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Home My WebLink About227275 12/17/2013 CITY OF CARMEL, INDIANA VENDOR: 00352419 Page 1 of 1 ONE CIVIC SQUARE BELL TECHLOGIX INC O CARMEL, INDIANA 46032 CHECK AMOUNT: $8,440.07 PO BOX 823342 PHILADELPHIA PA 19182-3342 CHECK NUMBER: 227275 CHECK DATE: 12/17/2013 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 102 4463201 24519 BI347126 224 . 44 •EOC PROJECT 102 4463201 24519 BI347127 2, 233 . 10tEOC PROJECT 102 4463201 24519 BI347142 2, 018 . 53 •EOC PROJECT 1701 4463201 BI347158 255 . 33` MICR FONT 102 4463201 24519 BI347165 567 . 60 • EOC PROJECT 102 4463201 24519 BI347166 3 , 141 . 07: EOC PROJECT Te&logix PAGE:l INVOICE:B I 347165 REMIT TO: INVOICE DATE: 12/10/13 BELL TECHLOGIX INC DUE DATE: 01/09/14 P.O. BOX 823342 PHILADELPHIA PA 19182-3342 TERMS:Net 30 317-333-7777 Net 30 Days 866-782-2355 �' SHIP TO: BILL TO: 1201825 Carmel Fire Dept CITY OF CARMEL 31 First Avenue NW ONE CIVIC SQUARE TODD LUCKOSKI PO#24519 ATTN: ACCOUNTS PAYABLE Carmel IN 46032 CARMEL IN 46032 USA ORDER: 710763 ORDER DATE: 12/04/13 CUSTOMER PO: 2 4 519 - - -- -- — CARRIER:-- FREIGHT TERMS: METHOD: TRANSPORTATION ID: SALESPERSON: JUANA YOUNCE CURRENCY: United States Dollars Carmel Fire Dept Terry err Crockett 317-571-2622 tcrockett @carmel . in.gov Cust PO Num: 24519 Contact name: Terry Crockett Phone: 3175712567x Email : tcrockett @carmel . in.gov BELL SO 710763 - 20103521 8 U6E99E 2 EA 567 . 60 CARE PACK 4-HOUR 24X7 3 YEARS 283 . 80 EA EXTENDED SERVICE AGREEMENT **************************************** PAST DUE ACCOUNTS CARRY INTEREST AT THE LESSER OF 1 . 5% PER MONTH OR THE MAXIMUM LEGAL RATE IN THE JURISDICTION IN WHICH THE CUSTOMER' S PRINCIPAL PLACE OF BUSINESS IS LOCATED ALL DELIVERY TERMS ARE F.O.B. ORIGIN **************************************** TO REQUEST A STATEMENT OF ACCOUNT PLEASE CONTACT 866-782-2355 EXT 7787 **************************************** FEDERAL TAX ID# 26-3683994 **************************************** FOR SERVICE CALL 1-800-999-9813 * * * * B A C K O R D E R S U M A R Y M 2 XP612AA 1 NVIDIA QUADRO NVS 300 GRAPHICS FREIGHT CHARGE: 0 . 00 GROSS AMOUNT: 567 . 60 INVOICE DISCOUNT: 0 . 00 NET AMOUNT: 567 . 60 TAX AMOUNT: 0 . 00 DOWN PAYMENT: 0 . 00 NET AMOUNT DUE: 567 . 60 Techlogax® PAGE:1 INVOICE:B I 347166 REMIT TO: INVOICE DATE: 12/10/13 BELL TECHLOGIX INC DUE DATE: 01/09/14 P.O. BOX 823342 PHILADELPHIA PA 19182-3342 TERMS:Net 30 317-333-7777 s Net 30 Days Y SHIP TO: BILL TO: 1201825 Carmel Fire Dept CITY OF CARMEL 31 First Avenue NW ONE CIVIC SQUARE T. Crockett PO #24519 ATTN: ACCOUNTS PAYABLE Carmel IN 46032 CARMEL IN 46032 USA ORDER: 710765 ORDER DATE: 12/04/13 