Street Suite 154-0470 or go to:www.pb.com/contact-us Pittsburgh,PA 15262-0001 Returns Check your agreement with us for our return policy on equipment,postage meters and software that you have purchased,Licensed,Leased or rented from Pitney Bowes. Page 2 of 2 VOUCHER NO. WARRANT NO. ALLOWED 20 Pitney Bowes IN SUM OF $ P.O. Box 371887 Pittsburgh, PA 15250 $52.00 ON ACCOUNT OF APPROPRIATION FOR Carmel Fire Department PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members 1120 2278380-OT13 I 43-530.03 I $52.00 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 OCT 112013 Fire Chief Title Cost distribution ledger classification if claim paid motor vehicle highway fund Irescribed 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 nrhom, 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)) 2278380-OT13 $52.00 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 Pitney Bores Terns rental invoice# 2013273-OT13 October 13,2013 Account name Invoice Summary - Schedule # 407 City Of Carmel Clerk Treasurers Term rental charges $410.00 ....................................................................................................................................................... Sales tax $0.00 Acct number ** Previous balance requested not to be shown by Lessee` 2018273 Total due November 6,2013 $410.00 Invoice number 2018273-OT13 Please see reverse side for invoice details. Past due notice: Your account is now past due. Please mail your payment today to Payment Options the return address. Online Account Management Register for MyAccount fd Your last payment of$410.00 was credited to your account on Sep 8, 2013. °-' www.pb.com/myaccount.Click Any payments received after Oct 6, 2013 may not be reflected on this invoice. View and Pay Bills for online Make check payable to Pitney Bowes. payments. Pay by Phone Questions about your statement? Why not ask Sophie,our new On-Line Virtual 1-800-288-2357 Agent?You can visit Sophie 24 hours a day or choose to Chat wiWan agent from 8:00 AM—8:00 PM EST.GO TO:www.pb.com/support For Questions? Thank you for choosing Pitney Bowes. ask Sophie °^ Pitney Bowes Virtual Agent Go to:www.pb.com/support or call: 1-800-288-2357 8 a.m to 6 p.m.EST Avoid late`charges Maii. .Qur payment with the.coUpon below and atlovsr up to. 1D days for magi and pr©t esstitg time Page 1 of 2 TAX ID 06-0495050 4 Tear off here 001907 X Term rental invoice ®rr— Pitney BoweS October 13,2013 ��ii�7 Acct number Invoice number 2018273 2018273-OT13 Details of term rental charges Charges for schedule 407 Equipment description: Charges for the period:Sep 30,2013 to Oct 30,2013 Mailing system Equipment location: 1 Civic Sq,Carmel IN Model number: Term rental charges $410.00 AZBB Total for schedule 407 $410.00 0 Model number: t" C-) 1FWV Total charges $410.00 ° Meter model: Serial number: o 1 W00 1368327 ° 0 0 0 0 Important information To order supplies from Pitney Bowes,call:1-800-243-7824 This transaction is governed by the terms and conditions of the appLicable Pitney Bowes Term RentaL agreement,current o For questions,call: as of the date of this invoice unless otherwise agreed to in writing by the parties. o Equipment purchase 1-800-322-8000 c� RentaL 1-800-288-2357 This term rental invoice represents the amount you currently owe Pitney Bowes for the o Leasing 1-000-288-2357 Pitney Bowes equipment and services. Service - 1-800-522-0020 —J--' - Postage By Phone®account 1-800-243-7800 Overnight checks should be mailed to: Purchase Power®account 1-800-243-7800 Pitney Bowes Email:mybills.supportfapb.com 500 Box 371887 500 Ross Street Suite 154-0470 or go to:www.pb.com/contact-us Pittsburgh,PA 15262-0001 Returns Check your agreement with us for our return policy on equipment,postage meters and software that you have purchased,licensed,leased or rented from Pitney Bowes. Page 2 of 2 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 'T�Ivu ' � Purchase Order No. Terms Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) 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 $ $ q10 ON ACCOUNT OF APPROPRIATION FOR Board Members PO#or INVOICE NO. ACCT#!TITLE AMOUNT DEPT.# I hereby certify that the attached invoice(s), or 410 1 bill(s) is (are) true and correct and that the [( 3 materials or services itemized thereon for which charge is made were ordered and received except 20 A O�X Signature Title Cost distribution ledger classification if claim paid motor vehicle highway fund