241331 01/22/15 (9,
CITY OF CARMEL, INDIANA VENDOR: 201250
ONE CIVIC SQUARE MID STATE TRUCK EQUIP CORP CHECKAMOUNT: $*******140.33*CARMEL, INDIANA 46032 11020 ALLISONVILLE RD CHECK NUMBER: 241331
FISHERS IN 46038 CHECK DATE: 01/22/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
601 5023990 81976 80.00 OTHER EXPENSES
601 5023990 82187 60.33 OTHER EXPENSES
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" Invoice
MID-STATE TRUCK EQUIPMENT ^gip p
11020 Allisonville Road q ; ,, Invoice Number:
Retail#: 001104675-001-0 82187
Fishers, IN 46038 -
�-sc;►crscarmcnr Invoice Date:
%11dF.%wIs
Phone: 317.849.4903a?.
�www.mid-statetruck.com 1/7/2015
Fax : 317.849.6441
BIII To Ship To
CARM WASWATER UTILITIES
760 THI AV NUE S.W.
SUITE 110
CARMEL, 6032
Handlin_p charge added to Credit Customer P.O. No. Terms --
Card orders over$500.00: 2.5%on
Visa, MIC,AMEX&Discover W1341,2281A NET 25 Days
Sales Rep ID Shipping Method Ship Date Due Date
AV i 1/7/2015
.__ 2/1/2015
�__...._.._.._._.._......._......... ..- ---._.....__........----_._.._... ----.._._.._. ---. .............- --
Qty Item Code Description Price Ea. Extension
2 HYD07020 1 HOSEIA x15",3/8"MORx1/4"MP 15.071 30.14
1 HYD01695 HOSE,1/4"x15-1/2",1/4"MPxl/4MP 12.19 12.19
2 HYD01835 BOSS SNOWPLOW OIL j 9.00 18.00
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Received : Pat
Date .
PO # :
ACCT
y
Use :
t
Serial #
Serial #
Subtotal $60.33
Cash [ ] Check [ ] # Sales Tax (7.0%) $0.00
Credit Card [ ] Auth. # v Total Invoice Amount $60.33
Payment Received $0.00
Received by Date
Balance Due $60.33
Thank you for your business!
MID-STATE TRUCK EQUIPMENT Q _ Invoice
11020 Allisonville Road _ Invoice Number:
Retail#: 001104675-001-0 .
81976
Fishers, IN 46038 I :-
Fidrt•Sc1�r Truiiipiipnteotc` Invoice Date:
indraiiapaels
Phone: 317.849.4903
tJ
Fax : 317.849.6441
www.mid-statetruck.com 1/5/2015
Bill To Ship To
CARMEL WATER DISTRIBUTION
3450 W. 131st St.
Westfield, IN 46074-8267
Handling charge added to Credit Customer P.O. No. Terms
Card orders over$500.00: 2.5% on
Visa, MIC,AMEX&Discover NET 25 Days
Sales Rep ID Shipping Method Ship Date Due Date
CJS cust. pick-up 1/5/2015 1/30/2015
Qty Item Code Description Price Ea. Extension
4 PARTS 1 BUYERS PLOW SHOE 20.00 80.00
Serial #
Serial #
Subtotal $80.00
Cash [ ] Check [ ] # Sales Tax (7.0%) $0.00
Credit Card [ ] Auth. # Total Invoice Amount $80.00
Payment Received $0.00
Received by Date
Balance Due $80.00
Thank you for your business!
i
VOUCHER # 142747 WARRANT # ALLOWED
201250
IN SUM OF $
MID STATE TRUCK EQUIP CORP
11020 ALLISONVILLE RD
FISHERS, IN 46038
Carmel Water Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
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PO# INV# ACCT# AMOUNT Audit Trail Code
82187 01-6500-04 $60.33
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Voucher Total
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
201250
MID STATE TRUCK EQUIP CORP Purchase Order No.
11020 ALLISONVI LLE RD Terms
FISHERS, IN 46038 Due Date 1/13/2015
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
1/13/2015 82187 $60.33
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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
Date Officer