CUSTOMER PO: 2 4 519 CARRIER:-- FREIGHT TERMS: FREIGHT CHARGE 121 METHOD: UNITED PARCEL GROUND TRANSPORTATION ID: SALESPERSON: JUANA YOUNCE CURRENCY: United States Dollars i P Carmel Fire Dept Terry Crockett 317-571-2622 tcrockett @carmel . in.gov Cust PO Num: 24519 Contact name: Todd Luckoski Phone: (317) -571-2590x Email : TLuckoski @carmel . in.gov Included PO#3 on shipping label . Bell to install hi-end gra hics card, serial port card and Optical drive. BELL SO 710765 - 20103104 1 E2A59UT#ABA 1 EA 1, 163 . 57 WORKSTATION Z230 CORE I7 4770 1163 . 57 EA 3 .4 GHZ Line Lot/Serial Details: 2UA3471DN9 EA 1 2 C2J98AT 1 EA 386 .45 NVIDIA NVS 510 GRAPHICS CARD 386 .45 EA QUADRO NVS 510 2GB 3 PA716A 1 EA 24 . 74 HP 24 . 74 EA SERIAL PANEL - DE-9 (M) - FOR 4 AR482AT 1 EA 152 .41 BLU-RAY WRITER DISK DRIVE 152 .41 EA 5 U1G37E 1 EA 78 . 74 CARE PACK 4 YEAR NBD ON-SITE 78 . 74 EA EXTENDED SERVICE AGREEMENT 6 ISR-760-0007 1 EA 50 . 00 HARDWARE CONFIGURATION 50 . 00 EA 7 A9P21A8#ABA 4 EA 1, 027 . 76 CPQ LA2405X 24-IN LED MONITOR 256 . 94 EA US Line Lot/Serial Details : FREIGHT CHARGE: GROSS AMOUNT: INVOICE DISCOUNT: NET AMOUNT: TAX AMOUNT: DOWN PAYMENT: NET AMOUNT DUE: PAGE:2 Techlogix INVOICE:B I 347166 REMIT TO: INVOICE DATE: 12/10/13 BELL TECHLOGIX INC DUE DATE: 01/09/14 P.O. BOX 823342 PHILADELPHIA PA 19182-3342 TERMS:Net 30 317-333-7777 Net 30 Days Ys SHIP TO: BILL TO: 1201825 Carmel Fire Dept CITY OF CARMEL 31 First Avenue NW ONE CIVIC SQUARE T. Crockett PO #24519 ATTN: ACCOUNTS PAYABLE Carmel IN 46032 UAAMEL IN 46032 ORDER: 710765 ORDER DATE: 12/04/13 CUSTOMER PO: 2 4 519 FREIGHTTERMS: FREIGHT CHARGE 121 METHOD: UNITED PARCEL GROUND TRANSPORTATION ID: SALESPERSON: JUANA YOUNCE CURRENCY: United States Dollars ji CN433711HK EA 1 mom CN433711HM EA 1 CN433711JJ EA 1 CN4337136L EA 1 8 NQ576AT 4 EA 65 .24 HP LCD SPEAKER BAR 16 . 31 EA SPEAKER 9 FH973AT 4 EA 63 . 12 DVI CABLE DISPLAYPORT (M) 15 . 78 EA DVI-D (F) 7 . 5IN 10 UOJ12E 4 EA 129. 04 ELECTRONIC HP CARE PACK NBD 32 . 26 EA **************************************** PAST DUE ACCOUNTS CARRY INTEREST AT THE LESSER OF 1 . 5o PER MONTH OR THE MAXIMUM LEGAL RATE IN THE JURISDICTION IN WHICH THE CUSTOMER'S PRINCIPAL PLACE OF BUSINESS IS LOCATED ALL DELIVERY TERMS ARE F.O.B. ORIGIN **************************************** TO REQUEST A STATEMENT OF ACCOUNT PLEASE CONTACT 866-782-2355 EXT 7787 **************************************** FEDERAL TAX ID# 26-3683994 FOR SERVICE CALL 1-800-999-9813 FREIGHT CHARGE: 0 . 00 GROSS AMOUNT: 3 , 141 . 07 INVOICE DISCOUNT: 0 . 00 NET AMOUNT: 3 , 141 . 07 TAX AMOUNT: 0 . 00 DOWN PAYMENT: 0 . 00 NET AMOUNT DUE: 3 , 141 . 