226429 11/19/2013 CITY OF CARMEL, INDIANA VENDOR: 362032 Page 1 of 1
ONE CIVIC SQUARE PAPER-LITE
CHECK AMOUNT: $450.00
CARMEL, INDIANA 46032 1711 WOOD VALLEY DRIVE
'y,roN,�o CARMEL IN 46032 CHECK NUMBER: 226429
CHECK DATE: 11/19/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1115 4351501 31317 4878 450 . 00 HARDWARE SUPPORT
INDIANA RETAIL TAX EXEMPT PAGE
City Carmel CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 39317
35-60000972
ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES,A/P
CARMEL, INDIANA 46032-2584 VOUCHER, DELIVERY MEMO, PACKING SLIPS,
FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL- 1997 SHIPPING LABELS AND ANY CORRESPONDENCE.
PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION
11/682013 Scanner Hardware Support
Paper-Lite Divison of Mathes Assoc., Inc. Carmel Communications
Terry Crockett
VENDOR SHIP
1711 Wooel Valley Drive TO 3 Civic Square V i
Carmel, IN 46032 Carmel, IN 46032
(317)571-2567
CONFIRMATION BVUENIT CONTRACT PAYMENTTERMS FREIGHT
QUANTITY F MEASUR E
DESCRIPTION UNIT PRICE EXTENSION
Account 43-515.01
1 Each Scanner Hardware Support s/n 138834/Lois Craig-Clerk's Office $150.00 $150.00
1 Each Scanner Hardware Support s/n 095510/Ann Davis-Clerk's office $150.00 $150.00
1 Each Scanner Hardware Support s/n 138459/Sue Wolfgang-Human Resources $150.00 $150.00
Sub'Dotal: $450.00
ra
Scanner Support
Send Invoice To:
City of Carmel
Terry Crockett
3 Civic Square
Carmel, IN 46032-
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
Carmel IS Dept, PAYMENT $450.00
• A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O.
NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND
VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED.
SHIPPING INSTRUCTIONS I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN
THIS APPROPRIA ION SUFFICIENT-TO
HIP REPAID. PAY FOR THE ABOVE ORDER.
• �i
•C.O.D.SHIPMENTS CANNOT BE ACCEPTED.
• ORDERED BY
PURCHASE ORDER NUMBER MUST APPEAR ON ALL
SHIPPING LABELS. Drector
•THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
q CLERK-TREASURER
DOCUMENT CONTROL NO. 31317 A.P.V. COPY-SIGN AND RETURN TO CLERK'S OFFICE
VOUCHER NO. WARRANT
ALLOWED 20
IN THE SUM OF$
S
_ a
ON ACCOUNT OF APPROPRIATION FOR
Board Members
PO#or INVOICE NO. ACCT#/TITLE AMOUNT
DEPT.## 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
— 20
Signature
- ._...............................-... _...........-..........................................._......._.
Title
Cost distribution ledger classification if _
claim paid motor vehicle highway fund
� 1 10-41 1 1 ewe 1-
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Invoice
1711 Wood Valley Drive
Carmel, IN 46032 DATE INVOICE#
11/13/2013 4878
BILL TO
City of Carmel
Three Civic Square
Carmel,IN 46032
Attn:T.Crockett
P.O. NO. TERMS DUE DATE
31317 Net 30 12/13/2013
DESCRIPTION QTY RATE AMOUNT
Support Renewal-Scanners-Fujitsu 6130-Serial 4 138834, 3 150.00 450.00
096610; 138459-Current support expires 12/26/13
Subtotal $450.00
Sales Tax (0.00) $0.00
Total $450.00
Phone# Fax# E-mail
812-350-5044 317-581-9409 nancv a gopaperlite.com
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))
11/13/13 4878 $450.00
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
120
Clerk-Treasurer
VOUCHER NO. WARRANT NO.
ALLOWED 20
Paper-Lite Divison of Mathes Assoc., Inc.
IN SUM OF $
1711 Wood Valley Drive
Carmel, IN 46032
$450.00
ON ACCOUNT OF APPROPRIATION FOR
IS Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT - Board Members
31317 I 4878 I 43-515.01 I $450.00 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
Thursday, November 14, 2013
Di ector ,, IS
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund