245919 06/03/15 4+ur c,q�f
q/ ,� CITY OF CARMEL, INDIANA VENDOR: 201250
• ONE CIVIC SQUARE MID STATE TRUCK EQUIP CORP CHECK AMOUNT: S""""145.00'
4' =Q CARMEL, INDIANA 46032 11020 ALLISONVILLE RD CHECK NUMBER: 245919
9.�y",oN� FISHERS IN 46038 CHECK DATE: , 06/03/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1203 R4359003 26826 84445 145.00 ANNUAL MOBILE MAINTEN
MID-STATE TRUCK EQUIPMENTInvoice
11020 Allisonville Road - Invoice Number:
Retail#: 001104675-001-0 ' ►" 84445
Fishers, IN 46038
Mid•scacclTruck Equipnecne Invoice Date:
Indr%mipwis
Phone: 317.849.4903 a .
tiJ
Fax : 317.849.6441 www.mid-statetruck.com 5/21/2015
Bill To Ship To
CITY OF CARMEL MEGAN McVICKER
ONE CIVIC SQUARE 317.571.2791
CARMEL, IN 46032
Handling-chancie-added to-Credit Customer P.O. No. Terms
Card orders over$500.00: 2.5%on
Visa, MIC,AMEX&Discover a& NET 25 Days
Sales-Rep ID Shipping Method Ship Date Due Date
MRR cust.pick-up 5/12/2015 6/15/2015
Qty Item Code Description Price Ea. Extension
1.5 LABOR ANNUAL SERVICE FOR MOBILE STAGE UNIT 80.00 120.00
--FIXED LEAVING FITTING
--CHECKED WHEEL BEARINGS
--REPLACED GROUND CABLE ON BATTERY
--TOPPED OFF HYDRAULIC TANK
1 shop-001 GROUND CABLE 25.00 25.00
HYDRAULIC FLUID
Serial #
Serial #
Subtotal $145.00
Cash [ ] Check [ ] # Sales Tax (7.0%) $0.00
Credit Card [ ] Auth. # Total Invoice Amount $145.00
Payment Received $0.00
Received by Date
Balance Due $145.00
Thank you for your business!
VOUCHER NO. WARRANT NO.
Mid-State Truck Equipment y ALLOWED 20
IN SUM OF$
11020 Allisonville Road
Fishers, IN 46038
$145.00
f
ON ACCOUNT OF APPROPRIATION FOR
i
Community Relations
PO#/Dept. INVOICE NO. ACCT#lrITLE AMOUNT
Board Members
26826 I 84445 I 43-590.03 I $145.00 1 hereby certify that the attached invoice(s), or
bill(s) is (are)true and correct and that the
i
materials or services itemized thereon for
which charge is made were ordered and
received except
i
Monday,June 01,2015
I
Director, Co unity Relations/Economic Development
Title
i
Cost distribution ledger classification if j
claim paid motor vehicle highway fund f
I
I
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))
05/21/15 84445 $145.00
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
, 20
Clerk-Treasurer