07 Techlogix PAGE:1 INVOICE:BI 347142 REMIT TO: INVOICE DATE: 12/0 9/13 BELL TECHLOGIX INC DUE DATE: 01/08/14 P.O. BOX 823342 PHILADELPHIA PA 19182-3342 TERMS:Net 30 317-333-7777 Net 30 Days 866-782-2355 �' SHIP TO: BILL TO: 1201825 Carmel Fire Dept CITY OF CARMEL 31 First Avenue NW ONE CIVIC SQUARE TODD LUCKOSKI PO#24519 ATTN: ACCOUNTS PAYABLE Carmel IN 46032 CARMEL IN 46032 USA ORDER: 710763 ORDER DATE: 12/04/13 CUSTOMER PO: 2 4 519 FREIGHT TERMS ---^- METHOD: TRANSPORTATION ID: SALESPERSON: JUANA YOUNCE CURRENCY: United States Dollars Carmel Fire Dept Terry Crockett 317-571-2622 tcrockett @carmel . in.gov Cust PO Num: 24519 Contact name: Terry Crockett Phone: 3175712567x Email : tcrockett @carmel . in.gov BELL SO 710763 - 20103521 2 XP612AA 1 EA 127 . 52 NVIDIA QUADRO NVS 300 GRAPHICS 127 . 52 EA CARD 512 MB 3 BP937AA 2 EA 61 . 06 DISPLAY ADAPTER 7 . 9IN 30 . 53 EA 4 PCISOUND5LP 1 EA 21 . 15 5 CHANNEL LP PCI SOUND CARD 21 . 15 EA 24-BIT 96 KHZ 5 652241-B21 2 EA 243 .32 DISK DRIVE DVD-RW SERIAL ATA 121 . 66 EA JACK BLACK 6 655710-S21 4 EA 1, 565.48 MIDLINE HARD DRIVE 1TB SATA600 391. 37 EA aTHN32627PU aTHN32627RF aTHN32627RH aTHN32627RW **************************************** PAST DUE ACCOUNTS CARRY INTEREST AT THE LESSER OF 1 . 5% PER MONTH OR THE MAXIMUM LEGAL RATE IN THE JURISDICTION IN WHICH THE CUSTOMER'S PRINCIPAL PLACE OF BUSINESS IS LOCATED **************************************** FREIGHT CHARGE: GROSS AMOUNT: INVOICE DISCOUNT: NET AMOUNT: TAX AMOUNT: DOWN PAYMENT: NET AMOUNT DUE: Techlogix E1! 0 PAGE:2 INVOICE:BI 347142 REMIT TO: INVOICE DATE: 12/0 9/13 BELL TECHLOGIX INC DUE DATE: 01/08/14 P.O. BOX 823342 PHILADELPHIA PA 19182-3342 TERMS:Net 30 317-333-7777 s Net 30 Days Y SHIP TO: BILL TO: 1201825 Carmel Fire Dept CITY OF CARMEL 31 First Avenue NW ONE CIVIC SQUARE TODD LUCKOSKI PO#24519 ATTN: ACCOUNTS PAYABLE Carmel IN 46032 CARMEL IN 46032 USA ORDER: 710763 ORDER DATE: 12/04/13 CUSTOMER PO: 2 4 519 --- - --CARRIER:-- ----- -- - - --- - -- - ---- - FREIGHT TERMS: METHOD: TRANSPORTATION ID: SALESPERSON: JUANA YOUNCE CURRENCY: United States Dollars ALL DELIVERY TERMS ARE F.O.B. ORIGIN **************************************** TO REQUEST A STATEMENT OF ACCOUNT PLEASE CONTACT 866-782-2355 EXT 7787 **************************************** FEDERAL TAX ID# 26-3683994 **************************************** FOR SERVICE CALL 1-800-999-9813 * * * * B A C K O R D E R S U 2 XP612AA 1 M M A R Y NVIDIA QUADRO NVS 300 GRAPHICS 8 U6E99E 2 ELECTRONIC HP CARE PACK 4-HOUR FREIGHT CHARGE: 0 . 00 GROSS AMOUNT: 2 , 018 . 53 INVOICE DISCOUNT: 0 . 00 NET AMOUNT: 2 , 018 . 53 TAX AMOUNT: 0 . 00 DOWN PAYMENT: 0 . 00 NET AMOUNT DUE: 2, 018 . 