242351 02/17/15 (9-
CITY OF CARMEL, INDIANA VENDOR: 201250
ONE CIVIC SQUARE MID STATE TRUCK EQUIP CORP CHECK AMOUNT: S*******196.86*
CARMEL, INDIANA 46032 11020 ALLISONVILLE RD CHECK NUMBER: 242351
FISHERS IN 46038 CHECK DATE: 02/17/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2201 4237000 82930 196.86 REPAIR PARTS
MID-STATE TRUCK EQUIPMENT Invoice
11020 Allisonville Road Invoice Number:
Retail#: 001104675-001-0 82930
Fishers, IN 46038
EqutpnKfic Invoice Date'.
Phone: 317.849.4903
2/912015
www.Mid-statetruck.com
Fax 317.849.6441
S
Bill To hip To
CARMEL STREET DEPARTMENT
3400 West 131 Street
WESTFIELD, IN 46074
7-I--
Handling charge added to Credit Customer P.O. No. Tefffyis 7_
Card orders over$500.00: 2.5%on
Visa, MIC, AMEX&Discover 020915 NET 25 Days
Sales Rep ID Shipping Method Ship Date Due Date
AV 2/9/2015 3/6/2015
1 Qty Item Code Description Price Ea. Extension
--—----------
1 mSC08001 08+VEH SIDE HARNESS 196.86 196.86
J --— - --- ! - --- - I - !- --
Serial #
Serial #
Subtotal $196.86
Cash Check [ Sales Tax (7.0%) $0.00
0.00
Total Invoice Amount $196.86
Credit CardAut # Payment Received 0.-00
Received by Date
Balance Due $1916.86
Thank
youforyour business!
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))
02/09/15 82930 _ $196.86
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
Mid-State Truck Equipment
IN SUM OF $
11020 Allisonville Road
Fishers, IN 46038
$196.86
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT
Board Members
2201 82930 42-370.00 $196.86 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
1A
Thursdaq�Fe r ry 12, 2015
Street Commissioner
Street Commissioner
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund