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242111 02/10/15 �%'.c\�. CITY OF CARMEL, INDIANA VENDOR: 367878 "; CHECK AMOUNT: $****"""666.15* r. �• ONE CIVIC SQUARE US MACHINERY =a CARMEL, INDIANA 46032 PO INDIANAPOLIS 881502 N 46208 CHECK NUMBER: 242111 ''�+eN'�° CHECK DATE: 02/10/15 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 651 5023990 SI-1324 666.15 OTHER EXPENSES e e ' Date Invoice# 1/16/2015 S3-i324 - . Bill To Ship To City of Carmel Utilities City of Carmel Utilities 9609 Hazel Dell Parkway 9609 Hazel Dell Parkway Y IN Indianapolis 46280 IN 46280 P.O. No. Terms Project Net 30 Quantity Description I Rate Amount Machine Make: National/ Machine Model: 500D/Vin# 33575/ Mileage: 2971 Labor Description: Perform OSHA inspection and DOT inspection, change hyd filter, check swing gear box and winch oil, load test unit, all ok. 1 Filter 17.77 17.77T 1 Shop Supplies 30.88 30.88T 6.5 Labor 95.00 617 0 Sales Tax 7.00% 3.41 All past due balances are subject to a late fee of 1.5 percent per month Total $K.5 i VOUCHER # 146642 WARRANT # �, ALLOWED 367878 IN SUM OF $ US MACHINERY LLC PO BOX 881502 INDIANAPOLIS, IN 46208 Carmel Wastewater Utility ON ACCOUNT OF APPROPRIATION FOR i Board members PO# INV# ACCT# AMOUNT j Audit Trail Code SI-1324 01-7502-06 $666.15 i f d i a i i Voucher Total $666.15 Cost distribution ledger classification if I� claim paid under vehicle highway fund Prescribed by State Board of Accounts City Form No.201 (Rev 1995) ACCOUNTS PAYABLE VOUCHER CITY OF CARMEL 1 f 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 367878 US MACHINERY LLC Purchase Order No. PO BOX 881502 Terms INDIANAPOLIS, IN 46208 Due Date 2/4/2015 t ` Invoice Invoice Description Date Number (or note attached i'nvoice(s) or bill(s)) Amount i 2/4/2015 S1-1324 i $666.15 f i i i 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