53 Techlogix PAGE:l INVOICE:B I 347126 REMIT TO: INVOICE DATE: 12/0 6/13 BELL TECHLOGIX INC DUE DATE: 01/05/14 P.O. BOX 823342 PHILADELPHIA PA 19182-3342 TERMS:Net 30 317-333-7777 Net 30 Days 866-782-2355 SHIP TO: BILL TO: 1201825 Carmel Fire Dept CITY OF CARMEL 31 First Avenue NW ONE CIVIC SQUARE TODD LUCKOSKI PO#24519 ATTN: ACCOUNTS PAYABLE Carmel IN 46032 CARMEL IN 46032 USA ORDER: 710763 ORDER DATE: 12/04/13 CUSTOMER P0: 2 4 519 CARRIER: - - FREiGHTTERMS:-- -- - - - - - -- METHOD: TRANSPORTATION ID: SALESPERSON: JUANA YOUNCE CURRENCY: United States Dollars ''}I I • ii' fpr� Carmel Fire Dept P Terry Crockett 317-571-2622 tcrockett @carmel . in.gov Cust PO Num: 24519 Contact name: Terry Crockett Phone: 3175712567x Email : tcrockett @carmel . in.gov BELL SO 710763 - 20103521 7 663201-B21 2 EA 224 .44 SMALL FORM FACTOR BALL BEARING 112 .22 EA RAIL KIT lU **************************************** PAST DUE ACCOUNTS CARRY INTEREST AT THE LESSER OF 1. 5% PER MONTH OR THE MAXIMUM LEGAL RATE IN THE JURISDICTION IN WHICH THE CUSTOMER'S PRINCIPAL PLACE OF BUSINESS IS LOCATED **************************************** ALL DELIVERY TERMS ARE F.O.B. ORIGIN **************************************** TO REQUEST A STATEMENT OF ACCOUNT PLEASE - CONTACT 866-782-2355 EXT 7787 **************************************** FEDERAL TAX ID# 26-3683994 **************************************** FOR SERVICE CALL 1-800-999-9813 * * * * B A C K O R D E R S U M M A R Y 2 XP612AA 2 NVIDIA QUADRO NVS 300 GRAPHICS 3 BP937AA 2 DISPLAY ADAPTER 7 . 9IN FREIGHT CHARGE: GROSS AMOUNT: INVOICE DISCOUNT: NET AMOUNT: TAX AMOUNT: DOWN PAYMENT: NET AMOUNT DUE: Techiogix PAGE:2 INVOICE:BI 347126 REMIT TO: INVOICE DATE: 12/0 6/13 BELL TECHLOGIX INC DUE DATE: 01/05/14 P.O. BOX 823342 PHILADELPHIA PA 19182-3342 TERMS:Net 30 317-333-7777 Net 30 Days 866-782-2355 SHIP TO: BILL TO: 1201825 Carmel Fire Dept CITY OF CARMEL 31 First Avenue NW ONE CIVIC SQUARE TODD LUCKOSKI PO#24519 ATTN: ACCOUNTS PAYABLE Carmel IN 46032 CARMEL IN 46032 USA ORDER: 710763 ORDER DATE: 12/04/13 CUSTOMER PO: 2 4 519 CARRIER: - -- _- '='FREIGHT TERMS:-- - . -- - - - METHOD: TRANSPORTATION ID: SALESPERSON: JUANA YOUNCE CURRENCY: United States Dollars e B 0 4 PCISOUND5LP 1 STARTECH.COM 5 CHANNEL LOW PRO 5 652241-321 2 HP 6 655710-S21 4 HP MIDLINE 8 U6E99E 2 ELECTRONIC HP CARE PACK 4-HOUR FREIGHT CHARGE: 0 . 00 GROSS AMOUNT: 224 .44 INVOICE DISCOUNT: 0 . 00 NET AMOUNT: 224 . 44 TAX AMOUNT: 0 . 00 DOWN PAYMENT: 0 . 00 NET AMOUNT DUE: 224 . 44 ® PAGE:1 INVOICE:B I 347127 REMIT TO: INVOICE DATE: 12/0 6/13 BELL TECHLOGIX INC DUE DATE: 01/05/14 P.O. BOX 823342 PHILADELPHIA PA 19182-3342 TERMS:Net 30 317-333-7777 Net 30 Days 866-782-2355 SHIP TO: BILL TO: 1201825 Carmel Fire Dept CITY OF CARMEL 31 First Avenue NW ONE CIVIC SQUARE TODD LUCKOSKI PO#24519 ATTN: ACCOUNTS PAYABLE Carmel IN 46032 CARMEL IN 46032 USA ORDER: 710763 ORDER DATE: 12/04/13 CUSTOMER PO: 2 4 519 CARRIER: -FREIGHT-TERMS: - _ METHOD: TRANSPORTATION ID: SALESPERSON: JUANA YOUNCE CURRENCY: United States Dollars o s I e Carmel Fire Dept Terry Crockett 317-571-2622 tcrockett @carmel . in.gov Cust PO Num: 24519 Contact name: Terry Crockett Phone: 3175712567x Email : tcrockett @carmel . in.gov BELL SO 710763 - 20103521 1 736664-SO1 2 EA 1, 654 . 92 PROLIANT DL320E GEN8 V2 SERVER 827 .46 EA RACK-MOUNTABLE aMX23450064 aMX234800HK 9 FQC-00129 2 EA 578 . 18 WINDOWS 7 PROFESSIONAL FULLPKG 289 . 09 EA **************************************** PAST DUE ACCOUNTS CARRY INTEREST AT THE LESSER OF 1 . 51 PER MONTH OR THE MAXIMUM LEGAL RATE IN THE JURISDICTION IN WHICH THE CUSTOMER'S PRINCIPAL PLACE OF BUSINESS IS LOCATED **************************************** ALL DELIVERY TERMS ARE F.O.B. ORIGIN **************************************** TO REQUEST A STATEMENT OF ACCOUNT PLEASE CONTACT 866-782-2355 EXT 7787 **************************************** FEDERAL TAX ID# 26-3683994 **************************************** FOR SERVICE CALL 1-800-999-9813 * * * * B A C K O R D E R S U M M A R Y FREIGHT CHARGE: GROSS AMOUNT: INVOICE DISCOUNT: NET AMOUNT: TAX AMOUNT: DOWN PAYMENT: NET AMOUNT DUE: Techiogix PAGE:2 INVOICE:B I 347127 REMIT T0: INVOICE DATE: 12/0 6/13 BELL TECHLOGIX INC DUE DATE: 01/05/14 P.O. BOX 823342 PHILADELPHIA PA 19182-3342 TERMS:Net 30 317-333-7777 Net 30 Days 866-782-2355 SHIP TO: BILL TO: 1201825 Carmel Fire Dept CITY OF CARMEL 31 First Avenue NW ONE CIVIC SQUARE TODD LUCKOSKI PO#24519 ATTN: ACCOUNTS PAYABLE Carmel IN 46032 CARMEL IN 46032 USA ORDER: 710763 ORDER DATE: 12/04/13 CUSTOMER PO: 2 4 519 CARRIER: — - FREIGHT TERMS: _- METHOD: TRANSPORTATION ID: SALESPERSON: JUANA YOUNCE CURRENCY: United States Dollars • OEM e 2 XP612AA 2 NVIDIA QUADRO NVS 300 GRAPHICS 3 BP937AA 2 DISPLAY ADAPTER 7 . 9IN 4 PCISOUND5LP 1 STARTECH.COM 5 CHANNEL LOW PRO 5 652241-321 2 HP 6 655710-S21 4 HP MIDLINE 8 U6E99E 2 ELECTRONIC HP CARE PACK 4-HOUR FREIGHT CHARGE: 0 . 00 GROSS AMOUNT: 2, 233 . 10 INVOICE DISCOUNT: 0 . 00 NET AMOUNT: 2, 233 . 10 TAX AMOUNT: 0 . 00 DOWN PAYMENT: 0 . 00 NET AMOUNT DUE: 2 , 233 . 10 VOUCHER NO. WARRANT NO. ALLOWED 20 Bell Industries % IN SUM OF $ P.O. Box 73286 Chicago, IL 60673 $8,184.74 ON ACCOUNT OF APPROPRIATION FOR Carmel Fire Department PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members 24519 347165 102-632.01 $567.60 1 hereby certify that the attached invoice(s), or 24519 347127 102-632.01 $2,233.10 bill(s) is (are) true and correct and that the 24519 347126 102-632.01 $224.44 materials or services itemized thereon for 24519 347166 102-632.01 $3,141.07 which charge is made were ordered and 24519 347142 102-632.01 $2,018.53 received except DEC 16 7093 Fire Chief 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)) 347165 $567.60 347127 $2,233.10 347126 $224.44 347166 $3,141.07 347142 $2,018.53 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 Techologix PAGE:l INVOICE:BI 347158 REMIT TO: INVOICE DATE: 12/10/13 BELL TECHLOGIX INC DUE DATE: 01/09/14 P.O. BOX 823342 PHILADELPHIA PA 19182-3342 TERMS:Net 30 317-333-7777 s Net 30 Days Y SHIP TO: BILL TO: 1201825 City of Carmel CITY OF CARMEL 3 Civic Square ONE CIVIC SQUARE PO#26768 ATTN: ACCOUNTS PAYABLE Carmel IN 46032 CARMEL IN 46032 USA ORDER: 710330 ORDER DATE: 11/07/13 CUSTOMER PO: 2 6 7 6 8 CARRIER: FREIGHT TERMS: METHOD: TRANSPORTATION ID: SALESPERSON: JUANA YOUNCE CURRENCY: United States Dollars sm p { yy 0 ,E C =,m—1 ity of Carmel Terry Crockett Cust PO Num: 26768 Contact name: Terry Crockett Phone: 3175712567x Email : tcrockett @carmel . in.gov As good or better than WSCA II pricing. BELL SO 710330 - 20103518 1 HG283FS 1 EA 255 .33 MICR FONT CARD / COMPACTFLASH 255 .33 EA **************************************** PAST DUE ACCOUNTS CARRY INTEREST AT THE LESSER OF 1 .5o PER MONTH OR THE MAXIMUM LEGAL RATE IN THE JURISDICTION IN WHICH THE CUSTOMER' S PRINCIPAL PLACE OF..BUSINESS IS LOCATED **************************************** ALL DELIVERY TERMS ARE F.O.B. ORIGIN **************************************** TO REQUEST A STATEMENT OF ACCOUNT PLEASE CONTACT 866-782-2355 EXT 7787 **************************************** FEDERAL TAX ID# 26-3683994 **************************************** FOR SERVICE CALL 1-800-999-9813 FREIGHT CHARGE: 0 . 00 GROSS AMOUNT: 255 . 33 INVOICE DISCOUNT: 0 . 00 NET AMOUNT: 255 . 33 TAX AMOUNT: 0 . 00 DOWN PAYMENT: 0 . 00 NET AMOUNT DUE: 255 . 33 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 Purchase Order No. Terms Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) SST_33 Total I hereby certify that the attached invoice(s), or bill(s), is (are) true and correct and I have audited same in accor- dance with IC 5-11-10-1.6. , 20 Clerk-Treasurer VOUCHER NO. WARRANT NO. ALLOWED 20 C IN SUM OF $ ON ACCOUNT OF APPROPRIATION FOR Board Members PO#or INVOICE NO. ACCT#!TITLE AMOUNT DEPT.# I hereby certify that the attached invoice(s), ao*t 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 20 Signature Title Cost distribution ledger classification if claim paid motor vehicle highway fund